CATHETER-ASSOCIATED URINARY-TRACT INFECTIONS

Each year millions of urethral catheters are used, and the most common complication is bacteriuria. Although usually asymptomatic, this bact eriuria may be associated with fever, acute py elonephritis, bacteremi a, and death, and in long-term catheterized patients, catheter obstruc tion, urinary tract stones, local periurinary infections, chronic rena l inflammation, chronic pyelonephritis, and bladder cancer. Only two p rinciples are universally recommended: (1) keeping the closed catheter system closed and (2) removing the catheter as soon as possible. Alth ough in most cases controlled trials have not been performed, alternat ive techniques, including condom, intermittent, suprapubic, and intrau rethral catheterization, seem to be associated with lower incidences o f bacteriuria and its complications than urethral catheterization.