CATHETER-ASSOCIATED BACTERIURIA IN LONG-TERM-CARE FACILITIES

Catheter-associated bacteriuria is the most common infection acquired in long-term care facilities. Complications include fever, acute pyelo nephritis, bacteremia, catheter obstruction, urinary stones, chronic i nterstitial nephritis, renal failure, and death. The closed-catheter s ystem has been the only innovation in this traditional method of care that has led to prevention of bacteriuria. Antimicrobial agents rarely are indicated to prevent or treat bacteriuria in long-term catheteriz ed patients, except for those with symptomatic infection. Alternative devices are available and often may be preferable to the indwelling ur ethral catheter. These patients and their reservoirs of bacteriuric or ganisms are sources of nosocomial outbreaks. Such outbreaks can be pre vented and controlled with attention to catheter hygiene, prevention o f patient-to-patient transmission on the hands of caregivers, and poss ibly use of antimicrobials to diminish bacterial concentrations in the urine