LOW-RISK OF BACTEREMIA DURING CATHETER REPLACEMENT IN PATIENTS WITH LONG-TERM URINARY CATHETERS

Background: Geriatric patients with long-term urinary catheters have a n increased morbidity and mortality. It is conceivable that catheter r eplacement causes bacteremia and contributes to this morbidity and mor tality. The purpose of our study was to determine the incidence and cl inical relevance of bacteremia induced by urinary catheter replacement s. Methods: We analyzed clinical signs and symptoms and laboratory mea sures (leukocyte count, C-reactive protein, urine sediment, urine cult ure) during 120 routine catheter replacements in geriatric patients. I n addition, blood cultures were drawn before and at 5, 15, and 30 minu tes after catheter replacement. Results: The urine cultures showed gro wth of 1 to 5 different microorganisms before replacement. Of 480 bloo d cultures, 27 (5.6%) were positive. However, the same species grew fr om blood and urine in only 5 catheter replacements. None of the patien ts met criteria for systemic inflammatory response syndrome. There wer e no significant differences in clinical and laboratory findings betwe en patients with and without bacteremia. Coagulase-negative staphyloco cci grew in 12 blood cultures. Their distribution over time suggested that they mainly represented catheter replacement-related bacteremia r ather than contaminants. Consequently, 64 intraurethral catheter segme nts were additionally cultured. Coagulase-negative staphylococci grew in 10 catheter cultures, but in only 2 simultaneously cultured urine s amples. Conclusion: Bacteremia induced by routine replacement of long- term urinary catheters occurred in 4.2% (5/120) of replacements in ger iatric patients. Such bacteremia did not have a detectable clinical re levance in our study.