Hospital-acquired urinary tract infection.

Nosocomial urinary tract infections (UTIs) account for up to 40% of all hospital-acquired infections. The associated morbidity and mortality are a major drain on hospital resources. Patients with indwelling urinary catheters, patients undergoing urological manipulations, long-stay elderly male patients and patients with debilitating diseases are at high risk of developing nosocomial UTIs. The organisms responsible usually originate from patients' endogenous intestinal flora, but occasionally from a moist site in the hospital environment. Nosocomial pathogens causing UTIs tend to have a higher antibiotic resistance than simple UTIs. Infection control policies are important in limiting the number of hospital-acquired UTIs. Other important points include catheterisation using an aseptic technique and sterile equipment and the use of closed drainage systems. UTIs should be treated only after a urine sample has been sent and the advice of a microbiologist sought. In the future catheters impregnated with antibiotics, and the use of newer materials, may lead to further reductions in the incidence of nosocomial UTIs.