[Catheter-related nosocomial urinary infections in intensive care: physiopathology, epidemiology and prevention].

OBJECTIVES

Nosocomial urinary tract infections associated with bladders catheters are common and poorly understood. Data on the prevention of urinary tract infections are numerous and heterogenous. This update article aimed at analysing mechanisms, epidemiology and prevention of these infections.

DATA SOURCES: We searched in the Medline database for articles in English or French, without limiting date of publication, using the following key words separely or in combination: urinary tract infection, nosocomial, catheter, infection urinaire, sonde urinaire.

STUDY SELECTION: We considered all categories of articles.

DATA EXTRACTION: Data on prevention of nosocomial urinary tract infections were analysed in depth.

DATA SYNTHESIS: The data on pathogenesis of nosocomial urinary tract infections are still controversial. Various means for preventing urinary tract infections have been recommended: addition of antibacterial agents to urinary drainage system, inclusion of antimicrobial components into the catheter itself, antibiotic prophylaxis or closed sterile drainage system. Their efficiency in intensive therapy unit has not yet been fully assessed. The therapy of these infections is still under debate and requires additional prospective studies to establish the optimal management.

CONCLUSION

Catheter-associated urinary tract infections reflect the general hygiene policy, starting with nurse practice patterns at catheter insertion, and ending with antibio-therapy prescriptions by medical staff.