Urinary Catheterization

Chapter 138 Urinary Catheterization







COMPLICATIONS



Infectious


Catheter-associated UTIs have been reported in the veterinary literature and the incidence may exceed 50%. These infections have played a role in nosocomial outbreaks in veterinary intensive care units (ICUs) and have the potential to cause serious morbidity and mortality. Resistant bacteria such as Klebsiella, Acinetobacter, Enterobacter, Citrobacter, Serratia, Pseudomonas spp, and Escherichia coli may cause catheter-associated UTIs in veterinary ICUs and may serve as a source within the ICU for other nosocomial infections.4-9


Catheter-associated UTIs are thought to occur as a result of introducing bacteria into the bladder during catheter insertion. In one study, there was a 20% incidence of UTIs following a one-time catheterization in female dogs.10 Once indwelling, the catheter provides a surface on which bacteria may migrate. This often involves a biofilm, a matrix of microorganisms and their produced glycocalyces, host salts, and proteins. Biofilms allow for the adherence of bacteria to catheter surfaces and provide protection from the host’s defenses. Not surprisingly, duration of catheterization and absence of a closed collection system has been positively correlated with catheter-associated UTIs.6


Prophylactic or concurrent administration of antibiotics may offer short-term protection against a UTI, but organisms that are resistant to the antibiotics often emerge. Therefore routine prophylactic antibiotics are not recommended; however, they could be considered in compromised patients with anticipated short-term urinary catheter use.4 Despite the morbidity and even mortality associated with urinary catheters, appropriate patient selection coupled with placement and maintenance protocols as described below resulted in a 10% incidence of nonresistant catheter-associated UTIs in a veterinary ICU. Most of these patients had urinary catheters placed for monitoring urine output and left in place for less than 4 days.4



Sep 10, 2016 | Posted by in SMALL ANIMAL | Comments Off on Urinary Catheterization
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