Departments of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Crit Care Med. 2010 Aug;38(8 Suppl):S373-9. doi: 10.1097/CCM.0b013e3181e6ce8f.
Urinary tract infection is the most common healthcare-associated infection in the intensive care unit and predominantly occurs in patients with indwelling urinary catheters. The predominant microorganisms causing catheter-associated urinary tract infection (CAUTI) in the intensive care unit are enteric Gram-negative bacilli, enterococci, Candida species, and Pseudomonas aeruginosa. Multidrug resistance is a significant problem in urinary pathogens. Duration of catheterization is the most important risk factor for development of CAUTI. Diagnosis, particularly in the intensive care unit setting, is very difficult, as asymptomatic bacteriuria may be difficult to differentiate from symptomatic CAUTI. In general, asymptomatic bacteriuria should not be treated, and treatment of CAUTI often requires removal of the catheter along with systemic antimicrobial therapy. General strategies for prevention of CAUTI apply to all healthcare-associated infections and include measures such as adherence to hand hygiene. Targeted strategies for prevention of CAUTI include limiting the use and duration of urinary catheterization, using aseptic technique for catheter insertion, and adhering to proper catheter care.
尿路感染是重症监护病房（ICU）中最常见的与医疗保健相关的感染，主要发生在留置导尿管的患者中。引起 ICU 导管相关性尿路感染（CAUTI）的主要微生物是肠革兰氏阴性杆菌、肠球菌、念珠菌和铜绿假单胞菌。多药耐药是尿路感染病原体的一个重大问题。导尿管留置时间是 CAUTI 发展的最重要危险因素。诊断，特别是在 ICU 环境中，非常困难，因为无症状菌尿可能难以与有症状的 CAUTI 区分。一般来说，无症状菌尿不应治疗，CAUTI 的治疗通常需要同时去除导管和全身抗菌治疗。预防 CAUTI 的一般策略适用于所有与医疗保健相关的感染，包括遵守手卫生等措施。预防 CAUTI 的针对性策略包括限制导尿管的使用和留置时间、使用无菌技术插入导尿管以及遵守正确的导管护理。
