[Nocosomial urinary tract infections].

Nosocomial urinary tract infections (UTI) are mainly related to urinary catheterisation. In this paper we review the pathogenic mechanisms, particularly the route by which the microorganisms colonise the urinary tract, their adhesion ability, and their capacity to form biofilms, and are related not only to the microorganism but also to the type of urinary catheter. The aetiology of catheter related UTI is variable, and multiresistant microorganisms are often isolated, making empirical antibiotic therapy complex. Clinical findings are frequently atypical, and its diagnosis is difficult. The therapeutic management of catheter-related UTI should be stratified according to the type of UTI: asymptomatic bacteriuria should not be habitually treated, but patients with septic shock should receive a broad spectrum antibiotic. In this review, the value of the different preventive measures are discussed.