Parida Satyen, Mishra Sandeep Kumar
Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
Indian J Crit Care Med. 2013 Nov;17(6):370-4. doi: 10.4103/0972-5229.123451.
The use of indwelling catheters in the Critical Care Units (CCUs) has a major role in determining the incidence and the morbidity as well as mortality from hospital-acquired urinary tract infections (UTIs). Instituting evidence-based protocols can significantly reduce both the prevalence of indwelling catheterization as well as the incidence of hospital-acquired UTIs. The prevalence of catheter-associated urinary tract infections (CAUTIs) in the CCUs is directly linked to the widespread use of indwelling catheters in these settings. CAUTIs result in significant cost escalation for individual hospitals as well as the healthcare system as a whole. A UTI is an inflammatory response to colonization of the urinary tract, most commonly by bacteria or fungi. A UTI should be differentiated from the mere detection of bacteria in the urinary tract. This condition, referred to as asymptomatic bacteriuria, is common and does not require treatment, especially in the patient with an indwelling urinary catheter. A CAUTI occurs when a patient with an indwelling urinary catheter develops 2 or more signs or symptoms of a UTI such as hematuria, fever, suprapubic or flank pain, change in urine character, and altered mental status. CAUTI is classified as a complicated UTI. The current review highlights the important management issues in critical care patients having CAUTI. We performed a MEDLINE search using combinations of keywords such as urinary tract infection, critical care unit and indwelling urinary catheter. We reviewed the relevant publications with regard to CAUTI in patients in CCU.
在重症监护病房（CCU）使用留置导管在决定医院获得性尿路感染（UTI）的发病率、发病率以及死亡率方面起着重要作用。制定循证方案可显著降低留置导尿的发生率以及医院获得性UTI的发病率。CCU中导管相关尿路感染（CAUTI）的发生率与这些环境中留置导管的广泛使用直接相关。CAUTI会导致个别医院以及整个医疗系统的成本大幅上升。UTI是对尿路定植的炎症反应，最常见的是由细菌或真菌引起。UTI应与仅在尿路中检测到细菌相区分。这种情况称为无症状菌尿，很常见，不需要治疗，尤其是对于留置导尿管的患者。当留置导尿管的患者出现2种或更多种UTI症状或体征时，如血尿、发热、耻骨上或侧腹疼痛、尿液性状改变和精神状态改变，就会发生CAUTI。CAUTI被归类为复杂性UTI。本综述强调了患有CAUTI的重症监护患者的重要管理问题。我们使用“尿路感染”、“重症监护病房”和“留置导尿管”等关键词组合进行了MEDLINE搜索。我们回顾了CCU患者中与CAUTI相关的出版物。
