Musco Stefania, Giammò Alessandro, Savoca Francesco, Gemma Luca, Geretto Paolo, Soligo Marco, Sacco Emilio, Del Popolo Giulio, Li Marzi Vincenzo
Unit of Neuro-Urology, Azienda Ospedaliera Careggi, 50134 Florence, Italy.
Unit of Neuro-Urology, Orthopaedic Trauma Center (CTO)-Spinal Unit Hospital, Città Della Salute e Della Scienza, 10126 Turin, Italy.
J Clin Med. 2022 Jun 14;11(12):3415. doi: 10.3390/jcm11123415.
New, contextualized modern solutions must be found to solve the dilemma of catheter-associated urinary infection (CAUTI) in long-term care settings. In this paper, we describe the etiology, risk factors, and complications of CAUTI, explore different preventive strategies proposed in literature from the past to the present, and offer new insights on therapeutic opportunities. A care bundle to prevent CAUTI mainly consists of multiple interventions to improve clinical indications, identifying a timeline for catheter removal, or whether any alternatives may be offered in elderly and frail patients suffering from chronic urinary retention and/or untreatable urinary incontinence. Among the various approaches used to prevent CAUTI, specific urinary catheter coatings according to their antifouling and/or biocidal properties have been widely investigated. Nonetheless, an ideal catheter offering holistic antimicrobial effectiveness is still far from being available. After pioneering research in favor of bladder irrigations or endovesical instillations was initially published more than 50 years ago, only recently has it been made clear that evidence supporting their use to treat symptomatic CAUTI and prevent complications is needed.
必须找到全新的、因地制宜的现代解决方案，以解决长期护理环境中与导尿管相关的尿路感染（CAUTI）难题。在本文中，我们描述了CAUTI的病因、危险因素及并发症，探讨了过去到现在文献中提出的不同预防策略，并提供了关于治疗机会的新见解。预防CAUTI的护理包主要包括多项干预措施，以改善临床指征、确定拔除导尿管的时间线，或者对于患有慢性尿潴留和/或无法治疗的尿失禁的老年体弱患者是否可以提供任何替代方案。在用于预防CAUTI的各种方法中，根据其防污和/或杀菌特性的特定导尿管涂层已得到广泛研究。尽管如此，提供整体抗菌效果的理想导尿管仍远未问世。在50多年前首次发表支持膀胱冲洗或膀胱内灌注的开创性研究之后，直到最近才明确需要有证据支持其用于治疗有症状的CAUTI和预防并发症。
