Ouslander J G, Greengold B, Chen S
Veterans Administration Medical Center, Sepulveda, California.
J Am Geriatr Soc. 1987 Dec;35(12):1063-70. doi: 10.1111/j.1532-5415.1987.tb04922.x.
In order to examine the relative frequency of urinary tract infection (UTI) and bacteriuria among male nursing home patients managed with and without external catheters (EC), we prospectively followed four cohorts of patients (EC worn continuously, N = 30; EC worn at night only, N = 19; incontinent without catheter, N = 13; and continent, N = 30) for a total of 497 patient months at risk. The proportion of patients with EC worn continuously who had at least one episode of bacteriuria (87%) and at least one UTI (40%), and the incidence of UTI (0.08 episodes per patient-month at risk) was significantly higher than among continent or incontinent patients without EC. Patients with EC at night only had an intermediate frequency of these findings. Differences in clinical and functional status characteristics among the four cohorts, in addition to the use of EC, could have contributed to the higher frequencies of bacteriuria and UTI. None of the clinical characteristics we examined were associated with the development of UTI among patients with EC. Further studies are necessary to identify factors associated with UTI among patients who are managed by EC so that effective preventive strategies can be developed and targeted to patients at high risk.
为了研究在使用和不使用外置导尿管（EC）管理的男性疗养院患者中尿路感染（UTI）和菌尿的相对频率，我们前瞻性地跟踪了四组患者（持续佩戴EC，N = 30；仅在夜间佩戴EC，N = 19；无导尿管的失禁患者，N = 13；以及尿失禁患者，N = 30），总共497个患者月的风险期。持续佩戴EC的患者中至少有一次菌尿发作的比例（87%）和至少有一次UTI的比例（40%），以及UTI的发生率（每患者月风险期0.08次发作）显著高于无EC的尿失禁或非尿失禁患者。仅在夜间使用EC的患者这些发现的频率处于中间水平。除了使用EC之外，四组患者在临床和功能状态特征方面的差异可能导致了菌尿和UTI的较高频率。我们检查的临床特征均与使用EC的患者中UTI的发生无关。有必要进行进一步研究以确定与使用EC管理的患者中UTI相关的因素，以便制定有效的预防策略并针对高危患者。
