Bladder Infection Causes | Catheter
Bladder Infection Caused by Catheter
Bladder infection(s) have a great deal to do with urine. It is hard to believe but urine is generally sterile (or free from microorganisms or germs); as long as it is stored inside the urinary bladder or ureter.
It is also important to keep in mind that pubic region (or skin as a whole) is contaminated with microorganisms that may/ may not cause bladder infection or disease under normal circumstances.
Yet, if these microorganisms gain access to the urinary bladder (Bladder Pains and Irritants); the risk of cystitis a.k.a bladder infection and UTI (urinary tract infection) increases several folds. Intact urinary catheter is among the leading causes of UTI in hospitalized patients. According to the latest statistics, the risk of developing bladder infection is directly associated with the duration of catheter placement. For example, approximately 26% patients develop UTI if the catheter is in place for about 2 to 10 days.
What are the Indications of Bladder Infection | Catheter?
Urinary catheter is a long tube that is used in clinical practice to drain the urine from the bladder. The narrow part of the tube is inserted via urethra into the muscular bladder, while the broader part of tube is usually connected to a bag or bottle for urine collection.
Some Common Therapeutic Indications of Urinary Catheter or Bladder Infection are
- Monitoring of urinary output in critical patients (such as in the setting of circulatory collapse or massive cardiac arrest) (Sex After Heart Attack? Are you Ready for this?) and burn victims.
- In bed-ridden patients or in individuals after major surgeries (abdominal, limb or pelvic procedures), major trauma to spine or other vital organs, patients of severe mental or psychiatric illnesses.
- History of bladder infection or urinary leakage and/or incontinence (especially in old age or after childbirth).
- In certain diagnostic procedures (Bladder Procedures | Bladder Surgeries) especially those that involve the disorders of kidney and urinary tract.
What are the Risk Factors That Increase Developing Bladder Infection or Catheter Induced UTI?
Long standing and poorly controlled diabetes (Excessive Sugar Consumption Effects) can increase the risk of catheter induced bladder infection or UTI, cystitis and proteinuria several fold. According to a recent report published in World Journal of Urology, the prevalence of UTI in diabetic population is 25.3%.
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Other Significant Risk Factors of Bladder Infection
- Obesity (or body mass index of 30 kg/m2 or higher).
- Insulin therapy.
- Uncontrolled hypertension.
- Female gender (due to smaller length of urethra) (Urethral Syndrome).
- Poor hygiene (or when catheterization is performed under septic condition).
- Lack of antibiotic support.
The signs and symptoms of a bladder infection or a catheter induced urinary infection are generally
vague mainly because the classical features of UTI such as urinary urgency and frequency are masked by the catheter. Following symptoms may arouse a suspicion.
- High grade fever with rigors and chills.
- Lower abdominal or pelvic pain (mostly dull and aching).
- Cloudiness of urine (in the bag/ bottle).
How Can You Minimize and Manage the Risk of a Bladder Infection | Catheter Induced Urinary Tract Infection?
Latest data indicates that most patients who develop catheter induced bladder infection are the ones who have prolonged catheter placement. For example, a report in BMC Urology suggested that about 14-38% of all the catheterized patients lack specific medical indication for catheter placement.
The Risk of Bladder Infection | Catheter Infection can be Minimized
- Maintain optimal personal hygiene (sponge baths, frequent hand-washing, use of gloves while changing the bag or adjusting catheter etc).
- Avoid twisting, kinking, pulling or twigging the catheter.
- Speak to your healthcare provider to remove the catheter if it is causing any discomfort or burning/ pain.
- Often times, healthcare providers introduce prophylactic antibiotics to reduce the risk of infection.
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Untreated or poorly managed bladder infection may involve other structures of urinary system (pyelonephritis or infection of kidneys), blood (septicemia or septic shock when bacterial agents infiltrate the blood stream), mental changes or confusion due to rising uric acid levels and other complications.
According to the results of a research study published in Archives of Physical Medicine and Rehabilitation, investigators suggested that the ideal course of action in the setting of catheter induced infection are either.
- Administration of antibiotics for a period of 5 days after changing the catheter.
- Administration of 10- day antibiotic regimen without changing the catheter.
About 82% to 89% patients respond to this therapy; however, depending upon the co-morbid medical/ health issues (such as hypertension, diabetes or renal dysfunction), other interventions can also be employed.
- Gould CU CA, Agarwal R, Kuntz G, Pegues D, (HICPAC) at HICPAC: Guideline for prevention of catheter-associated urinary tract infections 2009. Centres for disease control and prevention; 2009.
- Al-Rubeaan, K. A., Moharram, O., Al-Naqeb, D., Hassan, A., & Rafiullah, M. R. M. (2013). Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes. World journal of urology, 31(3), 573-578.
- Jansen, I. A., Hopmans, T. E., Wille, J. C., van den Broek, P. J., van der Kooi, T. I., & van Benthem, B. H. (2012). Appropriate use of indwelling urethra catheters in hospitalized patients: results of a multichannel prevalence study. BMC urology, 12(1), 25.
- Darouiche, R. O., Al Mohajer, M., Siddiq, D. M., & Minard, C. G. (2013). Short Versus Long Course of Antibiotics for Catheter-Associated Urinary Tract Infections in Patients With Spinal Cord Injury: A Randomized Controlled Noninferiority Trial. Archives of physical medicine and rehabilitation.