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Catheter Infection

Catheter Infection Introduction

Catheter infections, or “CAUTIs” (Catheter Associated Urinary Tract Infections), as they are known within the industry, have until recently been at an all time high, being assessed as the number one cause of infection in an acute care setting.

There are a number of reasons why patients become infected from the use of catheters and to understand why the Duette™ urinary drainage system works so effectively, you really need to understand exactly how and why the bladder becomes infected through the use of traditional Foley catheters, also known as indwelling catheters.

When we talk about catheter infections, the type of catheter we are actually referring to is an indwelling catheter, also known as the Foley. Another type of catheter, the condom catheter, is not associated with high rates of infection because it remains external to the body. To a lesser extent, intermittent catheters also cause infection, but not on the scale seen with an indwelling catheter. This is because the chances of catheter infection are directly linked to the amount of time the device stays in the body. The longer the patient stays catheterized, the higher the risk. Intermittent catheters are only designed to be used once and then removed, unlike indwelling catheters that remain inside the bladder.

There are two routes to the bladder when using an indwelling catheter. The catheter can be inserted through the urethra or the catheter is inserted through a suprapubic entrance, which is where an incision is made just above the pubic bone and the tube is inserted directly into the bladder. Both are invasive in nature and both open up the body to infection.

How does the bladder become infected?

It is important to understand that urine is the perfect breeding ground for bacteria. The body's main line of defence against bacteria contaminating the bladder is through urination. Any bacteria gaining access to the bladder will usually be removed when a person urinates and by urinating, approximately 90% of bacteria are removed from the bladder. The problem with catheterization is that the process of urination simply cannot happen naturally. Therefore, urine sits in the bladder making it ideal for any foreign bacteria to thrive and grow.

It is also a well known fact that the longer a catheter stays in the bladder, the higher the risk of contracting a UTI (urinary tract infection). In fact, in the first week of catheterization, the chances of contracting a UTI rises 5% each day the indwelling catheter remains in place. Unfortunately, the chances of contracting a UTI becomes inevitable for people who require long term use of an indwelling catheter.

The reason UTIs happen is two fold. The longer the catheter remains in place, the more time bacteria has to make its way through the catheter and into the bladder. Once it is there, the bladder is unable to remove urine in the natural form of urination and therefore allowing bacteria to be able to multiply in vast quantities very quickly.

There are several ways for bacteria to pass into the bladder. It can happen during the insertion of the catheter, the removal of the catheter, from the skin around the point of insertion of the catheter, or when changing the urine collection bag. Bacteria can also find its way into the bladder and create infections when health care professionals fail to take proper hygiene precautions and then come into contact with the area where the indwelling catheter enters into the body. It is extremely important for health care professionals and anyone else assisting with patient catheterization to wash their hands and use sterile supplies.

Not only does the Foley catheter prevent the body from being able to remove potentially harmful bacteria or “bacteriuria” through urination, but it also can be very damaging to the bladder wall. It can be particularly damaging to the body's ability to fight infection, as the bladder wall is coated with a mucinous layer known as “glycosaminoglycan” (GAG), that prevents foreign bacterium from attaching itself to the mucosal cells in the bladder. As studies have shown, the Foley trauma causing design has a tendency to erode the mucosal lining and cause suction aspiration damage to the bladder wall. The bladder wall is literally sucked into the drainage eye and in some cases, the catheter will even penetrate the bladder wall itself. This all serves to reduce the body's ability to protect itself.

What are the symptoms of a catheter infection?

Common symptoms of catheter infections or “CAUTIs” are:

A burning sensation during urination

Fever type symptoms

Pain or burning sensation below the stomach

Nausea and vomiting

Passing blood or cloudy urine

No symptoms at all, this is the most dangerous as the infection can continue to remain untreated in the early stages.

The Dangers of CAUTI

If left untreated, CAUTI cannot only be a very painful and traumatic experience, but also deadly. The CDC (Center of Disease Control) estimates that 13,000 deaths each year are attributed to catheter infection. The danger lies when micro-organisms are successful in colonising the bladder, which pathes a way for bacteria to spread throughout to other areas of the urinary system such as the kidneys and the prostate. If this happens, much lengthier treatments are required, which greatly increases costs and hospital confinement times. In worst case scenarios, acute infection can lead to the loss of one's life.

Treatments

If a catheter infection has been identified, the most widely used methods for treatment are the use of antibiotics. The use of antibiotics and the types will be decided based upon the symptoms observed and the severity of the infection.

Changing the existing catheter can help stop infections from spreading and if a person is able to remove the catheter altogether, then that is the best case scenario. However, sometimes the best case scenario of removing the catheter permanently just isn't an option.

What has been done to prevent catheter infections?

From the standpoint of the hospitals and medical staff, more attention to hygiene procedures and best practices have been implemented over the last few years. Most of the emphasis has been on either using alternatives to catheterization or reducing the amount of time an indwelling catheter remains in the body. If a patient needs to be catheterized with an intermittent catheter, then close monitoring systems have been utilized by many hospitals in an effort to prevent the onset of CAUTI.

Medical technology development has been somewhat lacking in solving the short comings of the Foley design to reduce trauma and infection rates. Attempts have been made over the years such as using different materials and anti-bacterial coatings, but essentially the underlying problems still exist.

The Duette™ urinary drainage system is the first real leap forward in design for dealing with the shortcomings of the Foley catheter, which has essentially remained the same since its introduction 75 years ago.

The Duette™ aims to work in tandem with the bladder's own natural defences, using our unique dual balloon technology that helps prevent damage to the bladder wall. This dual balloon technology is also proving to be instrumental in the fight against UTIs.

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