The role of biofilms and catheter associated urinary tract infections during endourological interventions
Dept of Urology, Jahn-Ferenc Hospital, Koves u. 1, Budapest 1204, Hungary
As part of the endourological development, a great variety of foreign bodies have been designed, and with the increasing number of biomaterial devices used in urology, biofilm formation is an issue of growing importance. Using a foreign body always increases the risk of infectious complications. Approximately 40% of nosocomial infections originate in the urinary tract, and most patients with nosocomial urinary tract infections (UTIs) have permanent urethral catheterisation or other urinary foreign bodies. Catheter associated urinary tract infections (CAUTI) are reservoirs for antibiotic resistance and contribute to morbidity in hospitals and long term care facilities. When UTI occurs in a catheterized patient it always requires special attention and knowledge. In case of CAUTIs there are different causative pathogens with different sensitivities due to the biofilm formation from what we see in the urinary tract without foreign body. The presence of a CAUTI needs special evaluation of the diagnostic results (e.g. urine cultures), and the choice of antibiotic, also the length of the therapy can differ from the convectional ones. The correct diagnosis and treatment of CAUTIs is of utmost importance for everybody dealing with urinary catheters.
The presentation summarizes the available methods for preventing biofilm formation on urinary foreign bodies and covers the evidence based management recommendations about the diagnosis and treatment of CAUTIs.