[Catheter-related nosocomial urinary infections in intensive care: physiopathology, epidemiology and prevention].
OBJECTIVE
Nosocomial urinary tract infections associated with bladders catheters are common and poorly understood. Data on the prevention of urinary tract infections are numerous and heterogenous. This update article aimed at analysing mechanisms, epidemiology and prevention of these infections.


METHODS
We searched in the Medline database for articles in English or French, without limiting date of publication, using the following key words separely or in combination: urinary tract infection, nosocomial, catheter, infection urinaire, sonde urinaire.


METHODS
We considered all categories of articles.


METHODS
Data on prevention of nosocomial urinary tract infections were analysed in depth.


RESULTS
The data on pathogenesis of nosocomial urinary tract infections are still controversial. Various means for preventing urinary tract infections have been recommended: addition of antibacterial agents to urinary drainage system, inclusion of antimicrobial components into the catheter itself, antibiotic prophylaxis or closed sterile drainage system. Their efficiency in intensive therapy unit has not yet been fully assessed. The therapy of these infections is still under debate and requires additional prospective studies to establish the optimal management.


CONCLUSIONS
Catheter-associated urinary tract infections reflect the general hygiene policy, starting with nurse practice patterns at catheter insertion, and ending with antibio-therapy prescriptions by medical staff.
Léone
M
M
Département d'anesthésie-réanimation, Hôpital Nord, chemin des Bourrellys, Marseille, France.
Arnaud
S
S
Boisson
C
C
Blanc-Bimar
M C
MC
Martin
C
C
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D020099:Coated Materials, Biocompatible; D003422:Critical Care; D003428:Cross Infection / Q000209:etiology* / Q000451:nursing / Q000503:physiopathology / Q000517:prevention & control; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000451:nursing; D014552:Urinary Tract Infections / Q000209:etiology* / Q000451:nursing / Q000503:physiopathology / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible