title: Preventing infection in elders with long-term indwelling urinary catheters.
abstract: OBJECTIVE
  To explore selected factors related to the prevention of catheter-associated urinary tract infections (UTIs) in older adults.
  
  
  METHODS
  This review of the literature examined multiple studies regarding UTIs, and UTIs in relation to silver-tipped catheters, cranberry juice/extract, and the bacterial lysate Escherichia coli OM-89.
  
  
  CONCLUSIONS
  Silver-tipped catheters retarded the development of the biofilm. The use of cranberry juice/extract showed few if any adverse reactions and avoided the problems of induced antibiotic resistance or introduction to supra-infections, such as Clostridium difficile infection. The immune stimulant OM-89 shows promise and may lead to simple and inexpensive preventive measures. Further research is needed to include elders, both men and women, and elders with long-term indwelling catheters.
  
  
  CONCLUSIONS
  Nurse practitioners (NPs) can assure that basic nursing principles regarding long-term indwelling catheter care are upheld, measures such as proper assessment and insertion, as well as the appropriate use of silver-tipped catheters. NPs can prescribe cranberry juice/extract and incur no apparent harm while possibly reducing infection rate. NPs must be aware of the dangers of administering prophylactic antibiotics that increase resistant microorganisms and can also increase susceptibility to C. difficile infection.
authors.affiliation: University of California, San Francisco, California, USA. GNP2BE@yahoo.com
authors.forename: Linda
authors.initials: L
authors.lastname: Muzzi-Bjornson
authors.forename: Liz
authors.initials: L
authors.lastname: Macera
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000627:therapeutic use; D001424:Bacterial Infections / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D018441:Biofilms; D055499:Catheter-Related Infections / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D016360:Clostridioides difficile / Q000187:drug effects; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D005260:Female; D005853:Geriatrics; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D009722:Nurse Practitioners; D018570:Risk Assessment; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D029799:Vaccinium macrocarpon
chemical_list: D000276:Adjuvants, Immunologic; D000942:Antigens, Bacterial; C050501:OM 89