Urinary catheter exchange prior to sample collection 2024 update

Mitchell MD, Holland S, O'Donnell JA, Pegues DA, Mull NK
Record ID 32018013718
English
Authors' objectives: Identify and evaluate outcomes associated with alternative approaches to collecting urine samples from patients with indwelling urinary catheters suspected of having catheter-associated UTIs.
Authors' results and conclusions: EVIDENCE SUMMARY ▪ There is strong evidence that urine samples taken from indwelling urinary catheters (IUC) that have been in place for an extended period of time will contain more bacteria and more bacterial species than samples taken from an IUC that has just been replaced. ▪ Replacing the IUC before collecting a specimen for urine culture results in fewer diagnoses of urinary tract infection. The grade of this evidence is low, but it logically follows from the data on bacterial concentration. The effect of catheter replacement before specimen collection on adverse events was not reported. ▪ Published clinical guidelines from the Infectious Diseases Society of America recommend replacing the IUC before collecting a specimen for culture, as a therapeutic measure as well as to make a more specific diagnosis of the causative bacterial species. These guidelines are widely endorsed but are based on very old evidence. An update to the guideline suggests considering replacing the IUC if it has been in place more than seven days. The PennPathway for managing patients with suspected urinary tract infection is in agreement with the latter suggestion. ▪ Most guidelines also recommend replacing the IUC before initiating antimicrobial therapy if it has not already been replaced for collection of a urine specimen. ▪ Clinical trials measuring the effect of replacing IUCs before urine specimen collection on patient outcomes such as mortality, sepsis, and length of hospital stay are lacking.
Details
Project Status: Completed
Year Published: 2024
URL for published report: https://www.med.upenn.edu/CEP/external-request-form.html
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: United States
MeSH Terms
  • Urinary Tract Infections
  • Bacteriuria
  • Catheter-Related Infections
  • Urine Specimen Collection
  • Urinary Catheterization
  • Urinary Catheters
Keywords
  • Foley
  • CAUTI
  • urine culture
  • urinalysis
  • IUC
  • bacteriuruia
Contact
Organisation Name: Penn Medicine Center for Evidence-based Practice
Contact Address: Penn Medicine Center for Evidence-based Practice, University of Pennsylvania Health System, 3600 Civic Center Blvd, 3rd Floor West, Philadelphia PA 19104
Contact Name: Nikhil Mull
Contact Email: cep@pennmedicine.upenn.edu
Copyright: <p>Center for Evidence-based Practice (CEP)</p>
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