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A prospective study on the pathogenesis of catheter-associated bacteriuria in critically ill patients

Abstract : Background: Updating the pathogenesis of catheter-associated bacteriuria (CA-bacteriuria) in the intensive care unit (ICU) is needed to adapt prevention strategies. Our aim was to determine whether the main pathway of CAbacteriuria in ICU patients was endoluminal or exoluminal. In a prospective study, quantitative urine cultures were sampled from catheter sampling sites, collector bags and the catheter outer surface near the meatus from days 1 to 15 after catheterization. The endoluminal pathway was CA-bacteriuria (defined as 10 2 CFU/mL) first in collector bags and then in catheters. The exoluminal pathway was CA-bacteriuria first in catheters, on day 1 in early cases and after day 1 in late cases. Results: Of 64 included patients, 20 had CA-bacteriuria. Means of catheterization days and incidence density were 6.81 days and 55.2/1000 catheter-days. Of 26 microorganisms identified, 12 (46.2%) were Gram positive cocci, 8 (30.8%) Gram negative bacilli and 6 yeasts. Three (11.5%) CA-bacteriuria were endoluminal and 23 (88.5%) exoluminal, of which 10 (38.5%) were early and 13 (50%) late. Molecular comparison confirmed culture findings. A quality audit showed good compliance with guidelines. Conclusion: The exoluminal pathway of CA-bacteriuria in ICU patients predominated and surprisingly occurred early despite good implementation of guidelines. This finding should be considered in guidelines for prevention of CA-bacteriuria.
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Submitted on : Friday, July 30, 2021 - 3:50:48 PM
Last modification on : Sunday, June 26, 2022 - 3:11:42 AM
Long-term archiving on: : Sunday, October 31, 2021 - 6:22:06 PM


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Claire Aumeran, Benoit Mottet-Auselo, Christiane Forestier, Paul-Alain Nana, Claire Hennequin, et al.. A prospective study on the pathogenesis of catheter-associated bacteriuria in critically ill patients. BMC Microbiology, BioMed Central, 2021, 21 (1), pp.1-10. ⟨10.1186/s12866-021-02147-9⟩. ⟨inserm-03310661⟩



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