ブックタイトルカテーテル関連尿路感染の予防のためのCDCガイドライン 2009｜株式会社メディコン

概要

カテーテル関連尿路感染の予防のためのCDCガイドライン 2009｜株式会社メディコン

IV. Recommendations for Further ResearchOur literature review revealed that many of the studies addressing strategies to prevent CAUTIwere not of sufficient quality to allow firm conclusions regarding the benefit of certaininterventions. Future studies of CAUTI prevention should:1) Be primary analytic research (i.e. systematic reviews, meta-analyses, interventionalstudies, and observational studies [cohort, case-control, analytic cross-sectionalstudies])2) Evaluate clinically relevant outcomes (e.g., SUTI, bloodstream infections secondaryto CAUTI)3) Adjust for confounders as needed using multivariable analyses4) Stratify outcomes by patient populations at risk for CAUTI5) Ensure adequate statistical power to detect differencesThe following is a compilation of recommendations for further research:1. Catheter materialsa. Antimicrobial and antiseptic-impregnated cathetersi. Effect of catheters on reducing the risk of SUTI and other clinically significantoutcomesii. Patient populations most likely to benefitiii. Incidence of antimicrobial resistance in urinary pathogensiv. Role of bacterial biofilms in the pathogenesis of CAUTIb. Standard cathetersi. Optimal materials for reducing the risk of CAUTI and other urethralcomplications2. Appropriate urinary catheter usea. Incontinent patientsi. Risks and benefits of periodic (e.g., nighttime) use of external cathetersii. Risk of local complications (e.g., skin maceration, phimosis) with the use ofexternal cathetersiii. Appropriate use of urinary catheters to manage sacral or perineal woundsb. Appropriate indications for continued use in postoperative patients and associatedrisks3. Antisepticsa. Use of antiseptic vs. sterile solutions for periurethral cleaning prior to catheterinsertionb. Use of antiseptics (e.g., methenamine) to prevent CAUTI4. Alternatives to indwelling urethral catheters and bag drainagea. Risks and benefits of suprapubic catheters as an alternative to chronic indwellingurethral cathetersb. Use of a urethral stent as an alternative to an indwelling catheter in selected patientswith bladder outlet obstructionc. Use of catheter valves in reducing the risk of CAUTI and other urinary complicationsd. Other alternative methods of urinary drainage< 原文 > IV. Recommendations for Further Research69