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

Evidence Review Table 2B. What are the risks and benefits associated with differentcatheters or collecting systems?2B.1.a. If the CAUTI rate is not decreasing after implementing a comprehensive strategy toreduce rates of CAUTI, consider using antimicrobial/antiseptic-impregnatedcatheters. The comprehensive strategy should include, at a minimum, the highpriority recommendations for urinary catheter use, aseptic insertion, andmaintenance (see Section III. Implementation and Audit). (Category IB)2B.1.b.2B.2.2B.3.2B.4.2B.5.2B.6.Further research is needed on the effect of antimicrobial/antiseptic-impregnatedcatheters in reducing the risk of symptomatic UTI, their inclusion among the primaryinterventions, and the patient populations most likely to benefit from these catheters.(No recommendation/unresolved issue)Hydrophilic catheters might be preferable to standard catheters for patients requiringintermittent catheterization. (Category II)Following aseptic insertion of the urinary catheter, maintain a closed drainagesystem. (Category IB)Complex urinary drainage systems (utilizing mechanisms for reducing bacterial entrysuch as antiseptic-release cartridges in the drain port) are not necessary for routineuse. (Category II)Urinary catheter systems with preconnected, sealed catheter-tubing junctions aresuggested for use. (Category II)Further research is needed to clarify the benefit of catheter valves in reducing the riskof CAUTI and other urinary complications. (No recommendation/unresolved issue)原文Q2C. What are the risks and benefits associated with different catheter managementtechniques?The available data examined the following catheter management techniques:1. Antimicrobial prophylaxis2. Urinary antiseptics (i.e., methanamine)3. Bladder irrigation4. Antiseptic instillation in the drainage bag5. Periurethral care6. Routine catheter or bag change7. Catheter lubricants8. Securing devices9. Bacterial interference10. Catheter cleansing11. Catheter removal strategies (clamping vs. free drainage prior to removal, postoperativeduration of catheterization)12. Assessment of urine volumes90 < 原文 > VIII. Evidence Review