New, contextualized modern solutions must be found to solve the dilemma of catheter-associated urinary infection (CAUTI) in long-term care settings. In this paper, we describe the etiology, risk factors, and complications of CAUTI, explore different preventive strategies proposed in literature from the past to the present, and offer new insights on therapeutic opportunities. A care bundle to prevent CAUTI mainly consists of multiple interventions to improve clinical indications, identifying a timeline for catheter removal, or whether any alternatives may be offered in elderly and frail patients suffering from chronic urinary retention and/or untreatable urinary incontinence. Among the various approaches used to prevent CAUTI, specific urinary catheter coatings according to their antifouling and/or biocidal properties have been widely investigated. Nonetheless, an ideal catheter offering holistic antimicrobial effectiveness is still far from being available. After pioneering research in favor of bladder irrigations or endovesical instillations was initially published more than 50 years ago, only recently has it been made clear that evidence supporting their use to treat symptomatic CAUTI and prevent complications is needed.
Journal of clinical medicine. 2022 Jun 14*** epublish ***
Stefania Musco, Alessandro Giammò, Francesco Savoca, Luca Gemma, Paolo Geretto, Marco Soligo, Emilio Sacco, Giulio Del Popolo, Vincenzo Li Marzi
Unit of Neuro-Urology, Azienda Ospedaliera Careggi, 50134 Florence, Italy., Unit of Neuro-Urology, Orthopaedic Trauma Center (CTO)-Spinal Unit Hospital, Città Della Salute e Della Scienza, 10126 Turin, Italy., Unit of Urology, Cannizzaro Hospital, 95122 Catania, Italy., Unit of Urological Robotic Surgery and Renal Transplantation, Azienda Ospedaliera Careggi, 50134 Florence, Italy., Unit of Obstetrics and Gynecology, Ospedale Maggiore di Lodi, 26900 Lodi, Italy., Unit of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.