RESUMO
Permanent drainage of the urinary tract by catheters or tubes causes bacteriuria. The potential harmful effects of the indwelling catheter's bacteriuria are related to: time since the insertion of the catheter; location of the catheter (urethra, bladder, kidney); catheter composition (latex, silicone, etc.); type of ineffective bacteria and specific pathogenic mechanisms; health status of the urinary tract being drained (prior radiation therapy, tumors, etc.); patient's health status (diabetes, immunodeficiency) and mobility; incidents and manipulations of the catheter, such as obstruction, irrigation, or retrieval. The evaluation of all mentioned factors enables strategies for prevention of septic episodes in relation with indwelling catheters, strategies that can be individualized for greater efficiency. Despite these preventive measures, infections secondary to the indwelling catheter may cause extremely severe septic episodes. Today, the indwelling catheter bacteriuria constitutes the greater source of nosocomial infection and its prevention and treatment a health care action of the highest importance. The study of mechanisms implied in the formation of biofilms, their pathogenic potential and preventive measures have been an attractive field of clinical and experimental research over the last years. The objective of this review is to make a synthesis of the works performed by our group.
Assuntos
Cateterismo Urinário/efeitos adversos , Infecções Urinárias/etiologia , Biofilmes , Pesquisa Biomédica , Humanos , Infecções Urinárias/microbiologia , Infecções Urinárias/prevenção & controle , Infecções Urinárias/terapiaRESUMO
El drenaje permanente, externo, del aparato urinario, mediante sondas y tubos, causa bacteriuria. Los potenciales efectos nocivos de la bacteriuria de la sonda permanente están relacionados con; tiempo de permanencia de la sonda; localización del catéter o sonda (uretra, vejiga, riñón); material que compone el catéter (látex, silicona, etc.); tipo de bacteria infectante y sus mecanismos patogénicos específicos; estado de salud del aparato urinario drenado (radiaciones previas, tumores, etc.); estado de salud del paciente portador de la sonda (diabetes, inmunodeficiencia) y motilidad del mismo; incidentes y manipulaciones de la sonda, tales como, obstrucciones, lavados o retirada de la misma. La valoración de todos los factores enumerados permite estrategias de prevención de los episodios sépticos relacionados con la sonda permanente, estrategias que pueden ser individualizadas para una mayor eficiencia. A pesar de estas medidas preventivas la infección motivada por la sonda permanente puede ocasionar episodios sépticos de extremada gravedad. La bacteriuria de la sonda permanente constituye hoy en día la mayor fuente de infección nosocomial y su prevención y tratamiento, una acción sanitaria de máxima importancia. El estudio de los mecanismos implicados en la formación de biofilms, su potencial patogénico y las estrategias preventivas han supuesto un atractivo campo de investigación clínica y experimental en los últimos años. Una síntesis de los trabajos realizados por nuestro grupo es el motivo de está revisión
Permanent drainage of the urinary tract by catheters or tubes causes bacteriuria. The potential harmful effects of the indwelling catheter`s bacteriuria are related to: time since the insertion of the catheter; location of the catheter (urethra, bladder, kidney); catheter composition (latex, silicone, etc.); type of ineffective bacteria and specific pathogenic mechanisms; health status of the urinary tract being drained (prior radiation therapy, tumors, etc.); patient`s health status (diabetes, immunodeficiency) and mobility; incidents and manipulations of the catheter, such as obstruction, irrigation, or retrieval. The evaluation of all mentioned factors enables strategies for prevention of septic episodes in relation with indwelling catheters, strategies that can be individualized for greater efficiency. Despite these preventive measures, infections secondary to the indwelling catheter may cause extremely severe septic episodes. Today, the indwelling catheter bacteriuria constitutes the greater source of nosocomial infection and its prevention and treatment a health care action of the highest importance. The study of mechanisms implied in the formation of biofilms, their pathogenic potential and preventive measures have been an attractive field of clinical and experimental research over the last years. The objective of this review is to make a synthesis of the works performed by our group
