206. A Comparison of the Microbiologic Profile of Indwelling Versus External Urinary Catheters
Session: Poster Abstract Session: Catheter-associated UTIs
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Abers.png (675.5 kB)
  • Background: In order to reduce catheter-associated urinary tract infection (CAUTI), external (condom) catheters are recommended as an alternative to indwelling (Foley) catheters. The microbiology associated with external catheters is not well established.  We investigated whether urine collected from external catheters, in comparison to indwelling catheters, would be more likely to contain skin flora organisms and less likely to contain typical urinary pathogens.

    Methods: We included the first positive urine culture from inpatients with a urinary catheter (external or indwelling) between October 2010 and June 2011. All organisms cultured from a urine specimen were recorded in the following non-exclusive categories: gram negative (any), gram-negative Enterobacteriaceae, gram-negative non-Enterobacteriaceae, gram positive (any), gram positive staphylococci, gram-positive enterococci, and Candida.

    Results: 308 cultures from 308 patients (mean age 72.2 years) were included, containing 593 identified organisms.  Of these cultures, 135 (44%) were from external catheters, while 173 (56%) were from indwelling catheters. The mean number of organisms identified per culture was significantly higher with external compared to indwelling catheters (2.3 vs. 1.7; p < .0001). The odds of having any gram-negative organism, Enterobacteriaceae, any gram-positive organism, staphylococci or enterococci did not differ significantly between catheter types. However, the odds of having non-Enterobacteriacae (mainly Pseudomonas) and Candida were both higher 3.0 times higher in indwelling catheters compared to external catheters (OR 3.0 and 2.3 respectively, p<0.01 for both comparisons). 

    Conclusion: We did not find expected differences in the microbiology of external and indwelling catheters. Specifically, the most common uropathogens (Enterobacteriaceae, enterococci) were equally common in these two catheter types. Switching between these catheter types is not likely to decrease the number of urine cultures that grow typical uropathogenic organisms.

    Michael S Abers, BA1, Quratulain Kizilbash, MD1, Nancy J Petersen, PhD1,2 and Barbara W. Trautner, MD, PhD1,2, (1)Baylor College of Medicine, Houston, TX, (2)VA Health Services Research and Development Houston Center of Excellence, Michael E. Debakey VA Medical Center, Houston, TX


    M. S. Abers, None

    Q. Kizilbash, None

    N. J. Petersen, None

    B. W. Trautner, None

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