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Catheter-Associated Bacteriuria

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Alternatives to Indwelling Urethral Catheterization ÎIn men for whom a urinary catheter is indicated and who have minimal post-void residual, condom catheterization should be considered as an alternative to short-term (A-II) and long-term (B-II) indwelling catheterization to reduce CA-bacteriuria in those who are impaired. cognitively > Comment: Data are insufficient to make a recommendation as to whether condom catheterization is preferable to short-term or long-term indwelling urethral catheterization for reduction of CA-UTI. > Comment: Data are insufficient to make a recommendation as to whether condom catheterization is preferable to short-term or long-term indwelling urethral catheterization for reduction of CA-bacteriuria in those who are cognitively impaired. ÎIntermittent catheterization should be considered as an alternative to short-term (C-I) or long-term (A-III) indwelling urethral catheterization to reduce CA-bacteriuria and an alternative to short-term (C-III) or long-term (A-III) indwelling urethral catheterization to reduce CA-UTI. ÎSuprapubic catheterization may be considered as an alternative to short-term indwelling urethral catheterization to reduce CA-bacteriuria (B-I) and CA-UTI (C-III). > Comment: Data are insufficient to make a recommendation as to whether suprapubic catheterization is preferable to long-term indwelling urethral catheterization OR whether intermittent catheterization is preferable to suprapubic catheterization for reduction of CA-bacteriuria or CA-UTI. Insertion Technique for Indwelling Urethral Catheter ÎIndwelling urethral catheters should be inserted using aseptic technique and sterile equipment (B-III). Intermittent Catheterization Technique ÎClean (non-sterile) rather than sterile technique may be considered in the outpatient (A-III) and institutional (B-I) setting with no difference in risk of CA-bacteriuria or CA-UTI. ÎMultiple-use catheters may be considered instead of sterile single-use catheters in the outpatient (B-III) and institutional (C-I) setting with no difference in risk of CA-bacteriuria or CA-UTI. > Comment: Data are insufficient to make a recommendation as to whether one method of cleaning multiple-use catheters is superior to another. ÎHydrophilic catheters are recommended for routine use to reduce the risk of CA-bacteriuria (B-II) or CA-UTI (B-II). > Comment: Data are insufficient to make recommendations on whether use of portable bladder scanners or "no-touch" technique reduce the risk of CA-UTI compared with standard care. 3 N OT N OT

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