MP20-15 FIBRINOGEN RELEASE AND DEPOSITION ON URINARY CATHETERS PLACED DURING UROLOGIC PROCEDURES (2015)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder II1 Apr 2015MP20-15 FIBRINOGEN RELEASE AND DEPOSITION ON URINARY CATHETERS PLACED DURING UROLOGIC PROCEDURES Jeffrey Larson, Aaron Potretzke, Jennifer Walker, Ana Lidia Flores-Mireles, Scott Hultgren, and Alana Desai Jeffrey LarsonJeffrey Larson More articles by this author , Aaron PotretzkeAaron Potretzke More articles by this author , Jennifer WalkerJennifer Walker More articles by this author , Ana Lidia Flores-MirelesAna Lidia Flores-Mireles More articles by this author , Scott HultgrenScott Hultgren More articles by this author , and Alana DesaiAlana Desai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.987AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Catheter-associated urinary tract infections are a common cause of hospital-associated infections. Previous animal models show that catheter placement induces inflammation and fibrinogen release, which accumulates on the catheter providing an environment for uropathogens such as Methicillin-Resistant Staph aureus (MRSA) and Enterococcus faecalis. The goal of this study was to examine urethral catheters placed for urologic procedures to test for fibrinogen deposition in humans and determine how long it takes for fibrinogen to become deposited on the catheter tip. METHODS Urethral catheters placed for urologic procedures were collected and sent to the lab after removal. The dwell time and procedure type was recorded for each patient. Presence of fibrinogen deposition was studied by staining each catheter with fluorescent tagged anti-human antibody. RESULTS A total of 23 catheters from different patients were studied of which 9 (39%) were removed in less than 24 hours (range 18 to 23 hours) and 14 were in place for a mean duration of 18.7 days. The catheters were placed for a variety of urologic procedures including 7 for retention, 6 after percutaneous nephrolithotomy, 4 after prostatectomy, 2 after partial nephrectomy and 1 after transurethral surgery. Fibrinogen deposition was present in all catheters in detectable levels as indicated by a representative sample in Figure 1. There was a correlation between the duration of catheter use and fibrinogen deposition although all catheters with a duration <24 hours had significant fibrinogen deposition indicating that the induced inflammatory response occurs within the first day of catheter placement. CONCLUSIONS These findings indicate that the induced inflammatory response of the urinary tract to catheter placement is a rapid response that occurs within the first 24 hours of catheter placement creating an ideal microenvironment for urinary pathogens such as MRSA or E. faecalis. While our study is limited by the number of catheters with <24 hour dwell time and may be confounded by recent urologic surgery, these findings may explain why prolonged catheterization is associated with increased risk of urinary tract infections whereas intermittent catheterization continues to have a lower overall infection risk in patients with urinary retention. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e228-e229 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeffrey Larson More articles by this author Aaron Potretzke More articles by this author Jennifer Walker More articles by this author Ana Lidia Flores-Mireles More articles by this author Scott Hultgren More articles by this author Alana Desai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...