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Organo Oficial de la Sociedad Mexicana de Urología

2006, Número 4

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Rev Mex Urol 2006; 66 (4)


Infección urinaria en pacientes portadores de catéter urinario

Guzmán EJ, Rivera BLM, Govea AA

Idioma: Español
Referencias bibliográficas: 39
Paginas: 177-182
Archivo PDF: 134.10 Kb.


RESUMEN

La infección del tracto urinario relacionada con catéter (ITUAC) varía en los estudios publicados, y con frecuencia, los términos “bacteriuria” e “infección del tracto urinario” (UTI) son usados de manera indistinta. Algunos especialistas consideran como ITUAC a los crecimientos ≥10² UFC de un patógeno predominante, especialmente si se asocian con piuria. En todo el mundo se realizan millones de cateterismos de vías urinarias con fines de control, reparación, diagnóstico y tratamiento asociados con riesgo de infección por procedimiento de 1 a 2%, el cual se incrementa de 3 a 7% por día.
Diversos estudios revelan que el uropatógeno predominante es la E. coli; sin embargo, en un estudio realizado por Wazait y cols. se encontró que de 1996 a 2001 hubo un cambio significativo en el espectro bacteriano y en la resistencia antimicrobiana; además, se observó mayor incidencia de infecciones polimicrobianas. Una vez colocado el catéter, incluso con una buena higiene del mismo, la entrada de bacterias puede posponerse sólo en forma temporal, ya que eventualmente todos los pacientes desarrollarán bacteriuria y es rara la infección del torrente sanguíneo por esta causa;8 sin embargo, aún así debe considerarse en los pacientes críticos que tienen episodios febriles, ya que la mortalidad se incrementa de 25 a 60%. El personal hospitalario que tiene la responsabilidad del cuidado del catéter debe tener un entrenamiento periódico en el que se enfaticen las técnicas correctas y las complicaciones secundarias que pueden presentarse con el uso de catéter urinario.


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