Catheters and Urinary Tract Infection

Abstract

To the Editor.— Referring to the article Prevention of Catheter-Associated Urinary Tract Infection (221:1270, 1972), I would like to comment: Although the catheter is associated with a high incidence of urinary tract infection, with proper management, the sequelae may be minimized. In our field of rehabilitation medicine, the indwelling catheter on a long-term basis is necessary in some patients with spinal cord injury, since they may have an incompletely emptying bladder, high residual urine volumes, associated sepsis, and pyelonephritis. In these cases, the indwelling catheter is a necessary evil. With proper management, the prognosis in chronic paraplegia is good since the 20-year mortality for chronic renal disease is 7%.1 Proper management of the patient with an indwelling catheter is relatively simple. Promoting an acidic urine will inhibit bacterial growth.2Furthermore, Andriole has clearly demonstrated water diuresis was associated with sterilization of the experimentally infected rat renal medulla.3