Association of rectal and urethral colonization with urinary tract infection in patients with indwelling catheters
R. Daifuku and W. E. Stamm
To assess the role of antecedent rectal and urethral colonization in the
pathogenesis of catheter-associated urinary tract infections, we
prospectively studied 64 patients, obtaining urine, rectal, and urethral
cultures on study entry, two days later, and every four days thereafter. Of
55 patients who remained catheterized for at least three days, urethral
colonization with the same microorganism present in bladder urine was
observed in the sampling period preceding the onset of bacteriuria in 12 of
18 infections in women and five of 17 in men. Rectal colonization with the
infecting strain preceded bacteriuria in 14 of 18 infections in women and
five of 17 in men. The identity of the urinary, urethral, and rectal
isolates was confirmed by speciation, serotyping, antibiograms, and
biotyping. We conclude that rectal and periurethral colonization often
precedes catheter-associated bacteriuria, especially in women, and that
effective preventive measures aimed at transurethral infection should be
developed.
