Determination of Bacteria Migration Speed through Urinary Catheter Systems in case of Urostomy

Juni 2015
FHH Brill, H Braunwarth, D Hegeholz, W Droste
Bibliografische Daten 
P219; Poster presentation: Healthcare-associated urinary tract infections, Poster area, 18.06.2015, 13:00

Introduction: Following a urostomy, the main aim from a hygiene perspective is to prevent bacteria from accumulating in the artificial drainage system (splint), e.g. as a result of contaminated urine. A return stop in the urostomy pouch keeps this risk to a minimum. In practice, however, splints are often pushed through the return stop to keep them more securely in place, which means that they may come into direct contact with the potentially contaminated urine.
Objectives: The Objective was to study the migration speed of clinically-relevant bacteria in catheter systems used after urostomy.
Methods: We carried out an in-vitro experiment in a commercially-available uriniferous system applied in a urostomy. This involved connecting two storage vessels: the first containing splints which had previously been rinsed once with artificial urine; and the second containing a bacterial suspension of the test bacteria (E. coli, P. aeruginosa and P. mirabilis), which had previously been soaked in artificial, sterile urine. The two storage vessels were inclubated at 36 °C for 24 to 72 hours. The splints were cut into segments of 5 cm after 24 hours, 48 hours and 72 hours. The colony-forming units (CFU) on the pieces were determined. Each experiment was carried out nine times before the average values and standard deviations were subsequently determined.
Results: After 24 hours the bacteria migrated into the splint, on average, as follows: E. coli 26.7 cm ± 20.6, S. aureus 27.2 cm ± 10.6 and P. mirabilis 12.8 cm ± 16.2. After 48 hours the bacteria migrated as follows: 35.0 cm ± 11.2 (E. coli), 51.7 cm ± 7.5 (S. aureus) and 41.7 cm ± 23.6 (P. mirabilis). The results after 72 hours were: 49.4 cm ± 14.5 (E. coli), 60 cm ± 16.0 (S. aureus) and 67.8 cm ± 3.6 (P. mirabilis).
Conclusion: The test bacteria grew relatively quickly through the catheter. It is likely that bacteria would grow through catheters with 80 cm length within a week at the latest. In this case, these is a direct infection risk for bladder and kidneys of the patient. These results should be taken into consideration during clinical use of the catheter systems in case urostomy.