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Urinary Tract Infection Following Instrumentation for Urodynamic Testing

Published online by Cambridge University Press:  21 June 2016

Richard J. Hamill*
Affiliation:
Sections of Infection Control and Infectious Diseases, Veterans Administration Medical Center, andBaylor College of Medicine, Houston, Texas
Charles E. Wright
Affiliation:
Sections of Infection Control and Infectious Diseases, Veterans Administration Medical Center, andBaylor College of Medicine, Houston, Texas
Nita Andres
Affiliation:
Sections of Infection Control and Infectious Diseases, Veterans Administration Medical Center, andBaylor College of Medicine, Houston, Texas
Maureen A. Koza
Affiliation:
Sections of Infection Control and Infectious Diseases, Veterans Administration Medical Center, andBaylor College of Medicine, Houston, Texas
*
Section of Infectious Diseases, V.A. Medical Center (151B), 2002 Holcombe Blvd. Houston, TX 77211

Abstract

After identifying a temporal cluster of urinary tract infections in patients who had undergone urodynamic procedures, we examined the techniques within the urodynamic laboratory and retrospectively reviewed charts of all 155 patients tested in the previous six months. The rate of acquired urinary tract infections was 18.7%. Risk factors for infection included undergoing cystometrograms and being subject to the first procedure performed in a day. Technical errors in the performance of the urodynamic studies included failure to completely disassemble the apparatus upon completion of a procedure, failure to use sterile components, and lapses in aseptic technique. Bacteria implicated in the outbreak were isolated from tubing, transducers, and flush solutions. After the institution of appropriate technique, all patients tested in the subsequent six months were followed. The rate of acquired urinary tract infection dropped to 5%. Urodynamic apparatus should be completely disassembled following the completion of a procedure; reassembly using sterile components should occur immediately prior to the next procedure; aseptic technique should be maintained; and patients should undergo routine urine screening before a procedure. Surveillance of urodynamic procedures may reveal correctable flaws in technique.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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