2026-04-22
Urinary tract infection (UTI) refers to an inflammatory reaction caused by the invasion of pathogenic microorganisms into the urinary tract. It is a common infection among hospitalized patients. According to relevant literature, urinary tract infections account for approximately 40% of hospital-acquired infections, ranking first. A survey of hospital outpatient clinics in the United States shows that the number of outpatient visits for urinary tract infections increased from 7 million in 1997 to 10.5 million in 2007, while the number of emergency department visits rose from 1 million to approximately 2.24 million. Chinese literature reports that urinary tract infections account for 20.8% to 31.7% of hospital-acquired infections, ranking second only to respiratory tract infections. In recent years, a large number of scholars have conducted research on the high incidence factors, common pathogenic microorganisms, and prevention measures of urinary tract infections. The following is a summary of the prevention of urinary tract infections.
1.Change lifestyle
Develop good personal hygiene and behavioral habits, especially for women. Studies have shown that alternative forms of contraception should be provided for women because behaviors such as taking oral contraceptives or using contraceptive rings can increase the probability of Escherichia coli colonization in the vagina and urethra; researchers have found that physiological bladder irrigation (drinking water) is of great significance in preventing urinary tract infections. Patients should be encouraged to drink more water. For those who can normally consume water, they should drink more than 2000ml per day and maintain a urine volume of more than 2000ml.
2. Prevention of Catheter-Associated Urinary Tract Infection (CAUTI)
Identify the indications clearly and avoid the use of indwelling urinary catheters as much as possible, especially for individuals at high risk of urinary tract infections; when necessary, alternative methods can be adopted, such as intermittent catheterization, using suprapubic catheters or urethral stents, or using condoms instead of catheters; bladder ultrasound scanners can also be used to monitor bladder volume to reduce unnecessary catheterization. At the same time, try to shorten the duration of catheterization as much as possible, and remove the catheter promptly when it is no longer needed. For surgical patients, the catheter should be removed as soon as possible after the operation, preferably within 24 hours, unless there is a need for continued use.
Some countries have significantly increased the use of electronic reminder systems since 2008. A meta-analysis conducted in the United States indicates that the use of electronic reminder systems can effectively shorten the duration of urinary catheter placement, reducing the incidence of CAUTI by 52%.
In addition, the type of urinary catheter selected should also be appropriately chosen. Silicone material has better performance than latex material. Antibacterial or silver alloy-coated urinary catheters can reduce or delay the occurrence of bacteriuria in patients with short-term indwelling catheterization, but whether they have a preventive effect on patients with long-term indwelling catheterization still needs further verification.
3. Bladder irrigation (not recommended)
According to relevant literature, bladder irrigation has no preventive effect on urinary tract infections. Instead, it can cause mechanical damage to the bladder wall, damage to the mucosa on the bladder surface, and cause urine to flow back into the bladder through the catheter lumen, thereby increasing the chance of external infection. Therefore, it is not recommended to routinely perform preventive bladder irrigation for patients with indwelling catheters.
4. Health Education
The survey research indicates that 60% of hospitals provide corresponding health education guidance to patients and their families, covering aspects such as the methods of catheter care, the judgment methods for symptoms and signs of urinary tract infections, and discharge guidance. Some scholars have conducted self-management interventions for patients, including encouraging them to fill out urination diaries, learning relevant knowledge manuals, and having nurses conduct home visits, which have improved patients' self-care abilities and ultimately achieved the goal of preventing urinary tract infections. A study shows that the current situation of home care for elderly patients with indwelling catheters is not optimistic. Issues such as the material of the catheter, replacement time, and urethral orifice care often involve blindness and randomness. 100% of the patients have urinary tract infections, and 49.5% have urinary tract irritation symptoms.
5. Prevention of Recurrent Urinary Tract Infections
Continuous prophylactic use of antibiotics has been recommended as a method to prevent recurrent urinary tract infections. The Public Health Agency of England recommends the use of low-dose antibiotics to prevent the frequent recurrence of nocturnal urinary tract infection symptoms. Metoxifluridine and furanotoin are commonly used preventive antibacterial drugs. The former achieves the preventive effect by inhibiting bacterial growth (especially Escherichia coli), while the latter works by interfering with bacterial metabolism and inhibiting bacterial adhesion. The disadvantage is that adverse reactions may occur, the most common of which are nausea and candida infection. Even at a low dose, complications may still arise after long-term use. Therefore, continuous prophylactic antibiotic treatment should be selected with caution, and the patient's physical condition should be monitored regularly during the treatment period. It has been reported that the use of estrogen, cranberry products, ascorbic acid vitamin C, mannitol, lactobacilli and vaccines can also prevent recurrent urinary tract infections. However, some of these methods remain controversial or lack further confirmation through basic research and clinical trials.
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