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Krankenhaushygiene up2date 2013; 08(01): 25-38
DOI: 10.1055/s-0032-1326392
Nosokomiale Infektionen
© Georg Thieme Verlag KG Stuttgart · New York

Die katheterassoziierte Harnwegsinfektion – was gibt es Neues?

Karl Lewalter
,
Helga Haefner
,
Sebastian Lemmen
,
Simone Scheithauer
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Publication Date:
27 March 2013 (online)

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Kernaussagen

  • Die nosokomiale Harnwegsinfektion gehört zu den häufigsten nosokomialen Infektionen. Sie ist zu 80 % katheterassoziiert.

  • Hauptrisikofaktor ist der Harnwegskatheter und der damit verbundene Eintrag von Mikroorganismen in die Harnblase.

  • Zur Vermeidung von katheterassoziierten Harnwegsinfektionen stehen zahlreiche Interventionsmöglichkeiten zur Verfügung.

  • Insbesondere die Einführung einiger ausgewählter, evidenzbasierter Maßnahmen als Bundle hat sich in der klinischen Praxis bewährt.

  • Unbedingt durchgeführt werden sollten: strenge Indikationsstellung, tägliche Evaluation der Indikation, aseptische Katheteranlage, Standardhygienemaßnahmen (v. a. Händedesinfektion), aktive Surveillance der katheterassoziierten Harnwegsinfektionsrate und Schulungen des Personals.

  • Antimikrobiell beschichtete Katheter sollten nur bei persistierend hohen Infektionsraten und Ausschöpfung aller anderen infektionspräventiven Maßnahmen zum Einsatz kommen.

  • Nicht durchgeführt werden sollten: routinemäßiger Katheterwechsel und Spülungen der Harnblase mit Antiseptika/Antibiotika.

  • Der Erfolg der Implementierung von infektionspräventiven Maßnahmen sollte durch Teilnahme an Surveillanceprogrammen, wie z. B. KISS, evaluiert werden.

 

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