The Severity of Urinary Tract Infection according to Duration of Indwelling Urethral Catheter and the Effect of Antibiotic Therapy in Rabbit

Kim, Sae Woong; Lee, Ji Youl; Kim, Jin Ho; Cho, Yong Hyun; Yoon, Moon Soo

Abstract

PURPOSE: The incidence and severity of catheter associated bacteriuria might be dependent on the catheterized duration and route, although this has not been clearly established yet. We evaluated the severity of urinary tract infection according to the duration of the indwelling urethral catheter and the effect of antibiotic therapy in rabbits.
MATERIALS AND METHODS
A total of 54 rabbits were divided into one control group and two experimental groups; antibiotic and no antibiotic group, which were subdivided according to catheterized period(1, 4, 7 and 14-day). We examined the urinalysis, urine culture, qualitative biofilm culture and scanning electro-microscopy of the urethral catheter.
RESULTS
1. In the urinalysis, pyuria developed significantly both in 4, 7, 14-day group of no-antibiotic and in 14-day of antibiotic group compared to the control group(p<0.05). In the no antibiotic 7-day group, pyuria developed significantly as compared to that of the antibiotic group(p<0.05). 2. In the urine culture, positive urine culture was increased significantly in 7, 14-day of no-antibiotic group and 14-day of antibiotic group compared to the control group(p<0.05). In the no antibiotic 7-day group, positive urine culture developed significantly as compared to the antibiotic group(p<0.05). 3. In the qualitative biofilm culture of the urethral catheter, positive culture developed significantly in the no antibiotic 7, 14-day group and the antibiotic 14-day group as compared to the control group(p<0.05). Positive biofilm culture was developed significantly in the no antibiotic 7, 14-day group as compared to the antibiotic group(p<0.05). 4. In scanning electro-microscopy, bacterial biofilm of the urethral catheter was similar to the qualitative biofilm culture, and increased with increasing duration of the catheterization.
CONCLUSIONS
It is suggested that the early removal of the urethral catheter is important for the reduction of chance of urethral catheter associated urinary tract infection. In case of a long-term indwelling urethral catheter(more than 2 weeks), prevention of urinary tract infection was very difficult despite antibiotic administration.