The risk of urine bacterial colonisation in patients with a permanent catheter after caesarean section

We present an observational study, conducted in Slovakia, concerning the occurrence of newly acquired urine colonisations in women with Foley catheters after a Caesarean section. A sample of urine was taken from each patient when the Foley catheter was first inserted, before the operation and was sent to the lab for culture. Later, a sample of urine was taken during the removal of the Foley catheter. Out of 176 women, the second urine sample culture result was positive in 13 women. Of those nine women had a positive pathogenic strain (5.1%). The prevalence of asymptomatic bacteriuria in our cohort was 7.7%.De novoacquired colonisation of urine was confirmed in 5.1% of cases. The only confirmed risk factor was delivery by an acute Caesarean section.Impact statement What is already known on this subject?:It is well known that catheterisation increases risk of colonisation of lower urinary tract by pathogens. However, the extent of this risk is not determined because there are no studies ofde novocolonisation in women with sterile urine before catheterisation. According to literature approximately 8% of women have asymptomatic bacteriuria, which could be confounding factor in previous studies. What do the results of this study add?:Our study excluded women with positive bacteriuria before insertion of Foley catheter. Therefore, the study only assessesde novocolonisation, dependent on insertion of Foley catheter during caesarean section. What are the implications of these findings for clinical practice and/or further research?:De novocolonisation was observed in 5.1% of women in our cohort, with emergency caesarean section as a confirmed risk factor. Therefore, practitioners should consider avoiding catheterisation during caesarean section.

Automated summary

This observational study in Slovakia found that 5.1% of women developed new urine colonisations after Foley catheter insertion post-Caesarean section, with emergency C-section as the only confirmed risk factor. Therefore, practitioners should consider avoiding catheterisation during C-sections.