BLADDER-CATHETER BLOCKAGE CAUSES
SUMMARY
1. Low urine volume: leads to higher concentration of debris.
2. Poor urine flow: can increase the incidence of encrustations which settle in the tubing and lead to formation of a bio-film.
3. Colonisation and biofilms: common with E coli, Pseudomonas aureginosa, Proteus, Klebsiella, Provedincia. Occurrs within 48 hours of catheterization. Can lead to re-colonisation after completion of antibiotics, within 4 weeks of catheter change.
4. Acidic urine: normal pH averages 6.0 but can range from 4.5—8.0.
- There is considerable encrustation at pH less than 6.7
- Urease is more active in an acid pH causing more urea to convert into ammonia
- Ammonia damages the protective layer of urothelial cells
- Urease producing bacteria are: Proteus mirabilis, Morganella morganii, Provedencia stuartii, Klebsiella pneumoniae, Proteus rettgeri, Proteus vulgaris, Staphylococcus aureus
- Urease producing bacteria also lead to a higher risk for stone formation
5. Encrustation: there is strong evidence that infection by Proteus mirabilis is the main cause of the crystalline biofilms that encrust and block Foley catheters[1].
Reference(s)
- ↑ Stickler, D., Feneley, R. The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control. Spinal Cord 48, 784–790 (2010). https://doi.org/10.1038/sc.2010.32.
Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.
