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Thread: Recipes for avoiding UTI's

  1. #411
    Senior Member Axle's Avatar
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    Thank you for the explanation. It makes sense. The key word here is prevent. No one is claiming that a water flush will kill bacteria. The objective is to flush out sediment so that the bacteria has nowhere to colonize. Of course the bacteria could colonize on the bladder wall. But that would be secondary. The first site bacteria would colonize is sediment where the bacteria has no antibodies to fight.

    I am not saying that Vetericyn is not as advertized nor am I denying that saline may be a better choice than distilled water. I am just saying what I heard and bouncing it off you. How about hydrogen peroxide? That would seem to me to be better than water or saline and less expensive than Vetericyn.
    Last edited by Axle; 01-17-2013 at 03:53 PM.

  2. #412
    Quote Originally Posted by Axle View Post
    Thank you for the explanation. It makes sense. The key word here is prevent. No one is claiming that a water flush will kill bacteria. The objective is to flush out sediment so that the bacteria has nowhere to colonize. Of course the bacteria could colonize on the bladder wall. But that would be secondary. The first site bacteria would colonize is sediment where the bacteria has no antibodies to fight.

    I am not saying that Vetericyn is not as advertized nor am I saying that saline may be a better choice than distilled water. I am just saying what I heard and bouncing it off you. How about hydrogen peroxide? That would seem to me to be better than water or saline and less expensive than Vetericyn.
    There is a lot going on in the bladder and the infection process that has to do with the complexity of biofilms and bladder walls. That said, my instillation of choice is Vetericyn. There is a member on Care Cure Community who has had experience with Hydrogen Peroxide. His screen name is Bob Clark. Maybe you could send him a private message to ask about his experience. Alternatively, you could do a search for threads and posts by Bob and read the experiences he has already posted.

    All the best,
    GJ
    Last edited by gjnl; 01-17-2013 at 12:46 AM.

  3. #413
    Senior Member Axle's Avatar
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    Thanks for all the information. I'll look into some more.

  4. #414
    Quote Originally Posted by Axle View Post
    Thanks for all the information. I'll look into some more.
    One problem is that the information on efficacy of intermittent catheterization (IC) with Vetericyn is hard to find. It seems to be scattered in haphazard fashion amongst thousands and thousands of posts about Vetericyn, nearly all of which deal with indwelling catheters. Of course, instillation for indwelling catheters is much simpler than in IC.


    Anyway, I do not specifically recall more than one or two people (actually I only remember one person) stating that they had successfully reduced or eliminated UTIs for a significant amount of time (more than 4 months) by instilling Vetericyn using intermittent catheters. I think this person also indicated that he still got a UTI using Vetericyn, but that its use invalidated the results of a C&S test, so he could not identify the pathogen until he stopped Vetericyn. He stated that instilling Vetericyn helped, but mainly, or only, with a regimen involving consuming raw garlic. I remember this, I think, because I remember trying to eat raw garlic on the basis of that, but disliking the taste.

    I don't claim my recollections are particularly accurate here. Perhaps someone should organize the posts so we get a sense of the specific experiences of people using Vetericyn for IC, or perhaps ask other users with IC/Vetericyn experience to set up a thread to post experiences.

    Also, I don't claim to have a better solution.
    Last edited by xsfxsf; 01-17-2013 at 04:32 PM.

  5. #415
    Senior Member Axle's Avatar
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    I am going to start with distilled water and take it from there. Sure it won't be sterile after opening. But if i keep it in a dark cool place (fridge) it should be clean enough for a flush. I am not looking to rid an infection. I am only looking to flush the bladder of sediment as a starting point. Why go to the big guns first?

  6. #416
    Senior Member Axle's Avatar
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    Perhaps I'll add some kosher salt to the distilled water to create saline. That should make a better wash than just distilled water. Thanks to everyone for your feedback.

  7. #417
    Quote Originally Posted by Axle View Post
    I am going to start with distilled water and take it from there. Sure it won't be sterile after opening. But if i keep it in a dark cool place (fridge) it should be clean enough for a flush. I am not looking to rid an infection. I am only looking to flush the bladder of sediment as a starting point. Why go to the big guns first?
    Vetericyn is not like an antibiotic that will cure an infection. Those of us who use it instill it into the bladder and retain it for a period of time to help prevent colonization and help prevent urinary tract infections (UTI). We use it daily. Think of Vetericyn as an antiseptic.

    Our SCI nurses recommend bladder flushes (flushes and instillations are different) to remove sediment only when you have sediment that clogs the catheter and prevents it from draining properly.

    If you use distilled water from the refrigerator, make sure you bring it to room temperature before flushing your bladder with it.

    All the best,
    GJ

  8. #418
    Senior Member Axle's Avatar
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    SCI nurses have lots of experience with this and I take that point into consideration. Perhaps a flush has only one application, a clogged catheter, for reasons I am unaware. I often get sediment in my urine and we know that bacteria can colonize on sediment. I have to wonder why I should discount a flush for that and why should I wait until the late stage of a clogged catheter before I flush.

  9. #419
    Quote Originally Posted by Axle View Post
    SCI nurses have lots of experience with this and I take that point into consideration. Perhaps a flush has only one application, a clogged catheter, for reasons I am unaware. I often get sediment in my urine and we know that bacteria can colonize on sediment. I have to wonder why I should discount a flush for that and why should I wait until the late stage of a clogged catheter before I flush.
    I don't recall if you mentioned how you manage your bladder, but I am assuming that you use either a suprapubic catheter or an indwelling uretharal foley catheter.

    Here are some quotes from SCI nurses in previous threads regarding the issue of bladder flushes.

    Quote Originally Posted by SCI-Nurse View Post
    It sounds like you have additional sediment in your bladder. Are you on an anti-cholinergic like ditropan XL? Using that will help your bladder muscle relax and empty better. In addition, flushing the catheter at least once a week with sterile water is helpful...
    pbr
    Quote Originally Posted by SCI-Nurse View Post
    I sympathize with you regarding your frustrations! While I do not often recommend bladder irrigation on a regular basis, it may be warranted in your case.
    You could try irrigation wiht 30cc normal saline once daily in addition to changing catheter every 14-21 days...
    Quote Originally Posted by SCI-Nurse View Post
    Bladder sludge and sand should be removed by a urologist in the office or during cystoscopy. Once this is done, then a preventive program may be called for.

    We also recommend the use of Renecidin for catheter clogging. Use as a daily instillation (not irrigation) can reduce the clogging. An instillation is different from an irrigation.

    Irrigation is flushing, usually fairly forcefully. It is critical that you never do this with more than 30 cc. of solution. You can flush back and forth with this volume, then change to clean solution and repeat again several times until clear.

    Instillation means putting (gently) 30 cc. of solution into the bladder through the catheter, then clamping the catheter and letting the solution "sit" for 15-30 minutes. This helps to dissolve the encrustations on the inside of the catheter..
    (KLD)
    Quote Originally Posted by SCI-Nurse View Post
    Routine irrigation should be avoided. It introduces foreign bacteria and actually increases your risk of UTI. Maintaining a closed system as much as possible will reduce your risks. Occasional irrigation for blockage is OK, but it is better to "irrigate from above" by drinking at least 3 quarts of water daily if you have an indwelling catheter.
    (KLD)
    Quote Originally Posted by SCI-Nurse View Post
    Generally the purpose of irrigating a catheter with a small amount of salt water routinely is to keep the catheter from clogging. So, if you have problems with that it is a good thing. On the other hand, opening what is to be a sterile system every day is not always the best thing. So, you have to make a choice based on your particular needs.
    JM
    Quote Originally Posted by SCI-Nurse View Post
    Routine irrigation is discouraged as it is more likely to cause infections. Unless your catheter is clogged, it should be maintained with as little disconnection as possible. Does your facility have an infection control nurse or consultant? I would insist that they review their policy of routinely doing this. Where I work, we looked at the literature and stopped doing this in the early 1980s.
    (KLD)
    These articles were posted by SCI nurse KLD:
    Ostomy Wound Manage. 2003 Dec;49(12):34-45.
    Indwelling catheter management: from habit-based to evidence-based practice.
    Smith, JM.
    Medical Services and Support Department, C.R. Bard Inc., Covington, GA, USA. joannsmithrn@aol.com

    Indwelling urinary catheters are used in the care of more than five million patients per year. Prevalence rates range from 4% in home care to 25% in acute care. Catheter-associated urinary tract infections account for more than 40% of all nosocomial infections and can be associated with significant complications. Clinical practices in catheter management vary widely and frequently are not evidence-based. Effective nursing measures include: identifying patients who no longer need indwelling catheters, discussing appropriate catheter alternatives, and providing patient and caregiver education. Many catheter-associated problems can be avoided by selecting a closed catheter system with a small size catheter (14 to 18 French with a 5-cc balloon), following manufacturer's recommendations for inflation/deflation, maintaining a closed system, securing the catheter, and properly positioning the drainage bag. Practices such as routine catheter irrigation should be avoided. Current recommendations related to the management of encrustation and blockage also are discussed. Providing evidence-based catheter management strategies may reduce the rate of catheter-associated urinary tract infection, catheter encrustation, and leakage as well as the discomfort and costs associated with these complications.

    Drugs Aging. 2005;22(8):627-39.Related Articles, Links
    Catheter-related urinary tract infection.
    Nicolle, LE
    Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada.

    Indwelling urinary catheters are used frequently in older populations. For either short- or long-term catheters, the infection rate is about 5% per day. Escherichia coli remains the most common infecting organism, but a wide variety of other organisms may be isolated, including yeast species. Bacteria tend to show increased resistance because of the repeated antimicrobial courses. Urinary tract infection (UTI) usually follows formation of biofilm on both the internal and external catheter surface. The biofilm protects organisms from both antimicrobials and the host immune response. Morbidity from UTI with short-term catheter use is limited if appropriate catheter care is practised. In patients with long-term catheters, fever from a urinary source is common with a frequency varying from 1 per 100 to 1 per 1000 catheter days. Long-term care facility residents with chronic indwelling catheters have a much greater risk for bacteraemia and other urinary complications than residents without catheters.Asymptomatic catheter-acquired UTI should not be treated with antimicrobials. Antimicrobial treatment does not decrease symptomatic episodes but will lead to emergence of more resistant organisms. For treatment of symptomatic infection, many antimicrobials are effective. Wherever possible, antimicrobial selection should be delayed until culture results are available. Whether to administer initial treatment by an oral or parenteral route is determined by clinical presentation. If empirical therapy is required, antimicrobial selection is based on variables such as route of administration, anticipated infecting organism and susceptibility, and patient tolerance. Renal function, concomitant medications, local formulary and cost may also be considered in selection of the antimicrobial agent. The duration of therapy is usually 10-14 days, but patients who respond promptly and in whom the catheter must remain in situ may be treated with a shorter 7-day course to reduce antimicrobial pressure. Relevant clinical trials are necessary to define optimal antimicrobial regimens for the management of catheter-acquired UTI.Prevention of catheter-acquired UTI and its complications is a major goal. With short-term catheters, avoiding their use or limiting the duration of use to as short a time as possible are the most effective prevention strategies. Maintaining a closed drainage system and adhering to appropriate catheter care techniques will also limit infection and complications. As the duration of catheterisation is the principal determinant of infection with long-term indwelling catheters, it is not clear that any interventions can decrease the prevalence of bacteriuria in this setting. Catheter flushing or daily perineal care do not prevent infection and may, in fact, increase the risk of infection. Complications of infection may be prevented by giving antibacterials for bacteriuria immediately prior to any invasive urological procedure, and by avoiding catheter blockage, twisting or trauma. The major focus of future advances in prevention of catheter-acquired UTI is the development of biomaterials resistant to biofilm formation. There is substantial current research addressing this issue, but current catheter materials all remain susceptible to biofilm formation.


    You will note that there are even differences between the SCI nurses as to what to use to irrigate or flush sediment from the catheter, i.e., sterile water, salt water, normal saline, and in some cases Renacidin (Citric Acid, Glucono-Delta- Lactone and Magnesium Carbonate Irrigation).

    Hope this helps.

    All the best,
    GJ

  10. #420
    Senior Member Axle's Avatar
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    I straight cath intermittently.

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