Case Studies

Chapter 11 Case 1

A 78-year-old woman with a long-term urethral catheter has a urine culture as part of her pre-assessment for a total knee replacement. You are called up by the nurse practitioner as they are concerned about the result below. On further questioning, the patient is systemically well and not suffering any catheter-related symptoms.

• 1. Does the patient have a UTI?

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  Correct answer:

  No.

• 2. What are the likely causes for this result?

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  Correct answer:

  Sample contamination by skin flora. Asymptomatic colonisation of the indwelling catheter.

• 3. Would you give antibiotics for her upcoming orthopaedic procedure?

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  Correct answer:

  Yes. The insertion of a prosthesis increases the risk of infection, so cover for the cultured organism should be given.

• 4. What other circumstances would this result justify antibiotics?

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  Correct answer:

  Any instrumentation of the urinary tract.