Most literature on the subject of bacteriuria in patients with urinary catheters has dealt with hospitalized patients who had been catheterized for brief periods. Only recently has the magnitude of the nosocomial hazards posed by nursing home patients with catheters been addressed. Based on 1980 United States census data, the number of patients in nursing homes is estimated to be greater than 1.2 million, with 436,000 patients being cared for in skilled-care facilities. Garibaldi et al1 found that 12% of the patients in the skilled-care facilities they surveyed had indwelling catheters. If this figure is representative of the nationwide prevalence of this practice, more than 50,000 nursing home patients are at risk for the infectious complications of indwelling catheters. Additionally, many more of these patients are at risk because of the potential for transfer of antibiotic-resistant bacterial organisms between patients.
With prolonged catheterization, bacterial colonization of the urinary bladder