During much of my medical career, my understanding of the human bladder was that it was a reservoir for the body’s metabolic waste and that it simply stores #urine until it signals a sense of fullness to motivate volitional voiding. As filling increases tissue distension, intensity of desire to void increases accordingly. Throughout most of the day, the bladder just passively fills. How reassuringly simple! I also understood that bladders, and mostly of females, are very vu

On the day of the UK’s launch of its new #AMR 5-year plan, I offer this account as it is closely linked in attempting to reduce the incidences of CAUTI, and thus, incident AMR risks. Here’s some food for thought Patients and health services suffer the scourge of CAUTI in both hospitals and communities. No approved strategy has made a substantial difference. Various alternatives exist but need unblocking by officialdom. Here’s a selection: 1 - #Catheter cleaning: To prevent

Recurrent #cystitis reportedly occurs in about 25% of women within months after a first episode, which far exceeds recurrences from other infections. Cystitis investigations reveal a worryingly high rate of associated #antimicrobial resistance (#AMR) compared with other common infections, suggesting bacteria survive our treatments, adapt and reinfect. Dead bacteria don’t do either, so despite clinical recovery, evidently many cystitis treatments, even uncomplicated ones, fail

“We know almost nothing about managing UTI.” This assertion went unchallenged at the British Society of #Antimicrobial Chemotherapy multidisciplinary conference of experts last year. Increasingly, we struggle because following #cystitis #treatments, #infection recurrences and #antimicrobial #resistance too often occur, compromising patients’ health and efficient service provision. PubMed UK searches reveal over 81,000 articles are available on “UTI” and more than 16,000 on

The distal urethra is a residency for #bacteria, mostly commensals, but sometimes potential uropathogens move in. #Catheterisation hygiene cleans the skin around the urethral meatus but does not remove bacteria residing in the distal urethra. Many people have focused time, effort and money on coatings that are supposed to prevent such bacteria surviving #catheter entry into the #bladder. Such a #coating would need to kill the potential pathogens before they are transferred fr