Catheter-associated urinary tract infection

Catheter-associated urinary tract Infection, or CAUTI, is a urinary tract infection associated with urinary catheter use.

Catheter-associated urinary tract infection
SpecialtyUrology

Core prevention

A number of combined practices such as improved hand hygiene, enhanced barrier protection and reduced catheter use when managing incontinence appear to reduce CAUTI.[1] Urinary catheters should be inserted using aseptic technique and sterile equipment (including sterile gloves, drape, sponges, antiseptic and sterile solution), particularly in an acute care setting. Although catheter use should be minimized in all patients, particularly those at higher risk of CAUTI and mortality (e.g. the elderly or those with impaired immunity),[2] a meta analysis suggests there is insufficient evidence to determine the value of different policies for replacing long term urinary catheters on patient outcomes.[3]

Incidence

Bacteria and yeast, including those naturally occurring as part of the human microbiome, can grow within biofilm that forms along the surface of urinary catheters. This leads to infection in the bladder, kidneys, and other organs connected to the urinary tract.[4]

CAUTI can lead to complications such as prostatitis, epididymitis, and orchitis in men, and cystitis, pyelonephritis, gram-negative bacteremia, endocarditis, vertebral osteomyelitis, septic arthritis, endophthalmitis, and meningitis in all patients. Complications associated with CAUTI cause discomfort to the patient, prolonged hospital stay, and increased cost and mortality.[4]

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References
  1. Meddings J, Saint S, Krein SL, Gaies E, Reichert H, Hickner A, McNamara S, Mann JD, Mody L (May 2017). "Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents". Journal of Hospital Medicine. 12 (5): 356–368. doi:10.12788/jhm.2724. PMC 5557395. PMID 28459908.
  2. "Catheter-Associated Urinary Tract Infections (CAUTI)". Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. 2009.
  3. Cooper FP, Alexander CE, Sinha S, Omar MI (July 2016). "Policies for replacing long-term indwelling urinary catheters in adults". The Cochrane Database of Systematic Reviews. 7: CD011115. doi:10.1002/14651858.CD011115.pub2. PMC 6457973. PMID 27457774.
  4. Nicolle LE (2014). "Catheter associated urinary tract infections". Antimicrobial Resistance and Infection Control. 3: 23. doi:10.1186/2047-2994-3-23. PMC 4114799. PMID 25075308.
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