Catheter-Associated Urinary Tract Infections
Key Points
Î Urinary tract infection (UTI) is one of the most common hospital-
acquired infections; 70%-80% of these infections are attributable to an
indwelling urethral catheter.
• The burden of CAUTI in pediatric patients is not well defined.
Î Twelve to sixteen percent of adult hospital inpatients will have a urinary
catheter at some time during admission.
Î The daily risk of acquisition of bacteriuria varies from 3%-7% while an
indwelling urethral catheter remains in situ.
Î In one 3-year Canadian study, the incidence of urinary-to-bloodstream
infections was 1.4/10,000 patient-days. All-cause 30-day mortality in
these patients was 15%.
Î Catheter use is associated with negative outcomes in addition to
infection, including nonbacterial urethral inflammation, urethral
strictures, mechanical trauma, and mobility impairment.
Basic Practices for Preventing CAUTI
(recommended for all acute care hospitals)
Appropriate infrastructure for preventing CAUTI
Î Provide and implement written guidelines for catheter use, insertion,
and maintenance (III).
Î Ensure that only trained, dedicated personnel insert urinary catheters
(III).
Î Ensure that supplies necessary for aseptic technique for catheter
insertion are available and conveniently located (III).
Î Implement a system for documenting the following in the patient
record: physician order for catheter placement, indications for
catheter insertion, date and time of catheter insertion, name of
individual who inserted catheter, nursing documentation of placement,
daily presence of a catheter and maintenance care tasks, and date and
time of catheter removal. Record criteria for removal or justification
for continued use (III).
Î Ensure that there are sufficient trained personnel and technology
resources to support surveillance for catheter use and outcomes (III).
Surveillance for CAUTI
(if indicated on the basis of facility risk assessment or regulatory requirements)
Î Identify the patient groups or units in which to conduct surveillance on
the basis of risk assessment, considering frequency of catheter use and
potential risk (eg, types of surgery, obstetrics, critical care) (III).
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