RESOURCES FOR MANAGING HOSPITAL-ACQUIRED CONDITIONS

Catheter-Associated Urinary Tract Infections

According to the National Healthcare Safety Network’s (NHSN) surveillance data from 2006-2007, catheter-associated urinary tract infections (CAUTI) are the second most commonly reported Healthcare-Associated Infection (HAI) in acute care hospitals. They account for one third of the more than 28,000 infections reported to this national database during this time. CAUTIs have been associated with increased morbidity, mortality, hospital cost, and length of stay and can lead to unnecessary antimicrobial use. Furthermore, urinary drainage systems used with catheterized patients can serve as reservoirs for multidrug-resistant bacteria that can be transferred to others.

Urinary catheters are used frequently in hospitalized patients and also in long term care patients. About 15% to 25% of hospitalized patients may receive short-term indwelling urinary catheters. In the long term care setting, approximately 50,000 residents have catheters at any given time.

One of the challenges in preventing CAUTIs is provider awareness that an indwelling catheter is in place. Studies show that some healthcare providers are unaware that their patients have urinary catheters, which may lead to prolonged and unnecessary use. Another challenge is catheters that are inserted for inappropriate reasons, such as staff convenience. In the acute care setting, CAUTI seems to occur most frequently in trauma and ICU patients and least frequently in patients on the medical and surgical clinical units.

Morbidity and mortality from CAUTIs is relatively low compared to other HAIs. However, the large number of urinary catheters used creates a significant burden, including other urinary complications and deaths. CAUTIs are a leading cause of healthcare related bloodstream infections that arise from a secondary source.

Many CAUTIs may be preventable with appropriate infection control and patient care measures. According to the CDC, up to 380,000 infections and 9,000 deaths related to CAUTIs per year could be avoided if all recommended prevention strategies were followed.

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