Strategies to Prevent Catheter‐Associated Urinary Tract Infections in Acute Care Hospitals

• Published in: Infection control and hospital epidemiology 2008-10, Vol.29 (S1), p.S41-S50
• Main Authors: Lo, Evelyn, Nicolle, Lindsay, Classen, David, Arias, Kathleen M., Podgorny, Kelly, Anderson, Deverick J., Burstin, Helen, Calfee, David P., Coffin, Susan E., Dubberke, Erik R., Fraser, Victoria, Gerding, Dale N., Griffin, Frances A., Gross, Peter, Kaye, Keith S., Klompas, Michael, Marschall, Jonas, Mermel, Leonard A., Pegues, David A., Perl, Trish M., Saint, Sanjay, Salgado, Cassandra D., Weinstein, Robert A., Wise, Robert, Yokoe, Deborah S.
• Format: Article
• Language: English
• Subjects: Catheters; Health care industry; Health outcomes; Hospitals - standards; Humans; Indwelling catheters; Infection Control - methods; Infection Control - standards; Infections; Nursing; Patient surveillance; Predisposing factors; Recommendations; Supplement Article: SHEA/IDSA Practice Recommendation; Urethral catheterization; Urinary Catheterization - adverse effects; Urinary Catheterization - standards; Urinary Tract Infections - drug therapy; Urinary Tract Infections - prevention & control; Urine
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/591066

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion. 1. Burden of CAUTIs a. Urinary tract infection is the most common hospital-acquired infection; 80% of these infections are attributable to an indwelling urethral catheter. b. Twelve to sixteen percent of hospital inpatients will have a urinary catheter at some time during their hospital stay. c. The daily risk of acquisition of urinary infection varies from 3% to 7% when an indwelling urethral catheter remains in situ. 2. Outcomes associated with CAUTI a. Urinary tract infection is the most important adverse outcome of urinary catheter use. Bacteremia and sepsis may occur in a small proportion of infected patients. b. Morbidity attributable to any single episode of catheterization is limited, but the high frequency of catheter use in hospitalized patients means that the cumulative burden of CAUTI is substantial. c. Catheter use is also associated with negative outcomes other than infection, including nonbacterial urethral inflammation, urethral strictures, and mechanical trauma.