Catheter Associated Urinary Tract Infection (CAUTI)

A urinary tract infection, commonly known as a UTI, is an infection that occurs in the urinary tract. An infection in the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder and/or the urethra (the tube through which urine travels from the bladder to leave the body) is considered a urinary tract infection. 

A urinary tract infection happens when bacteria are able to enter the urinary tract and begins to multiply. Typically, the urinary tract is sterile, meaning that bacteria do not belong there and the area is usually free of bacteria in a healthy individual. 

The placement of a urinary catheter, or a Foley catheter, increases the risk of a urinary tract infection. The placement of the catheter is done using sterile techniques, yet there is still the possibility of bacteria being introduced into the urinary tract. Once the catheter is in place, the risk of bacteria entering the urinary tract is increased by having a foreign body present.

The majority of surgical patients have a foley catheter placed during their surgical procedure unless it is a very brief surgery. The catheter may be taken out immediately after surgery, or it may stay in for a day or longer depending on the type of surgery and the rate of recovery. 

Signs and Symptoms

• Burning when urinating
• The urgent need to urinate
• Blood in the urine
• The pressure in the lower back and/or abdomen
• Fever

Prevention

The placement of a Foley catheter should be done using sterile techniques. This means that the skin is cleansed, sterile gloves are worn and the sterile catheter itself is never touched without sterile technique.

The best way to prevent a catheter-associated UTI is to not have a catheter at all. Some patients cannot be without a catheter, for those individuals the next best thing is to remove the catheter as soon as possible. 

Never touch the catheter without first washing your hands properly. 

Poor hygiene, whether or not a catheter is present, can dramatically increase the risk of infection. When using toilet tissue, wiping from the front to the back is essential to the prevention of urinary tract infections. Wiping from the back to front can introduce fecal matter into the opening of the urinary tract.

When bathing, the tubing closest to the body should also be gently cleansed and rinsed, along with the genital area. 

Diagnosis

To diagnose a urinary tract infection, a sample of urine must be obtained. From there one or more tests may be performed. First, a urinalysis tests the urine for the presence of infection and is used to determine if a urinary tract infection is present. Next, if needed, a culture and sensitivity are performed to determine the best antibiotic to use if the infection is resistant to treatment.

Treatments

Urinary tract infections are typically treated with two types of medication. First, an antibiotic is prescribed to treat the infection and rid the urinary tract of bacteria. Second, a medication such as Pyridium is often prescribed to help relieve the pain and irritation caused by the UTI while the antibiotic is taking effect.  

Pyridium and other medications that relieve UTI symptoms can change the color of urine and interfere with a urinalysis and should not be used prior to giving a sample of urine.