Catheter-Associated Urinary Tract Infections Free Essay

Features of Urinary Tract Infections


Urinary tract infection (UTI) is a collective term used to describe infections affecting any part of the urinary tract, ureters, urethra, kidneys, and the urinary bladder. The kidneys and the ureters comprise the upper urinary tract while the urethra and the urinary bladder comprises the lower tract (Tan & Chlebicki, 2016). Adult women are more likely to develop UTIs than adult men. In fact, urinary tract infections affect women about 30 times more often than men (Tan & Chlebicki, 2016). The reason behind this has been attributed to the fact that the primary pathogen causing UTIs, Escherichia coli (Tandogdu & Wagenlehner, 2016) is contained as normal flora in the skin surrounding the anus and the distance between the anus and the urinary tract in women is short. This allows easy passage of the bacteria into the urinary tract.

According to the centers for disease control and prevention, UTIs ranks among the highest number of reported healthcare-associated infections. UTIs can be primary or secondary occurring from underlying disease, and they can also be acquired in the hospital, about 75 percent of hospital-acquired urinary tract infections are associated with a urinary catheter (Centers for disease control and prevention, 2017). It is one of the most common infections acquired by patients in the hospital, a biofilm develops in these catheters leading to bacteriuria which could subsequently lead to bacteremia, and catheter-associated urinary tract infections account for 20 percent of health-care acquired bacteremia in acute care settings and 50 percent in long-term facilities (Nicolle, 2014). These biofilms contain bacterial containing anti-microbial resistant (Soto, 2014). Indwelling catheters are known to be the most common indwelling device used in healthcare facilities accounting for about 17 percent, 23 percent, and 9 percent in medical, surgical, and rehabilitation units respectively (Nicolle, 2014). Indwelling catheters are either short term (less than 30 days) or long term (more than 30 days), acute care settings often use short term catheters, however, the longer it stays in the patient, the higher the chances of developing biofilm that could lead to bacteriuria and bacteremia which are the underlying factors in CAUTI (Nicolle, 2014; Barbadoro et al., 2015).

Proper hand hygiene and proper aseptic insertion techniques (Nicolle, 2014, Saint et al., 2016) are known to be effective in the prevention of catheter-associated urinary tract infection (CAUTI). Evidence-based guidelines have also been set in order to prevent the incidence of CAUTI, avoidance of catheter use, policies for insertion and maintenance of catheter, catheter selection, and surveillance of CAUTI (Nicolle, 2014; Barbadoro et al., 2015; Galiczewski, 2016). Researches to implement the use of anti-microbial coated catheters are being carried out as it is believed that this would prevent the high incidence of CAUTI in hospitals and therefore reducing the burden it may cause on the hospital, the patients, and their families (Tenke, Koves, & Johansen, 2014). In some health-care institutions, there have been nurse-driven protocols to prevent CAUTI, the basis of which involved discontinuation of indwelling catheters as well as the use of bladder ultrasound along with intermittent catheterizations (Alexaitis & Broome, 2014). Other researches have shown that the use of urinary catheter reminders and stop orders have significantly reduced the incidence of catheter-associated urinary tract infections (Meddings et al., 2014).

Prolonged use of indwelling catheters is the primary cause of CAITI. Therefore it is essential that healthcare providers remove catheters as quickly as possible and as soon as they are no longer needed. Hand hygiene and aseptic techniques have also been known to reduce CAUTI. Evidence-based guidelines to prevent this infection which include avoidance of catheter have also been implemented in healthcare institutions.


Alexaitis, I., & Broome, B. (2014). Implementation of a nurse-driven protocol to prevent catheter-associated urinary tract infections. Journal of nursing care quality29(3), 245-252.

Barbadoro, P., Labricciosa, F. M., Recanatini, C., Gori, G., Tirabassi, F., Martini, E., … & Prospero, E. (2015). Catheter-associated urinary tract infection: Role of the setting of catheter insertion. American Journal of infection control43(7), 707-710.

Centers for Disease Prevention and Control (2017). Catheter-associated Urinary Tract Infections (CAUTI). Retrieved on 1 February 2019 from

Galiczewski, J. M. (2016). Interventions for the prevention of catheter-associated urinary tract infections in intensive care units: an integrative review. Intensive and Critical Care Nursing32, 1-11.

Meddings, J., Rogers, M. A., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2014). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf23(4), 277-289.

Nicolle L. E. (2014). Catheter-associated urinary tract infections. Antimicrobial resistance and infection control3, 23. doi:10.1186/2047-2994-3-23

Saint, S., Greene, M. T., Krein, S. L., Rogers, M. A., Ratz, D., Fowler, K. E., … & Faulkner, K. (2016). A program to prevent catheter-associated urinary tract infection in acute care. New England Journal of Medicine374(22), 2111-2119.

Soto, S. M. (2014). Importance of biofilms in urinary tract infections: new therapeutic approaches. Advances in biology2014.

Tandogdu, Z., & Wagenlehner, F. M. (2016). Global epidemiology of urinary tract infections. Current opinion in infectious diseases29(1), 73-79.

Tan, C. W., & Chlebicki, M. P. (2016). Urinary tract infections in adults. Singapore medical journal57(9), 485-90.

Tenke, P., Köves, B., & Johansen, T. E. (2014). An update on the prevention and treatment of catheter-associated urinary tract infections. Current opinion in infectious diseases27(1), 102-107.



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"The terms offer and acceptance.", 17 May 2016

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"The terms offer and acceptance.", 17 May 2016

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"The terms offer and acceptance.", 17 May 2016

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