Definition

The urinary tract includes the kidneys, bladder, and tubes connected to them. Infections can start in any part of this tract. A catheter-associated urinary tract infection (CAUTI) is one that starts while a catheter is in place or shortly after it is taken out. The catheter is a tube that is passed up into the bladder. It allows urine to drain out when the body is not able to do so.

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Causes

CAUTI is caused by a germ that has entered the urinary tract. In this case, the germs may be brought into the tract by the catheter. A care team will take many steps to prevent infections. However, a CAUTIs can happen when:

• The catheter is being placed. It can pick up germs from skin around the area.
• Urine flows back into the bladder.
• Germs from a bowel movement come in contact with the catheter.
• Equipment is not used or cleaned as it should be.
• There are leaks around the catheter.

Risk Factors

The risk of CAUTI increases with the amount of time the catheter is in place.

CAUTI is more common in women. The chances of CAUTI are also higher in those with:

• A catheter in place for more than 2 days
• Older age
• A history of UTIs
• Kidney problems
• Diabetes
• Immune system problems

Symptoms

Not everyone with CAUTI has symptoms. In those that have them, symptoms may include:

• Fever or chills
• Problems thinking clearly
• Vague feeling of illness
• Feeling tired or sluggish
• Pain in the back or belly
• Pain in or around the testicles
• Blood in the urine

Once the catheter is removed, symptoms may also include:

• Urge to pass urine often
• Only a small amount of urine is passed
• Burning or pain when passing urine
• Pelvic pain

Diagnosis

The doctor will ask about your symptoms and health past. A physical exam will be done. The doctor may suspect a CAUTI based on your answers and the exam.

To confirm a UTI the doctor may order:

• Urinalysis—to look for signs of infection
• Urine culture—to find the exact germ causing the infection

Treatment

The tube will be taken out as soon as it can.

Antibiotics will fight the infection. They may be given through an IV or taken by mouth. The medicine can be changed based what germ is causing problems.

Prevention

The best step is to avoid catheter use if not needed. To help prevent an infection when a catheter is needed, the care team will:

• Wash their hands before and after touching the tube.
• Remove the tube as soon as possible.

People with a catheter can also take steps including:

• Ask if the catheter is needed. Ask when it can be removed.
• Make sure care team washes their hands before and after touching the tube.
• Keep the urine bag is below the level of the bladder.
• Make sure the tube is not pulled, kinked, or twisted.