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Catheter-associated Urinary Tract Infection

(CAUTI)

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 due to a tube placed in the bladder. The tube is called a catheter. It allows urine to drain out when the body is not able to do so.
A CAUTI needs to be treated right away to prevent more problems.
The Urinary Tract
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Causes

CAUTI is caused by a germ that gets into 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 CAUTI 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 stool (poop) come in contact with the catheter.
  • Equipment is not used or cleaned as it should be.
  • There are leaks around the catheter.

Risk Factors

CAUTI is more common in women and older people. Other things that raise the risk are:
  • A catheter in place for more than 2 days
  • A history of UTIs
  • Kidney problems
  • Diabetes
  • Immune system problems

Symptoms

Not everyone with CAUTI has symptoms. In those that have them, symptoms may be:
  • Fever or chills
  • Problems thinking clearly
  • Feeling tired, weak, or ill
  • 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
  • Passing only a small amount of urine
  • Burning or pain when passing urine
  • Pelvic pain

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. The doctor may suspect a CAUTI based on symptoms and an 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

Antibiotics will treat the infection. They may be given through an IV or taken by mouth. The medicine can be changed based what germ is causing problems.
The catheter will be taken out as soon as it can.

Prevention

The best step is to not use a catheter unless needed. When a catheter is needed, the risk of infection can be lowered by:
  • Proper training of:
    • Staff who insert catheters
    • People who use catheters
  • Washing hands before and after touching the catheter
  • Making sure the catheter is clean and working properly

RESOURCES

Centers for Disease Control and Prevention
https://www.cdc.gov
Institute for Healthcare Improvement
http://www.ihi.org

CANADIAN RESOURCES

Health Canada
https://www.canada.ca
Infection Prevention and Control Canada
https://ipac-canada.org

References

Catheter-associated urinary tract infection (CAUTI). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/catheter-associated-urinary-tract-infection-cauti . Accessed July 28, 2021.
Catheter-associated urinary tract infections (CAUTI). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hai/ca%5Futi/uti.html. Accessed July 28, 2021.
Flores-Mireles A, Hreha TN, et al. Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Top Spinal Cord Inj Rehabil. 2019;25(3):228-240.

Revision Information

  • Reviewer: EBSCO Medical Review Board Dan Ostrovsky, MD
  • Review Date: 07/2021
  • Update Date: 07/28/2021