Catheter Associated Uti

Definition of Catheter Associated Uti

A catheter associated urinary tract infection (UTI) is an infection of the bladder. This type of UTI is caused by using a urinary catheter. A urinary catheter is a thin tube that is placed through the urethra to drain urine from the bladder. A urinary catheter is used:

• during and after some surgeries
• to collect a urine specimen
• to monitor accurate urine output
• when the bladder is not working due to illness or injury

What is going on in the body?

When a urinary catheter is put into the bladder, there is a chance that bacteria may be introduced. This may occur if:

• the catheter is inserted under unsterile conditions
• the normal bacteria on the skin outside spread up the tube after it is inserted into the bladder (where it is not normal to have bacteria)

The bacteria multiply in the bladder and cause a urinary tract infection.

What are the signs and symptoms of the infection?

Only 20% to 30% of people with catheter associated UTI's have symptoms. When symptoms are present, they may include:

• painful urination
• the frequent need to urinate right away
• blood in the urine
• fever
• flank pain (in the back of the body, between the ribs and hips)

What are the causes and risks of the infection?

The risk of getting catheter associated UTI are increased in:

• females
• older people
• someone with an underlying illness

The risk increases the longer the urinary catheter is kept in place.

What can be done to prevent the infection?

The best way to prevent catheter associated UTI's is to:

• have the urinary catheter removed as soon as possible.
• use intermittent catherization rather than leaving the urinary catheter in place continuously. With intermittent catheterization, the catheter is removed as soon as urine is drained from the bladder. Intermittent catheterization is done several times each day.
• be sure the catheter is inserted under sterile conditions
• apply an antibacterial ointment at the opening of the urethra
• place the urinary drainage bag below the level of the bladder so that urine can flow easily into it

How is the infection diagnosed?

A catheter associated urinary tract infection is diagnosed by obtaining a urine specimen and sending it to the laboratory for a urine culture.

What are the long-term effects of the infection?

Untreated urinary tract infections can spread further up the urinary tract to the kidney where the infection is called pyelonephritis. A UTI can also lead to becteremia, a condition where bacteria enter the bloodstream. This can be a life threatening illness.

What are the risks to others?

A catheter associated urinary tract infection is not contagious.

What are the treatments for the infection?

A catheter associated UTI is treated with antibiotics. The antibiotic chosen will depend on the type of the bacteria found in the urine. If a fever is present, acetaminophen (i.e., Tylenol) or aspirin should be given. The urinary catheter should be removed as soon as possible.

What are the side effects of the treatments?

All medications have side effects and may cause allergic reactions. Antibiotics can cause stomach upset as well as other symptoms.

What happens after treatment for the infection?

A urine culture should be done at the end of the antibiotic therapy, to make sure the infection has cleared up.

How is the infection monitored?

If a person has a long-term urinary catheter in place, urine specimens should be obtained periodically to check for any bacteria in the urine. Any new or worsening symptoms should be reported to the healthcare provider.