CATHETER-ASSOCIATED URINARY TRACT INFECTIONS

"Catheter-associated urinary tract infections are the most       

frequent (accounting for about 35% of nosocomial infection)

but carry the lowest mortality rate and lowest cost." http://www.americansmadandangry.org

What is “catheter-associated urinary tract infection”?

An infection of the urinary system, including the bladder and

kidneys. Germs, for example, bacteria and yeast do not

normally live in these ares. If germs are introduced then an

infection could occur. If a patient has a catheter germs can

easlily travel along the catheter and cause this infection. If an

infection occurs while the catheter is in place this is called a

catheter-associated urinary tract infection.

What is a urinary catheter?

A tube placed in the bladder to help drain the bladder. Urine drains through the tube into a bag that collects the urine.

What are appropriate uses of a catheter?

• If patient has urinary retention or bladder obstruction
• Need for accurate measurements of urinary output
• Perioperative for certain surgical procedures          
• Patients who are having urologic surgeries
• Prolonged surgeries
• Patients who receive large doses of volume or diuretics during surgery
• To aide in healing of open sacral wounds or perineal wounds in incontinent patients
• Patient with unstable back/lumbar spine injuries and pelvic factures
• To improve comfort for end of life care

How do patients acquire catheter-associated urinary tract infections?

If germs enter the urinary tract they have the ability to cause infection. Many of the germs that cause UTIs are commonly found in the intestines that do not usually cause an infection. Germs may enter the urinary tract when the catheter is being placed by a healthcare member or if the catheter has been left in the bladder for an extended period of time.

“Once a catheter is placed, the daily incidence of bacteremia is 3-10%. From 10-30% of patients with short term catheterization, for instances 2-4 days, develop bacteremia and are asymptomatic. Form 90-100% of patients with long term catheterizations develop bacteremia.” http://emedicine.medscape.com

What are symptoms of urinary tract infections?

• Burning or pain in lower abdomen
• Burning during urination
• Fever
• Bloody urine
• Abnormal urine color (cloudy)               
• Frequency of urination
• Foul or strong urine odor
• Leakage of urine around the catheter site
• Flank pain
• Confusion and mental changes (especially in older adults)

Can catheter-associated urinary tract infections be treated?

Yes, usually with oral or IV antibiotics. First sign of UTI the catheter should be removed immediately.

The best practice is to minimize the use of catheters in ALL patients.

Discussion Question: What is healthcare doing to help prevent catheter-associated urinary tract infections?

References:

http://www.americansmadandangry.org

http://emedicine.medscape.com

http://www.cdc.gov

http://www.americansmadandangry.org