Prevention of Catheter-Associated Urinary Tract Infections (CAUTI)

Publication Date: December 1, 2009
Last Updated: March 14, 2022

Recommendations

Appropriate Urinary Catheter Use

Insert catheters only for appropriate indications (see Table 2 for guidance), and leave in place only as long as needed. (Category IB)
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  • Minimize urinary catheter use and duration of use in all patients, particularly those at higher risk for CAUTI or mortality from catheterization such as women, the elderly, and patients with impaired immunity.
(Category IB)
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  • Avoid use of urinary catheters in patients and nursing home residents for management of incontinence.
(Category IB)
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  • Further research is needed on periodic (e.g., nighttime) use of external catheters (e.g., condom catheters) in incontinent patients or residents and the use of catheters to prevent skin breakdown.
(Recommendation for further research)
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  • Use urinary catheters in operative patients only as necessary, rather than routinely.
(Category IB)
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  • For operative patients who have an indication for an indwelling catheter, remove the catheter as soon as possible postoperatively, preferably within 24 hours, unless there are appropriate indications for continued use.
(Category IB)
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Consider using alternatives to indwelling urethral catheterization in selected patients when appropriate. ()
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  • Consider using external catheters as an alternative to indwelling urethral catheters in cooperative male patients without urinary retention or bladder outlet obstruction.
(Category II)
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  • Consider alternatives to chronic indwelling catheters, such as intermittent catheterization, in spinal cord injury patients.
(Category II)
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  • Intermittent catheterization is preferable to indwelling urethral or suprapubic catheters in patients with bladder emptying dysfunction.
(Category II)
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  • Consider intermittent catheterization in children with myelomeningocele and neurogenic bladder to reduce the risk of urinary tract deterioration.
(Category II)
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  • Further research is needed on the benefit of using a urethral stent as an alternative to an indwelling catheter in selected patients with bladder outlet obstruction.
(Recommendation for further research)
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  • Further research is needed on the risks and benefits of suprapubic catheters as an alternative to indwelling urethral catheters in selected patients requiring short- or longterm catheterization, particularly with respect to complications related to catheter insertion or the catheter site.
(Recommendation for further research)
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Proper Techniques for Urinary Catheter Insertion

Perform hand hygiene immediately before and after insertion or any manipulation of the catheter device or site. (Category IB)
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Ensure that only properly trained persons (e.g., hospital personnel, family members, or patients themselves) who know the correct technique of aseptic catheter insertion and maintenance are given this responsibility. (Category IB)
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In the acute care hospital setting, insert urinary catheters using aseptic technique and sterile equipment. (Category IB)
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  • Use sterile gloves, drape, sponges, an appropriate antiseptic or sterile solution for periurethral cleaning, and a single-use packet of lubricant jelly for insertion.
(Category IB)
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  • Routine use of antiseptic lubricants is not necessary.
(Category II)
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  • Further research is needed on the use of antiseptic solutions vs. sterile water or saline for periurethral cleaning prior to catheter insertion.
(Recommendation for further research)
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In the non-acute care setting, clean (i.e., non-sterile) technique for intermittent catheterization is an acceptable and more practical alternative to sterile technique for patients requiring chronic intermittent catheterization. (Category IA)
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  • Further research is needed on optimal cleaning and storage methods for catheters used for clean intermittent catheterization.
(Recommendation for further research)
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Recommendation Grading

Overview

Title

Prevention of Catheter-Associated Urinary Tract Infections (CAUTI)

Authoring Organization

Publication Month/Year

December 1, 2009

Last Updated Month/Year

January 4, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Long term care

Intended Users

Social worker, nurse, nurse practitioner, physician, physician assistant

Scope

Prevention, Management, Treatment

Diseases/Conditions (MeSH)

D014552 - Urinary Tract Infections, D055499 - Catheter-Related Infections

Keywords

urinary catheter, catheter-associated urinary tract infection (CAUTI), catheter-associated urinary tract infection

Supplemental Methodology Resources

Evidence Tables

Methodology

Number of Source Documents
281
Literature Search Start Date
July 1, 2007
Literature Search End Date
July 1, 2008