Catheter-Associated Bacteriuria

Publication Date: March 1, 2010

Key Points

Key Points

Catheter-associated (CA)-bacteriuria is the most common healthcare-associated infection in hospitals and long-term care facilities worldwide.

Many episodes of CA-bacteriuria are preventable.

The most effective way to reduce CA-ASB and CA-UTI is to reduce urinary catheterization by restricting use to patients who have clear indications and by removing the catheter as soon as it is no longer needed.

Table 1. Acceptable Indications for Indwelling Urinary Catheter Use

Having trouble viewing table?

Clinically significant urinary retention

Temporary relief or longer term drainage if medical therapy is not effective and surgical correction is not indicated.

Urinary incontinence

For comfort in a terminally ill patient.

If less invasive measures (behavioral and pharmacological interventions, incontinence pads) fail and external collecting devices are not an acceptable alternative.

Accurate urine output monitoring required

Frequent or urgent monitoring needed, such as critically ill patients.

Patient unable or unwilling to collect urine

During prolonged surgical procedures with general or spinal anesthesia.

Selected urological and gynecological procedures in the perioperative period.


Definitions and Diagnosis

...ions and Diagnosi...

...patients with indwelling urethral,...


...in a man with a condom catheter is defined by the...


...ients with indwelling urethral, in...


...symptoms compatible with CA-UTI include...

...patients with spinal cord injury, increased...


...the catheterized patient, pyuria is NOT...

...esence, absence or degree of pyuria...

Pyuria accompanying CA-ASB should NOT be inter...

...ence of pyuria in a symptomatic patient su...


...rized patient, the presence or absenc...


...CA-ASB should NOT be done except in research...

...in selected clinical situations suc...


The term "CA-bacteriuria" is used when...


Strategies

Strategie...

...ion of Inappropriate Urinary Catheter Inse...

...imiting Unnecessary Cathe...

...lling catheters should be placed only...

...elling urinary catheters should not be u...

...should develop a list of appropriate indi...

...titutions should require a physicia...

...should consider use of portable b...

...tinuation of Catheter...

...isk of CA-bacteriuria (A, I)659...

...-UTI, (A, II)659...

...d CA-UTI. (A, II)...

...ould consider automatic stop-orders to...


...es to Consider Prior to Catheter Insertio...

Infection Prev...

...spitals and long-term-care facilities should devel...

...gies should include education and tra...

...tions may consider feedback of CA-bacteriuria ra...

...are insufficient to make a recommendation as to wh...

...tives to Indwelling Urethral Catheterization...

...catheterization...

...o short-term and ( A , II...

...erm ( B , II )659...

...ntermittent catheteriz...

short-term or ( C...

...ong-term ( A , III )...

...erm or ( C , III )659...

...term ( A , III )659...

...prapubic catheteriza...

...A-bacteriuria and ( B , I )6...

...( C , III )659...

...echnique for Indwelling Urethral Catheter...

...lling urethral catheters should be inserted...

...ent Catheterization Technique...

...-sterile) rather than sterile tech...

...utional ( B , I )659...

Multiple-use catheters may be considered instea...

...d institutional ( C ,...

...ic catheters are NOT recommended for...

...CA-UTI. ( B , II )659...

...ntimicrobial-Coated Catheter...

In patients with short-term indwelling urethra...


...ategies to Consider After Catheter I...

...d Catheter System...

...atheter drainage system, with ports in the di...

...-UTI ( A , III )6...

...ith short-term indwelling urethral or su...

...UTI ( A , III )in patients with long-t...

...ution-specific strategies should be...

and that the drainage bag and connect...

...a preconnected system (catheter preattached t...

...acteriuria or ( A , I )...

...-UTI. ( A , III )659...

Prophyla...

...rt- ( A , III )659...

...g-term ( A , II )659...

...salts should NOT be used routinely to reduce CA-...

...nic indwelling urethral or suprapubic ( A ,...

...henamine salts may be considered for the reduc...

...ing a methenamine salt to reduce CA-U...

...roducts should NOT be used routinely to reduce CA-...

...nced Meatal Car...

...tal cleansing with povidone-iodine solut...

...eter Irrigation

...cteriuria or ( A , I )659...

...UTI ( A , II...

...ter irrigation with antimicrobials may...

...irrigation with normal saline should...

...als in the Drainage Bag...

...eriuria or ( A , I )659...

.... ( A , I )659...

...tine Catheter Chan...

...ufficient to make a recommendation as to...

...c Antimicrobials at Time of Catheter Removal...

...of catheter placement to reduce CA-UTI...

...t the time of catheter removal or ( B , I )...

...cement ( A , III )6...

...g and Treatment of CA-ASB in Catheteri...

...rm or ( A , II )659...

long-term ( A , I...

...ing and treatment of CA-ASB are NOT recomm...

...er catheterized patients ( A ,...

...pregnant women ( A , III )...

...ergoing urologic procedures for which visible m...

...eening and Treatment of CA-ASB at Catheter Remov...

...eatment of CA-ASB that persists 48 h...

...e Culture and Catheter Replacement...

...ecimen for culture should be obtain...

...f the catheter can be discontinued, a void...

...ling catheter has been in place for more than 2 w...

...ne culture should be obtained from the freshly pla...

...catheter can be discontinued, a voided m...

...ion of Treatment...

...h CA-UTI who have prompt resolution of...

...ays is recommended in those with a delay...

...n of levofloxacin may be considered in patients w...

...y antimicrobial regimen may be considered for...

Figure 1. Urinary...