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

Definitions and Diagn...

CA-ASB in patients with indwelling urethr...


...n a man with a condom catheter is defined b...


...3 in patients with indwelling urethral, indwell...


...and symptoms compatible with CA-UTI inc...

...ts with spinal cord injury, increased spastici...


...heterized patient, pyuria is NOT di...

...ence, absence or degree of pyuria should NOT...

...ia accompanying CA-ASB should NOT be...

...pyuria in a symptomatic patient sugges...


...theterized patient, the presence or abse...


...reening for CA-ASB should NOT be done except i...

...selected clinical situations such as p...


The term "CA-bacteriuria" is used when no dist...


Strategies

Strategie...

...of Inappropriate Urinary Catheter...

Limiting Unnecessary Catheterizat...

...catheters should be placed only when t...

...ry catheters should not be used for the management...

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

...utions should require a physician’s order i...

...tions should consider use of portable bladde...

...scontinuation of Cat...

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

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

...CA-UTI. (A, II)65...

...ns should consider automatic stop-...


...es to Consider Prior to Catheter Inser...

...ection Prevention...

...als and long-term-care facilities should de...

...tegies should include education and training of...

...consider feedback of CA-bacteriuria rates to nu...

...sufficient to make a recommendation as to...

...Indwelling Urethral Catheterization...

...dom catheterization...

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

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

...rmittent catheterizatio...

...m or ( C , I )659...

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

short-term or ( C , I...

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

...ic catheterization...

CA-bacteriuria and ( B , I )65...

...TI. ( C , III )65...

...ique for Indwelling Urethral Catheter...

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

...ermittent Catheterization Techniqu...

...n (non-sterile) rather than sterile te...

and institutional ( B , I...

...iple-use catheters may be considered i...

...tutional ( C , I )659...

...catheters are NOT recommended for routin...

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

...obial-Coated Catheters...

...patients with short-term indwelling ure...


...on Strategies to Consider After Catheter...

Closed Catheter Sys...

...sed catheter drainage system, with ports...

...A-UTI ( A , III )65...

...s with short-term indwelling urethral o...

..., III )in patients with long-term indw...

...ion-specific strategies should be developed to...

...hat the drainage bag and connecting tube are al...

...a preconnected system (catheter preattached to...

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

...-UTI. ( A , III...

...rophylaxis

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

...g-term ( A , II )65...

...thenamine salts should NOT be used...

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

...amine salts may be considered for the reducti...

...using a methenamine salt to reduce CA-UTI, the u...

...roducts should NOT be used routinely to red...

Enhanced Meatal Car...

...aily meatal cleansing with povidone-iodine solutio...

...eter Irrigation...

...teriuria or ( A , I...

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

...irrigation with antimicrobials may be considere...

...irrigation with normal saline should...

...icrobials in the Drainage Bag...

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

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

...ne Catheter Change...

...sufficient to make a recommendation a...

...ophylactic Antimicrobials at Time of...

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

...atheter removal or ( B , I )659...

...cement ( A , III )659...

...and Treatment of CA-ASB in Catheterized Pati...

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

...erm ( A , I )659

...d treatment of CA-ASB are NOT reco...

...atheterized patients ( A , III )659...

...in pregnant women ( A , III )659...

...nd patients undergoing urologic procedures fo...

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

...ntimicrobial treatment of CA-ASB that persists 48...

Urine Culture and Catheter Replacement Befo...

...urine specimen for culture should be obtai...

...atheter can be discontinued, a voided mid...

...ndwelling catheter has been in place...

...e should be obtained from the fresh...

...e catheter can be discontinued, a voided mids...

...ation of Treatment...

...tients with CA-UTI who have prompt resol...

...14 days is recommended in those with a delaye...

...imen of levofloxacin may be considered in pat...

...-day antimicrobial regimen may be considered...

...ure 1. Urinary Catheters...