A catheter-associated urinary tract infection (CAUTI) is one of the most common infections a person can contract in the hospital, according to the American Association of Critical-Care Nurses (AACCA, 2012).
Indwelling catheters are the typical cause of this infection. An indwelling catheter is a tube inserted into your urethra. It drains urine from your bladder into a collection bag. You may need a catheter if you have had surgery or cannot control your bladder function.
A CAUTI has similar symptoms to a typical urinary tract infection (UTI). These include:
- cloudy urine
- blood in the urine
- strong urine odor
- urine leakage around your catheter
- pressure, pain, or discomfort in your lower back or stomach
- unexplained fatigue
CAUTIs can be difficult to diagnose in already-hospitalized patients because similar symptoms may be part of the patients’ original illnesses. In elderly patients, changes in mental status or confusion can be signs of a CAUTI.
If you have a catheter and notice any localized discomfort, tell your nurse or doctor right away.
Prompt treatment of a CAUTI is essential. An untreated UTI can lead to a more-serious kidney infection. In addition, patients with catheters may already have conditions that compromise their immune systems. Fighting off a CAUTI can cause further immune system stress. This makes patients more vulnerable to future infections.
Bacteria or fungi may enter your urinary tract via the catheter. There, they can multiply, causing an infection.
There are a number of ways infection can occur during catheterization. For example:
- the catheter may become contaminated upon insertion
- the drainage bag may not be emptied often enough
- bacteria from a bowel movement may get on the catheter
- urine in the catheter bag may flow backward into the bladder
- the catheter may not be regularly cleaned
Clean insertion and removal techniques can help lower the risk of a CAUTI. Daily catheter care is required as well. Catheters should not be left in longer than needed; longer use is associated with a higher risk of infection.
A CAUTI is diagnosed using a urine test. Urinalysis can detect blood cells in your urine. Their presence may signal an infection.
Another useful test is a urine culture. This test identifies any bacteria or fungi in your urine. Knowing what caused the infection can help your doctor treat it.
Sometimes, your bladder does not move urine out of your body quickly enough. This can happen even with a catheter. Retained urine is more likely to grow bacteria. Infection risk increases the longer urine stays in your bladder. Your doctor may recommend an imaging test, such as an ultrasound scan, of your bladder to see if you are retaining urine.
CAUTIs tend to be more resistant to treatment than other UTIs. This is true in general for hospital-acquired infections. CAUTIs are dangerous because they can lead to severe kidney infections. This makes prompt diagnosis and treatment vital for your long-term health.
Your doctor will likely prescribe antibiotics to kill off any harmful bacteria. In most cases, these will be oral antibiotics. However, you may be given intravenous (IV) antibiotics in the case of a severe infection. If the infection causes bladder spasms, your doctor may prescribe an anti-spasmodic to lessen bladder pain.
Increasing your fluid intake can also help you feel better by flushing bacteria from your urinary system. However, some fluids should be avoided. These include:
- citrus fruit juices
- caffeinated beverages, such as sodas
CAUTIs are one of the most common hospital-related infections. Therefore, many healthcare organizations place great emphasis on prevention.
Doctors should carefully consider whether a catheter is necessary. They should also remove a necessary catheter as soon as possible.
In addition, you or the hospital staff should:
- clean around the catheter each day
- clean the skin around the catheter each day
- keep the drainage bag below your bladder
- empty the drainage bag several times per day
- keep the catheter tube from kinking
- wash your hands before and after touching the catheter or drainage bag
- change the catheter at least once per month
Frequent hand washing and good hygiene practices on the part of hospital staff can help prevent CAUTIs.