cauti

Catheter-associated urinary tract infection (CAUTI) is a urinary tract infection that occurs in a patient with an indwelling urinary catheter or who has recently had one removed. It is among the most common healthcare-associated infections, especially in hospital and long-term care settings. CAUTI typically arises from bacterial colonization of the catheter surface and bladder, with biofilm formation facilitating infection and persistence.

Risk factors include prolonged catheterization, older age, diabetes, immune suppression, female sex, recent urinary tract infection, and frequent catheter manipulations. Systemic infection may develop if the bacteria spread beyond the bladder.

Clinical presentation in catheterized patients can be non-specific. Fever, malaise, or delirium may occur; localized suprapubic discomfort is less reliable due to the catheter. Diagnosis relies on symptoms compatible with UTI and a positive urine culture in the setting of catheter use.

Prevention emphasizes avoiding unnecessary catheterization, prompt removal, aseptic insertion, and maintaining a closed drainage system; regular catheter care and minimal manipulation reduce risk. Alternatives such as intermittent catheterization or non-catheter strategies should be used when possible.

Treatment involves removing or replacing the catheter if needed, obtaining cultures to guide antibiotic choice, and using targeted antibiotics for symptomatic CAUTI. Asymptomatic bacteriuria is generally not treated. Duration follows guidelines and clinical response.

CAUTIs contribute to longer hospital stays, higher costs, and increased antimicrobial resistance. Guidelines from organizations such as the CDC and IDSA stress stewardship and prompt, appropriate catheter management to lower risk.