Catheter-associated Urinary Tract Infection

Abstract

Catheter-associated urinary tract infection (CAUTI) is the most commonly occurring nosocomial infection worldwide, accounting for approximately 40% of all hospital acquired infections. A fair number of hospitalized patients undergo insertion of a urinary catheter at some point during their stay, and the use of indwelling urinary catheters appears to be increasing. Instrumentation of the urinary tract is always a high risk factor for CAUTI. A urinary catheter compromises the normal protective mechanisms of the urinary tract and enables bacterial colonization/biofilm formation on the catheter surface. Bacteriuria may progress toward CAUTI, which has been associated with increased morbidity, mortality, hospital cost, and duration of stay. Unfortunately, many physicians are not aware of appropriate indications for use of indwelling urethral catheters as well as accurate criteria for CAUTI. These conditions could result in superfluous catheterization, a potential source of CAUTI, leading to unnecessary use of antimicrobials for treatment of asymptomatic bacteriuria, resulting in emergence of resistant organisms. We discuss the overall view of CAUTI: definition, pathophysiology, pathogenesis, treatment, and prevention, mainly including descriptions associated with the indwelling urethral catheter.