Catheter-associated Urinary Tract Infections

Abstract

Catheter-associated urinary tract infections (CAUTIs) are a major source of nosocomial infections and represent a significant burden in morbidity and costs. Although several different approaches to disease prevention are being investigated, the most effective methods of prevention are to avoid unnecessary catheterisations and to remove catheters as soon as possible. An optimal catheter material or coating is still awaited. The growing number of publications regarding implementation of reminder systems and infection control programs shows the importance of these measures, which can effectively decrease the rate of CAUTIs. Systemic antibiotic prophylaxis is not recommended for long-term indwelling catheterisation. Treatment of catheter-related asymptomatic bacteriuria should be avoided, as this may increase the rate of antibiotic resistance without eradicating the bacteria. Systemic antibiotic treatment is indicated only for symptomatic CAUTIs. Alternative methods of urinary drainage may be preferable to indwelling urethral catheterisation. Evidence-based catheter management and treatment of CAUTIs are mandatory. Patient summaryThis review summarises different management options for the prevention and treatment of catheter-associated urinary tract infections. Treatment for bacteria in catheterised urine in the absence of symptoms should be avoided, as this may increase the rate of antibiotic resistance without eradicating the bacteria. Systemic antibiotic treatment is indicated only for symptomatic infections. The most effective methods of prevention are to avoid unnecessary catheterisation and to remove catheters as soon as possible.