Diagnosis and Management of Catheter-Associated Urinary Tract Infection

Abstract

The widespread use of urinary catheters is associated with a rising number of catheter-associated infections (CA-UTI) and the approach to these infections presents a diagnostic challenge due to difficulty in differentiating this entity from catheter-associated asymptomatic bacteriuria (CA-ASB). This article reviews the current literature regarding diagnosis, microbiology, treatment, and prevention of CA-UTIs. Misconceptions surrounding diagnostic technique and indications for testing result in unneeded antimicrobial administration. Due to the substantial burden of CA-UTIs, much emphasis has been placed on prevention and the most successful prevention strategies are aimed at behavioral changes to minimize unnecessary catheterizations. There are significant clinical sequelae of CA-UTIs and they pose a substantial burden on the healthcare system. Clinicians must accurately diagnose and manage CA-UTIs to prevent unnecessary antibiotic use which often leads to increasing antimicrobial resistance. In an effort to prevent CA-UTIs, healthcare systems should focus on prevention of unnecessary urinary catheterizations or prompt removal of urinary catheters once they are no longer indicated.