Catheter-related Urinary Tract Infections Research Articles

Prevention of healthcare associated infections: a descriptive study.

This study aims to verify whether there are, and to which degree, knowledge and adherence to guidelines on the prevention and control of healthcare associated infections by nursing staff. Study design. A descriptive study was conducted on a sample of nurses in the areas of medicine, surgery, and its own specialties of the Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico in Milan from 1st December 2015 to 29th February 2016. The knowledge of the nursing staff have been investigated through the use of questionnaires with anonymous self-reporting method; inspections in the wards using observational grids were carried out in order to verify adherence to best-practice principles. The data collected concern, both for the knowledge and for the practice, the following macro-areas: a) Cleaning, disinfection and sterilization, b) Hand hygiene, c) Standard and isolation precautions, d) Prevention of catheter-related urinary tract infections, e) Prevention of catheter-related bacteremia, f) Prevention of surgical site infections, g) Prevention of respiratory tract infections. Statistical analyzes were performed using Microsoft Office Excel and STATA software. 245 nurses from 16 wards were involved. In each wards 4 inspections were conducted. 128 completed questionnaires were returned, all considered for the analysis of data; the adhesion was 52.2%. The participants achieved an overall score of 15.0 ± 4.1 (mean ± SD) on a maximum achievable score of 23 and >75% of them have reached a sufficient level. Among the most positive results, it must be underlined that nurses have demonstrated a higher level of knowledge for hand hygiene, with >81% correct answers; that the lumens of central venous catheters, when not in use, were kept covered with a protective cap in more than 99% of cases; that, for patients bearers of urinary catheter, the urinary drainage bag was maintained below the level of the bladder, as recommended, in more than 91% of the cases. On the contrary, as a very negative result, we found the greatest knowledge gap as regards cleaning, disinfection and sterilization, with a number of incorrect answers approaching 50%; furthermore, 64% of nurses wore jewels on their wrists, and / or hands when in action; finally, the alcohol-based handrub device could be easily reached from at least one of the beds of the room in less than 13% of the cases. Some knowledge gaps and differences with respect to adherence to best-practice principles for the prevention and control of healthcare associated infections was highlight by the present study.

Evaluation of Risk Factors for Catheter-Related Urinary Tract Infections Caused by Carbapenem-Resistant Klebsiella pneumonia

Evaluation of Risk Factors for Catheter-Related Urinary Tract Infections Caused by Carbapenem-Resistant Klebsiella pneumonia

Catheter-related urinary nosocomial infections in intensive care units: An epidemiologic study in North of Iran.

Background:Urinary tract infection (UTI) is one of the most common infections in developing countries. The aim of this study was to investigate the incidence of nosocomial catheter- associated UTI and its related factors in hospitalized patients in intensive care units of hospitals affiliated to Mazandaran University of Medical Sciences, in 2014.Methods:This cross-sectional study was conducted on patients who were admitted in hospitals and urinary catheterization was performed for them. Beds of intensive care units were followed-up for the occurrence of catheter-associated UTI for 14 months. Data were analyzed using SPSS Version 16.Results:Our results showed that of the 1409 patients (11648 catheter - days), the incidence of catheter-related UTI was 18.2% (among 256 individuals) equals to 21.987 per 1,000 catheter - days. E. coli was the most important cause of UTI. The results show that the history of the underlying disease, duration of catheterization and perineal washing were significantly associated with the incidence of UTIs.Conclusion:The findings of this study show a high incidence of UTIs caused by catheters in ICU. The incidence of this infection increased hospital length of stay and hospital cost. It seems that the necessary use of urinary catheters and its reduced duration use can be effective in decreasing this incidence.

Device-Associated Healthcare-Associated Infections (DA-HAI) and the caveat of multiresistance in a multidisciplinary intensive care unit

BackgroundDevice-Associated Healthcare-Associated Infections (DA-HAI), including Ventilator-Associated Pneumonia (VAP), Central-Line-Associated Blood Stream Infection (CLABSI), and Catheter-Related Urinary Tract Infection (CAUTI), are considered as principal contributors to healthcare hazard and threat to patient safety as they can cause prolonged hospital stay, sepsis, and mortality in the ICU. The study intends to characterize DA-HAI in a tertiary care multidisciplinary ICU of a teaching hospital in eastern India. MethodsThis prospective outcome-surveillance study was conducted among 2157 ICU patients of a 760-bedded teaching hospital in Eastern India. Clinical, laboratory and environmental surveillance, and screening of HCPs were conducted using the US Centers for Disease Control and Prevention (CDC)’s National Healthcare Safety Network (NHSN) definitions and methods. ResultsWith 8824 patient/bed/ICU days and 14,676 device days, pooled average device utilization ratio was 1.66, total episodes of DA-HAI were 114, and mean monthly rates of DA-HAI, VAP, CLABSI, and CAUTI were 4.75, 2, 1.4, and 1.25/1000 device days. Most common pathogens isolated from DA-HAI patients were Klebsiella pneumoniae (24.6%), Escherichia coli (21.9%), and Pseudomonas aeruginosa (20.2%). All Acinetobacter baumanii, >80% K. pneumoniae and E. coli, and >70% P. aeruginosa were susceptible only to colistin and tigecycline. One P. aeruginosa isolate was panresistant. ConclusionMean rates of VAP, CLABSI, and CAUTI were 14.4, 8.1, and 4.5 per 1000 device days, which are comparable with Indian and global ICUs. Patients and HCPs form important reservoirs of infection. Resolute conviction and sustained momentum in Infection Control Initiatives are an essential step toward patient safety.

A Systematic Review of the Unintended Consequences of Clinical Interventions to Reduce Adverse Outcomes

This is a systematic review of the literature on unintended consequences of clinical interventions to reduce falls, catheter-related urinary tract infection, and vascular catheter-related infections in hospitalized patients. A systematic search of the literature was conducted in CINAHL and PubMed. We developed a screening tool and a two-stage screening process to identify relevant articles. Nine articles met inclusion criteria, and of those, 8 reported on interventions to reduce patient falls. Four studies reported a positive, unexpected benefit; 3 studies reported a negative, unexpected detriment; and 4 reported a perverse effect (different from what was expected). Three studies reported both positive and perverse effects arising from the intervention. In 4 of the studies, despite fall prevention interventions, patients fell while trying to get to the bathroom, suggesting that interventions to reduce one adverse outcome (i.e., CAUTI) may be associated with another outcome (i.e., patient falls). In some cases, there were positive outcomes for those who implemented and/or evaluated interventions. We encourage colleagues to collect and report data on possible unintended consequences of their interventions to allow a fuller picture of the relationship between intervention and all outcomes to emerge.

The Effectiveness of Clinical Reminder System Applied to Reduce Catheter-associated Urinary Tract Infection in Critically Ills

Background: Healthcare associated infections have been an important issue for patient's safety. The urinary catheters are invasive catheters frequently used in the critically ill patients, however, are also the major factors of catheter-related urinary tract infections. Objective: The purpose of this study is to evaluate the effectiveness of clinical reminder system for critically ills on preventing the catheter-associated urinary tract infections (CAUTIs). Methods: A pre-post quasi-experimental design study was conducted in a 42-bed medical-surgical ICU in a medical center. Study was divided into three phases. Phase I: To develop an evidence-based and expert opinion were collected to develop indications of catheter removal; Phases II: Control group data were collected. Phases III: Implantation of clinical reminder information system for removing urinary catheter, and then the experimental group data were collected. Results, Discussion & Conclusion: There were 104 patients in experimental group and 114 patients in control group. The study results revealed that the experimental group had a lower rate of CAUTI and catheterization days (p < .05). The results of this study provide reference for clinical nursing care personnel on catheter removal and improvement of the rate of CAUTI.

Device-associated infections in a paediatric intensive care unit in Pakistan

This study assessed the effect of implementation of active infection control and surveillance on the occurrence of device-associated infections (DAIs) in a paediatric intensive care unit (PICU) from 2012 to 2015. There were 1378 patients, equating to 4632 patient-days, on the PICU, and 29 DAI episodes, giving an incidence rate of 2.1% and an incidence density rate of 6.26 per 1000 patient-days. The rates of central-line-associated bloodstream infections, ventilator-associated pneumonia and catheter-related urinary tract infections were 7/1000 central-line-days, 1.17/1000 ventilator-days and 0.24/1000 urinary-catheter-days, respectively. Despite the overall low rate of DAIs in the PICU, there was a relatively high rate of central-line-associated bloodstream infections.

The problem with red, amber, green: the need to avoid distraction by random variation in organisational performance measures

‘The Problem with…’ series covers controversial topics related to efforts to improve healthcare quality, including widely recommended but deceptively difficult strategies for improvement and pervasive problems that seem to resist...

Characteristics of superinfections during treatment with tigecycline

Tigecycline has a broad-spectrum in vitro activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant (MDR) strains. However, some Gram-negative bacteria are intrinsically resistant or have reduced susceptibility to tigecycline.We performed a prospective, observational study of 43 patients who received tigecycline as the treatment for serious infections due to MDR Gram-negative microorganisms, to evaluate superinfections.In 60.5% of our patients, tigecycline-resistant (T-R) Gram-negative microorganisms were isolated, representing superinfection in 37.2% and colonization in 23.5%. Pseudomonas aeruginosa was the predominant pathogen (48.4%) followed by Providencia stuartii, Proteus mirabilis and Stenotrophomonas maltophilia. Median time elapsed between tigecycline prescription and isolation of T-R pathogens was 7 days. The 16 superinfections consisted of ventilator-associated pneumonias (43.75%), catheter-related bloodstream infections (37.5%), intra-abdominal infections (12.5%) and urinary tract infection (6.25%). Attributed mortality to superinfections was 31.25%. The comparison of various potential risk factors for isolation of T-R microorganisms did not reveal statistically significant results.

Invasive Device Related Nosocomial Infections in Adult Intensive Care Unit of an Oncology Hospital: Evaluation of Five Years

INTRODUCTION: Surveillance of invasive device related nosocomial infections is important for planning infection control procedures. We aimed to evaluate these infections in intensive care unit patients during the period between 2009 and 2013 and the effect of malignancy on mortality rates in this group. METHODS: Surveillance of nosocomial infections is done prospectively in our intensive care unit. The data of patients were recorded from our national surveillance system. The causative microorganisms of nosocomial infections were classified by conventional methods and verified by VITEK 2 automated system. “Centers for Diseases Control and Prevention” criteria were used to diagnose nosocomial infections. RESULTS: Mean nosocomial infection incidence in this period was 40,75/1000 patient days and 85-100% of them were invasive device related nosocomial infections. We found that the usage of central venous catheter and catheter related bloodstream infection rates were declined significantly during this period (p: 0,0005). Gram negative bacilli, especially Acinetobacter spp were the most common microorganisms that caused catheter related blood stream infections and ventilator associated pneumoniae. Gram negative bacilli and Candida spp. were the most common microorganisms causing catheter related urinary tract infections. Intensive care unit mortality rates were statistically higher in patients with malignancy than the others in 2013 (p:0,010). DISCUSSION AND CONCLUSION: We observed that catheter related blood stream infection rates were decreased during the study period while catheter related urinary tract infections and ventilator associated pneumoniae rates did not change during the study period. Acinetobacter baumannii is a serious problem in our intensive care unit. We observed that intensive care unit mortality rate is higher in patients with invasive device related nosocomial infections in the presence of malignancy.

Biodegradable hydrophilic polyurethane PEGU25 loading antimicrobial peptide Bmap-28: a sustained-release membrane able to inhibit bacterial biofilm formation in vitro.

Catheter-related infection makes up a large part of hospital infection and contributes 80% to all nosocomial urological infection, costing hundreds of millions dollar per year for treatment. Biodegradable hydrophilic material incorporating antibiotic substance is a promising way to prevent catheter-related infection. And antimicrobial peptide seems an optimal drug for its desirable antibiotic effect. In the current research, we produced a new kind of antibiotic material by incorporating antimicrobial peptide Bmap-28 with polyurethane PEGU25 and tested its effect on Proteus mirabilis in vitro. Compared with the control group, PEGU25 membrane incorporating Bmap-28 had a significant lower bacteria load after co-cultured with the Proteus mirabilis. And its antibiotic effect could be observed throughout the whole 7-day test. Also the Bmap-28 membrane could delay catheter obstruction caused by encrustation. Our findings reveal that PEGU25 incorporating Bmap-28 can well inhibit bacterial biofilm formation of common pathogens for catheter-related urinary tract infection in vitro, which makes it a promising antibiotic material for medical tubes for urology.

Role of duration of catheterization and length of hospital stay on the rate of catheter-related hospital-acquired urinary tract infections.

ObjectiveOur aim is to prove that duration of catheterization and length of hospital stay (LOS) are associated with the rate of hospital-acquired urinary tract infections (UTI), while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis on admission, associated comorbidities, age, sex, precautions that should be taken to avoid UTI, and comparison with other studies.MethodsThe study was done in a university teaching hospital with a 920-bed capacity; this hospital is a tertiary care center in Riyadh, Saudi Arabia. The study was done on 250 selected patients during the year 2010 as a retrospective descriptive study. Patients were selected as purposive sample, all of them having been exposed to urinary catheterization; hospital-acquired UTI were found in 100 patients. Data were abstracted from the archived patients’ files in the medical record department using the annual infection control logbook prepared by the infection control department. The data collected were demographic information about the patients, clinical condition (diagnosis and the LOS), and possible risk factors for infection such as duration of catheterization, exposure to invasive devices or surgical procedures, and medical condition.ResultsThere was a statistically significant association between the rate of UTI and duration of catheterization: seven patients had UTI out of 46 catheterized patients (15%) at 3 days of catheterization, while 30 patients had UTI out of 44 catheterized patients (68%) at 8 days of catheterization (median 8 days in infected patients versus 3 days in noninfected patients; P-value <0.05), which means that the longer the duration of catheterization, the higher the UTI rate. There was a statistically significant association between the rate of UTI and LOS: three patients had UTI out of 37 catheterized patients (8%) at 10 days LOS, while 42 patients had UTI out of 49 catheterized patients (85.7%) at 18 days LOS. The longer the LOS, the higher the UTI rate: LOS for each patient (median 18 days for infected patients versus 10 days for noninfected patients; P-value <0.05), and number of hospital-acquired catheter-related UTI (100 patients had UTI out of 250 catheterized patients, P=0.04).ConclusionReduction of the duration of catheterization and LOS of the patient have a positive impact in reduction of catheter-related UTI.

Evaluation of Fever in the Intensive Care Unit

Fever is a common and serious problem in patients in the intensive care unit (ICU), but its cause is sometimes difficult to determine. Such fevers may be infectious or noninfectious. Infectious causes include ventilator-associated pneumonia, intravascular catheter-related infection, surgical site infection, catheter-related urinary tract infection, and Clostridium difficile infection. Noninfectious causes include transfusion reaction, drug fever, acute pancreatitis, deep vein thrombosis, pulmonary embolism, adrenal insufficiency, and hyperthyroidism. The medical history should be reviewed carefully and a physical examination performed whenever fever occurs in patients in the ICU. (Korean J Med 2015;88:658-662)

Self-management intervention for long-term indwelling urinary catheter users: randomized clinical trial.

People using long-term indwelling urinary catheters experience multiple recurrent catheter problems. Self-management approaches are needed to avoid catheter-related problems. The aim was to determine effectiveness of a self-management intervention in prevention of adverse outcomes (catheter-related urinary tract infection, blockage, and accidental dislodgement). Healthcare treatment associated with the adverse outcomes and catheter-related quality of life was also studied. A randomized clinical trial was conducted. The intervention involved learning catheter-related self-monitoring and self-management skills during home visits by a study nurse (twice during the first month and at 4 months-with a phone call at 2 months). The control group received usual care. Data were collected during an initial face-to-face home interview followed by bimonthly phone interviews. A total of 202 adult long-term urinary catheter users participated. Participants were randomized to treatment or control groups following collection of baseline data. Generalized estimating equations were used for the analysis of treatment effect. In the intervention group, there was a significant decrease in reported blockage in the first 6 months (p = .02), but the effect did not persist. There were no significant effects for catheter-related urinary tract infection or dislodgment. Comparison of baseline rates of adverse outcomes with subsequent periods suggested that both groups improved over 12 months. A simple-to-use catheter problems calendar and the bimonthly interviews might have functioned as a modest self-monitoring intervention for persons in both groups. A simplified intervention using a self-monitoring calendar is suggested-with optimal and consistent fluid intake likely to add value.

Occurrence of catheter-associated urinary tract infection in critical care units

Background: Catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection. The etiological agents of which may be varied. Advancing age, debilitation, diabetes mellitus, duration of catheterization are the risk factors. Complications include prostatitis, epididymitis, cystitis, pyelonephritis and septicemia in high-risk patients, adding to hospitalization and morbidity. With this background the present study was undertaken Objectives: (1) To identify microbial pathogens associated with urinary tract infection (UTI) in catheterized patients from Intensive Care Units (ICU) (2) to determine the susceptibility pattern of these isolates to antimicrobial agents (3) to determine the effect of days of catheterization and UTI. Materials and Methods: Consecutive urine samples of 345 catheterized patients admitted in ICUs were included in the study. They were processed by standard microbiological procedures. Isolated organisms were speciated, and antibiotic susceptibility performed as per standard guidelines. Results: From the 345 urine samples of catheterized patients, 205 showed no growth and were found to be sterile. Bacterial growth was seen in 69 patients and fungal growth in 50 patients. Among the bacterial isolates, Escherichia coli were isolated in 39, followed by Klebsiella spp. 14. The other isolates included Pseudomonas spp., Group D streptococci and methicillin-resistant Staphylococcus aureus. In the fungal isolates, Candida glabrata was the most common isolate. High resistance was seen among Klebsiella isolates (nalidixic acid-86% and cefotaxime-86%). Conclusion: Development of CAUTI is common in critically ill patients. Emphasis should be placed on good catheter management and reducing the duration of catheterization rather than prophylaxis in order to reduce the incidence of catheter-related UTI. Culture and susceptibility testing play a vital role in the management if UTI occurs.

Retrospective Analysis of Never Events in Panniculectomy and Abdominoplasty Patients and Their Financial Implications

In 2008, the Centers for Medicare and Medicaid Service adapted a list from the National Quality Forum consisting of 10 hospital-acquired conditions, also known as never events. Deeming such events as preventable in a safe-hospital setting, reimbursement is no longer provided for treatments arising secondary to these events. A retrospective chart review identified 90 panniculectomy and abdominoplasty patients. The hospital-acquired conditions examined include surgical-site infections (SSI), vascular-catheter associated infections, deep venous thrombosis/pulmonary embolism, retained foreign body, catheter-related urinary tract infection, manifestations of poor glycemic control, falls and trauma, air embolism, pressure ulcers (stages III and IV), and blood incompatibility. Information regarding age, American Society of Anesthesiologists (ASA) classification, body mass index, smoking, and chemotherapy were collected. Patients were divided into 2 groups, namely, those who developed never events and those with no events. Of the 90 patients, 14 (15.5%) developed never events because of SSI. No events occurred in the remaining 9 categories. Statistically significant risk factors included American Society of Anesthesiologists classification, age, and diabetes mellitus. The most common never event was SSI. In light of the obvious prevalence of the risk factors in patients who develop these events, the question of whether never events are truly unavoidable arises. Despite this, awareness of the impact on patient care, health care and hospital reimbursement is vital to understanding the new paradigm of the "one size fits all."

Securing urethral catheters can help to reduce their complications

British Journal of Neuroscience NursingVol. 10, No. 4 CommentSecuring urethral catheters can help to reduce their complicationsSue WoodwardSue WoodwardSearch for more papers by this authorSue WoodwardPublished Online:26 Aug 2014https://doi.org/10.12968/bjnn.2014.10.4.162AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Billington A, Crane C, Jownally S, Kirkwood L, Roodhouse A (2008) Minimizing the complications associated with migrating catheters. Br J Community Nurs 13(11): 502–67 Link, Google ScholarDarouiche RO, Goetz L, Kaldis T, Cerra-Stewart C, AlSharif A, Priebe M (2006) Impact of StatLock securing device on symptomatic catheter-related urinary tract infection: a prospective, randomized, multicenter clinical trial. Am J Infect Control 34(9): 555–60 Crossref, Google ScholarFakih MG, Pena ME, Shemes S et al. (2010) Effect of establishing guidelines on appropriate urinary catheter placement. Acad Emerg Med 17(3): 337–40. doi: https://doi.org/10.1111/j.1553-2712.2009.00677.x Crossref, Google ScholarFisher J (2010) The importance of effective catheter securement. Br J Nurs 19(18): S14–8 Link, Google ScholarFreeman C (2009) Why more attention must be given to catheter fixation. Nurs Times 105(29): 35–6 Google ScholarNazarko L (2009) Providing effective evidence-based catheter management. Br J Nurs 18(7 Suppl): S4–S12 Link, Google ScholarOrme LA, Smith RJ, Berry JC (2008) Development and evaluation of CliniFix, a catheter/tubing fixation device. Br J Nurs 17(8): 544–9 Link, Google ScholarVaidyanathan S, Soni BM, Brown E, Singh G (2005) Erosion of urethra in female patients with spinal cord injury. Spinal Cord 43(7): 451 Crossref, Google ScholarWilson M (2013) Catheter lubrication and fixation: interventions. Br J Nurs 22(10): 566–9 Link, Google Scholar FiguresReferencesRelatedDetailsCited byManaging complications associated with the use of indwelling urinary catheters19 October 2020 | Nursing Standard, Vol. 35, No. 11Management of indwelling urinary catheters for people with learning disabilitiesLearning Disability Practice, Vol. 22, No. 4Urinary catheter securement: what are the options?19 October 2015 | Nursing and Residential Care, Vol. 17, No. 11Urine-drainage leg bags: an overview9 October 2015 | British Journal of Nursing, Vol. 24, No. Sup18Assessing and treating urinary incontinence in men4 June 2015 | British Journal of Community Nursing, Vol. 20, No. 6 2 August 2014Volume 10Issue 4ISSN (print): 1747-0307ISSN (online): 2052-2800 Metrics History Published online 26 August 2014 Published in print 2 August 2014 Information© MA Healthcare LimitedPDF download

Hospital-acquired Urinary Tract Infections in Patients with Diabetes and Urinary Catheterization

Objective Urinary tract infection (UTI) is the most common hospital-acquired infection. Foley catheter-related UTI is associated with increased mortality, morbidity, length of hospital stay, and costs. Few studies have compared the pathogens by bacterial strains, resistance to antibiotics, comorbidities, and related risk factors in hospital-acquired UTI patients with or without diabetes and with or without a Foley catheter. The objective of this study was to compare the variables of hospital-acquired UTI between these two groups. Methods In this retrospective chart review study, we included hospital-acquired UTI patients (hospitalization time > 48 hours) with either diabetes or a Foley catheter from a medical center in Taipei (Taiwan) between January 1, 2011 and December 31, 2012. We excluded patients with positive urine culture for bacteria within 48 hours of admission. Clinically related information was collected using case data sheets. Results We analyzed 595 patients with hospital-acquired UTI; the infection rate of hospital-acquired UTI in our study was significantly higher in patients with a urinary catheter (n = 497) than in those without (p Conclusion Unlike having diabetes, having a urinary catheter was a significant risk factor for hospital-acquired UTI (p

Manage catheter-related urinary tract infection in the elderly in long-term care by limiting catheter use and avoiding the inappropriate use of antimicrobials

Elderly residents of long-term care facilities often require chronic indwelling catheterization for the management of urinary voiding. As a result of urethral catheterization, residents are bacteriuric, primarily due to biofilm formation along the catheter, and may develop symptomatic urinary tract infection (UTI). To avoid the development of resistance, UTI should be treated with short courses of appropriate antimicrobials. Strategies, including avoiding the use of catheters whenever possible, should be followed to prevent and manage catheter-related UTI in elderly long-term care residents.

An update on prevention and treatment of catheter-associated urinary tract infections

Catheter-related urinary tract infections (UTIs) are among the most important nosocomial infections. This review summarizes the latest advances in the field of catheter care and the management of catheter-associated UTIs. The most efficient methods to prevent catheter-associated UTIs are to avoid unnecessary catheterizations and to remove catheters as soon as possible. The use of different reminder systems and implementation of infection control programs can effectively decrease catheter-associated UTIs, although their introduction can be challenging. There is still no evidence to support the routine use of antimicrobial-impregnated catheters, but the use of hydrophilic-coated catheters for clean intermittent catheterization can effectively reduce infections. Preliminary results with chlorhexidine-coated catheters are promising. In cases of serious catheter-associated UTI in patients with a history of previous antibiotic therapy or healthcare-associated bacteraemia, empirical antibiotic treatment should be initiated with activity against multiresistant uropathogens. Suprapubic catheterization is not superior to urethral catheters in terms of reducing the rate of catheter-related bacteriuria. A technology to prevent catheter-associated UTIs is still not available; however, there are promising results with new approaches such as the use of reminder systems and infection control programs, which can effectively decrease the rate of catheter-associated UTIs. There is evidence supporting the use of hydrophilic coated catheters for clean intermittent catheterization, but an optimal catheter material or coating still has to be developed. Evidence-based catheter management is crucial for every patient in need of a catheter.