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Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals

Published online by Cambridge University Press:  02 January 2015

Evelyn Lo ,
Lindsay Nicolle ,
David Classen ,
Kathleen M. Arias ,
Kelly Podgorny ,
Deverick J. Anderson ,
Helen Burstin ,
David P. Calfee ,
Susan E. Coffin  and
Erik R. Dubberke
...Show all authors
Evelyn Lo
Affiliation:
University of Manitoba, Winnipeg, Canada
Lindsay Nicolle
Affiliation:
University of Manitoba, Winnipeg, Canada
David Classen
Affiliation:
University of Utah, Salt Lake City
Kathleen M. Arias
Affiliation:
Association for Professionals in Infection Control and Epidemiology, Washington, D.C.
Kelly Podgorny
Affiliation:
Joint Commission, Oakbrook Terrace, Chicago
Deverick J. Anderson
Affiliation:
Duke University Medical Center, Durham, North Carolina
Helen Burstin
Affiliation:
National Quality Forum, Washington, D.C.
David P. Calfee
Affiliation:
Mount Sinai School of Medicine, New York, New York
Susan E. Coffin
Affiliation:
Children's Hospital of Philadelphia andUniversity of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Erik R. Dubberke
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Victoria Fraser
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Dale N. Gerding
Affiliation:
Loyola University Chicago Stritch School of Medicine, Chicago Hines Veterans Affairs Medical Center, Hines, Illinois
Frances A. Griffin
Affiliation:
Institute for Healthcare Improvement, Cambridge
Peter Gross
Affiliation:
Hackensack University Medical Center, Hackensack, New Jersey University of Medicine and Dentistry–New Jersey Medical School, Newark, New Jersey
Keith S. Kaye
Affiliation:
Duke University Medical Center, Durham, North Carolina
Michael Klompas
Affiliation:
Brigham and Women's Hospitaland Harvard Medical School, Boston, Massachusetts
Jonas Marschall
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Leonard A. Mermel
Affiliation:
Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
David A. Pegues
Affiliation:
David Geffen School of Medicine at the University of California, Los Angeles
Trish M. Perl
Affiliation:
Johns Hopkins Medical Institutions and University, Baltimore, Maryland
Sanjay Saint
Affiliation:
Ann Arbor Veterans Affairs Medical Center and theUniversity of Michigan Medical School, Ann Arbor, Michigan
Cassandra D. Salgado
Affiliation:
Medical University of South Carolina, Charleston
Robert A. Weinstein
Affiliation:
Stroger (Cook County) Hospital andRush University Medical Center, Chicago
Robert Wise
Affiliation:
Joint Commission, Oakbrook Terrace, Chicago
Deborah S. Yokoe
Affiliation:
Brigham and Women's Hospitaland Harvard Medical School, Boston, Massachusetts
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Extract

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.

1. Burden of CAUTIs

a. Urinary tract infection is the most common hospital-acquired infection; 80% of these infections are attributable to an indwelling urethral catheter.

b. Twelve to sixteen percent of hospital inpatients will have a urinary catheter at some time during their hospital stay.

c. The daily risk of acquisition of urinary infection varies from 3% to 7% when an indwelling urethral catheter remains in situ.

2. Outcomes associated with CAUTI

a. Urinary tract infection is the most important adverse outcome of urinary catheter use. Bacteremia and sepsis may occur in a small proportion of infected patients.

b. Morbidity attributable to any single episode of catheterization is limited, but the high frequency of catheter use in hospitalized patients means that the cumulative burden of CAUTI is substantial.

c. Catheter use is also associated with negative outcomes other than infection, including nonbacterial urethral inflammation, urethral strictures, and mechanical trauma.

Type
SHEA/IDSA Practice Recommendations
Information
Infection Control & Hospital Epidemiology , Volume 29 , supplement S1: A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals , October 2008 , pp. S41 - S50
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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