Learning About Catheter-Linked Urinary Tract Infections

A catheter-linked urinary tract infection (CAUTI) is an infection of the urinary tract. It's caused by bacteria that get into the tract when a urinary catheter is used. This is a tube that's placed into the bladder to drain urine.

This tract includes the kidneys, ureters, bladder, and urethra. The kidneys filter blood and make urine. The ureters carry urine from the kidneys to the bladder. The bladder stores urine. The urethra carries urine from the bladder to the outside of the body.

A urinary catheter is a thin, flexible tube. It's placed in the bladder to drain urine. Urine flows through the tube into a bag outside of the body. There are different types of urinary catheters. The most common type is an indwelling catheter. This is also known as a urethral catheter. This is because it's placed into the bladder through the urethra. It's also called a Foley catheter.

A urinary catheter is needed when:

• You can't move around for a long time after surgery or injury.
• You have a surgery that requires you to be under anesthesia for a long time.
• You have a blockage in your urinary system.
• Your doctor needs to precisely measure the amount of urine you pass.
• The function of your kidneys and bladder is being tested.

In most cases, the catheter is short-term. You'll need it only until the problem that needs it is taken care of.

Bacteria can get into the urinary tract as the catheter is put into the urethra. Bacteria can also get in while the catheter is in place. The common bacteria that cause a CAUTI are ones that live in the intestine. These bacteria don't normally cause problems in the intestine. But when they get into the urinary tract, an infection can occur.

Left untreated, a CAUTI can lead to health problems. These may include infections of the bladder, prostate, and kidney. A CAUTI can keep you in the hospital longer. If the infection is not treated in time, you may have serious health problems.

Tell a doctor or seek medical care right away if you or a loved one has:

• A burning feeling, pressure, or pain in the lower belly.
• A fever or chills.
• Urine in the collecting bag that is cloudy or bloody (pink or red).
• A burning feeling in the urethra or genital area.
• Aching in the back (by the kidneys).
• Nausea and vomiting.
• Confusion, sleepiness, or a change in behavior. (This mainly affects older people.)

Sometimes you may not have any symptoms. But you may still have a CAUTI.

Your doctor will order tests if you have symptoms. These may include a urine test and blood tests.

Treatment may involve:

• Antibiotics. Your doctor will likely prescribe antibiotics if you have symptoms. If you don't have symptoms, you may not get antibiotics. This is to prevent an increase in bacteria that can't be killed by certain antibiotics.
• Removing the catheter. The catheter will be taken out when your doctor decides it's no longer needed. This often helps stop the infection.
• Changing the catheter. If you still need a catheter, the old one will be taken out. A new one will be put in. This may help stop the infection.

To keep patients from getting a CAUTI, staff members will:

• Prescribe a catheter only when it's needed. It's taken out as soon as it's no longer needed.
• Wash their hands or use an alcohol-based hand cleanser before they do catheter care.
• Use a clean (sterile) method when placing the catheter into the urinary tract. They will wash their hands with soap and water before they put the catheter in. Then they will put on sterile gloves. They will use a sterile catheter kit that has cleansers to clean the genital area.
• Hang the bag lower than your bladder. This helps stop urine from flowing back into your bladder.
• Check that the bag is emptied when needed.
• Do clean intermittent catheterization. This means that a catheter is put in so you can urinate. It's then taken out right away. It may be done several times a day.

Here are some things you can do to help prevent a CAUTI.

• Every day, ask your doctor how long you need to have the catheter. The longer you have it, the higher your chance of getting a CAUTI.
• Ask a caregiver to clean their hands and put on gloves before they touch your catheter.
• If you've been taught how to care for your catheter, wash your hands before and after each session.
• Check that your bag is lower than your bladder. If it's not, tell your caregiver.
• Don't disconnect the catheter and drain tube. Doing so lets germs get into the catheter.
• Cleaning the genital and perineal areas is very important. It helps decrease bacteria around the catheter. Ask your doctor what you should use and how often to clean these areas.

• Before you leave the hospital, make sure you know how to care for your catheter at home.
• Ask your doctor how long you need the catheter. Ask if you need to make a follow-up appointment to have it taken out.
• Always use a clean (sterile) method when caring for your catheter. Wash your hands before and after doing any catheter care.
• Contact your doctor or seek medical care right away if you have symptoms of a CAUTI (see above).