Catheter associated urinary tract infection
Introduction: A urinary tract infection is an infection, most commonly caused by E. coli, of either the lower or upper urinary tract. Urinary tract infections are the most common hospital acquired infection and the majority of the urinary tract infections acquired are associated with an indwelling urinary catheter. Recently, hospitals and other healthcare facilities have taken a special interest in the prevention of catheter associated urinary tract infections which is likely due to recent healthcare reforms. Facilities will usually have to cover the cost of any hospital acquired catheter associated urinary tract infection, hence why most ...view middle of the document...
The infection can be caused during insertion with unclean equipment, or after insertion if the catheter is left in place.
Diagnosis: The primary diagnosis of CAUTI is by finding bacteria in the urine, along with an elevated white blood cell count after a urinalysis. However, there are other symptoms that are associated with a UTI. The patient may experience pain or a burning sensation in their bladder or urethra, they may experience fever, malaise, hematuria, bladder spasms or leakages, catheter obstruction, change in mental status, a change in urine color or a foul odor from their urine.
Risk Factors: Some individuals are more at risk to obtain CAUTI than others. Risk factors increase if the person is female, pregnant, malnourished, diabetic, or if the person has other sites of infections or has an immunodeficiency. Also, how equipment is used can increase risk factors. If the catheter is left in place for extended periods of time, not inserted with sterile technique, or not positioned correctly. You want the tubing and drainage bag below the patient’s bladder so there isn’t any backflow.
Treatment: As stated before, the facility in which the CAUTI was obtained will have to pay for the treatment. Antibiotics are the usual treatment for urinary tract infections. The facility will need to do a culture and sensitivity test of the microbes in the urine to identify the microorganism causing the infection. A choice of treatment with oral or parenteral antimicrobial drugs will be based on the results of the tests.
Prevention: Prevention is the best method when dealing with CAUTI. There are many techniques and methods which will decrease the chances of your patient acquiring CAUTI, but it is always best to seek information from your facilities polices first. Some general principles of prevention include; Only catheterizing a patient if it is necessary, using sterile technique while performing insertion of a urinary catheter, use a catheter with the smallest size lumen possible, minimize the duration of the catheterization, maintain a closed drainage system, keep the tubing and collection bag below the patient’s bladder, routine perineal and catheter care in individuals with long-term catheterization.
Appropriate catheter use is important in the prevention of CAUTI. You should only insert a catheter for appropriate indications and only leave it in as long as needed. Indications for catheter use include; acute urinary retention or bladder...