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 urinary tract when a urinary catheter is used. This is a tube that’s placed into the bladder to drain urine.

The urinary tract

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.

What is a urinary catheter?

A urinary catheter is a thin, flexible tube. It's placed in the bladder to drain urine. Urine flows through the tube into a collecting 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 small balloon keeps the catheter in place inside the bladder.

Why is a urinary catheter needed?

A urinary catheter is needed for any of these:

• 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 healthcare provider needs to precisely measure the amount of urine you pass.

• The function of your kidneys and bladder is being tested.

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

How does a CAUTI develop?

Bacteria can get into the urinary tract as the catheter is put into the urethra. Bacteria can also get into the urinary tract 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.

Why is a CAUTI of concern?

Left untreated, a CAUTI can lead to health problems. These problems 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.

What are the symptoms of a CAUTI?

Tell a healthcare provider or seek medical care right away if you or a loved one has any of these symptoms:

• A burning feeling, pressure, or pain in your lower belly (abdomen)

• Fever or chills

• Urine in the collecting bag that is cloudy or bloody (pink or red)

• Burning feeling in the urethra or genital area

• Aching in your back (by the kidneys)

• Nausea and vomiting

• Confusion, sleepiness, or a change in behavior (mainly affects older people)

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

How is a CAUTI diagnosed?

Your healthcare provider will order tests if you have symptoms of a CAUTI. These include a urine test and blood tests.

How is a CAUTI treated? 

Treatment may involve any of these:

• Antibiotics. Your healthcare provider will likely prescribe antibiotics if you have symptoms. Be aware that if you don’t have symptoms, you may not be given 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 healthcare provider 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.

How do hospital and long-term facility staff prevent CAUTIs?

To keep patients from getting a CAUTI, staff members take these steps:

• 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 doing catheter care.

• Use a clean (sterile) method when placing the catheter into the urinary tract. To do that, before putting the catheter in, the caregiver washes their hands with soap and water. Then they put on sterile gloves. A sterile catheter kit that has cleansers is used to cleanse 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 regularly.

• Do clean intermittent catheterization. This means a catheter is put in so you can urinate. It's then taken out right away. It may be done several times a day.

What you can do as a patient to prevent a CAUTI

You can help prevent a CAUTI by doing the following:

• Every day, ask your healthcare provider how long you need to have the catheter. The longer you have a catheter, the higher your chance of getting a CAUTI.

• Ask a caregiver to clean their hands and put on gloves before touching 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 healthcare provider what you should use and how often to clean these areas.

If you are discharged with an indwelling catheter

• Before you leave the hospital, make sure you know how to care for your catheter at home.

• Ask your healthcare provider how long you need the catheter. Also ask if you need to make a follow-up appointment to have the catheter taken out.

• Always use a clean (sterile) method when caring for your catheter. Wash your hands before and after doing any catheter care.

• Call your healthcare provider or seek medical care right away if you develop symptoms of a CAUTI (see above).