genitourinary disorders
Catheter Associated Urinary Tract Infections
Introduction
A catheter-associated urinary tract infection (CAUTI) is a urinary tract infection (UTI) in which the positive culture was taken when an indwelling urinary catheter had been in place for>2 calendar days. Patients with indwelling bladder catheters are predisposed to bacteriuria and UTIs. Symptoms may be vague or may suggest sepsis. Diagnosis depends on the presence of symptoms. Testing includes urinalysis and culture after the catheter has been removed and a new one inserted. The most effective preventive measures are avoiding unnecessary catheterization and removing catheters as soon as possible. (See also Introduction to Urinary Tract Infections (UTIs) .) Bacteria can enter the bladder during Bladder Catheterization , through the catheter lumen, or from around the outside of the catheter. A biofilm develops around the outside of the catheter and on the uroepithelium. Bacteria enter this biofilm, which protects them from the mechanical flow of urine, host defenses, and antibiotics, making bacterial elimination difficult. Even with thoroughly aseptic catheter insertion and care, the chance of developing significant bacteriuria is about 5% every day the catheter is indwelling ( Risk factors for UTI include duration of catheterization, female sex, Diabetes Mellitus (DM) , opening a closed system, and suboptimal aseptic techniques. Indwelling bladder catheters can also predispose to UTIs can also develop in women during the days after a catheter has been removed. 