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A Catheter-Associated Urinary Tract Infection denoted as CAUTI, is one of the most common infections a patient can contract at a healthcare institution. This infection occurs when germs (typically bacteria) enter the urinary tract through the urinary catheter and cause infection.

What is a Urinary Catheter?

A catheter is inserted into a patient’s body who is unable to empty his/her bladder due to urinary retention or surgery. An indwelling urinary catheter is a drainage tube that is inserted into the urinary bladder through the urethra and connected to a collection bag. It basically drains urine from the bladder into the collection bag.

What are the Symptoms of a CAUTI?

CAUTI has similar symptoms to that of a urinary tract infection. The indicators include:-

  • Blood in urine
  • Cloudy urine
  • Strong urine odor
  • Pressure, pain or discomfort in the stomach or lower back
  • Urine leakage around the catheter
  • Chills
  • Fever
  • Fatigue
  • Vomiting

What are the causes of CAUTI?

If not properly inserted, bacteria or fungi may enter the urinary tract through the catheter, leading to their multiplication inside the body causing an infection. There are different ways that CAUTI can occur during catheterization. Some of the prominent causes include:-

  • Improper insertion of the catheter
  • Not emptying the drainage bag frequently
  • Bacteria from bowel movement may infect catheter
  • Urine in the collection bag may flow backward into the bladder and cause infection
  • Use of unclean catheter

How is CAUTI Diagnosed and Treated?

CAUTI is commonly diagnosed through a Urinalysis that detects blood cells in the urine. Urine culture is another test that helps in identifying bacteria or fungi in the urine. Moreover, at times the bladder doesn’t move urine out of the body quickly enough, resulting in urinary retention. This can occur even when the catheter is inserted, and retained urine can increase the risks of bacterial growth. So, the doctor may recommend an imaging bladder test like an ultrasound scan to identify if the patient is retaining urine.

CAUTI can be treated by first changing or removing the catheter followed by prescribing antibiotics to the patient. The treatment is determined based on the patient’s infection level. Additionally, increasing fluid intake can also help in removing bacteria from the urinary system. However, certain fluids such as alcohol, citrus fruit juices, caffeinated beverages, etc. must be avoided.

Steps Taken by Healthcare Centers to Prevent CAUTIs

Being one of the most prevalent hospital-related infections, healthcare organizations often put great emphasis on preventing the spread of CAUTIs. Some of the precautionary measures used by medical practitioners include:-

  • Doctors only insert catheter after examining its necessity and ensure to remove it as soon as possible.
  • Medical staff follows proper procedures for urinary catheter insertion, maintenance, and removal.
  • If the patient’s condition permits, the doctor uses alternatives of indwelling urethral catheterization such as penile clamps, pads, protective underwear, etc.
  • Healthcare centers frequently conduct quality improvement programs and in-service training to improve the techniques, uses, and procedures associated with catheter insertion, maintenance, and removal of indwelling catheters.
  • Typically, healthcare organizations maintain a system of documenting patient records that includes indications for catheter insertion, data and time of insertion and removal, medical staff who inserted the catheter, etc. in order to monitor and mitigate the chances of CAUTI.

Steps Patients Can Take to Prevent CAUTI

Patients with a urinary catheter can ensure the following precautions in order to prevent CAUTI:

  • Understand why the catheter is needed and check-up during the course of the treatment whether it is still required.
  • Research about the healthcare center prior admission and if possible, check the CAUTI Rate.
  • If patients have a catheter inserted for a longer period of time, they must clean their hands before and after touching the catheter.
  • Silicon catheter is a safer option if the catheter needs to be inserted for a long duration.
  • Check the urine bag position; it should always be below the bladder level.
  • Don’t tug or pull on the catheter tubing
  • If patients have any symptoms of CAUTI like fever, cloudy urine, lower back pains, etc., they should immediately notify the concerned medical staff immediately.

Taking The Right Measures to Obtaining Quality Treatment

Healthcare Associated Infections (HAIs) are a common and expensive occurrence and catheter-associated urinary tract infections (CAUTI) are one of the most prevalent HAIs. CAUTI can be avoided at healthcare centers by practicing clear insertion and removal techniques. Moreover, frequent hand-washing and good hygiene practice by both, medical staff and patients also play a vital role in mitigating the risks associated with CAUTI. It is imperative for healthcare centers to take the necessary measures in order to maintain a low CAUTI rate and ensure quality care.

Dr. Rishab Sharma

Dr. Rishab Sharma MBBS, MD (Internal Medicine) He is associated with Fortis Escorts Hospital, Jaipur. Dr. Rishab has wide experience in managing a variety of diseases, as well as managing critical care units in large government and corporate hospitals.

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