Understanding CAUTI

CAUTI stands for Catheter Associated Urinary Tract Infection. CAUTI is a common affliction today and is the second most common cause of bloodstream infection. The diagnosis of CAUTI is based on finding bacteriuria; along with an enhanced white blood cell count (WBC) based examination and analysis of the patient’s urine.

Symptoms of CAUTI –

• Increased serum WBC

• Burning pain in the area of the urethra, flank or the bladder
• Fever or chills
• Malaise
• Offensive urine odour
• Change in color and character of urine, it might become cloudy or have more sediments
• Hematuria
• Bladder spasms / leakage
• Catheter obstruction
• The increase in weakness or spasticity in patients who are already suffering from any neurological disease or disorder
• Change in mental frame of mind in young as well as old, but more in the latter, such as, lethargy, , delirium, or subtle changes in behavior
• Bacteraemia (especially after trauma to the urinary mucosa)

So what are the risks associated with CAUTI?

Research studies have indicated that factors like history of previous catheter use, the duration the catheter is in situ , the length of hospital stay before catheter insertion, the reason for and location of catheter insertion are all risks associated with this infection. The direct relation between the duration the catheter is in suit and the development of CAUTI is quite well established and accepted. Some other innate risk factors such as increasing age, gender and general debilitation are also associated with this infection.

CAUTI can be prevented by implementing the following initiatives:

• Insert catheters only for appropriate indications.
• Remove unnecessary catheters.
• Perform hand hygiene in compliance with CDC or WHO.
• Provide education on proper insertion and maintenance.
• Limit insertion of catheters to trained personnel.
• Insert catheters using aseptic technique and sterile equipment.
• Ensure that the indwelling catheters are secured well after insertion so that it does not move or shift and to prevent urethral traction.
• Make sure that the drainage is closed.
• Maintain unobstructed urine flow.
• Cleaning the metal area with antiseptic solutions and ensure routine hygiene.
• Make sure that the catheter is removed within 48 hours of surgery
• Implement and promote alternatives to indwelling urinary catheterization

The world has woken up to this infection that’s spreading like wild fire and has started taking some positive steps in the awareness initiative. Awareness is leading to prevention tips that if followed will help reduce the occurrence of CAUTI to a great extent.

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