The IDIOTS Guide to Catheter Associated Urinary Tract Infection (CAUTI)
Definitions
CAUTI: catheter associated urinary tract infection
CA-ASB: Catheter associated asymptomatic bacteriuria
Short term catheter <28 days, long term >28 days
Epidemiology
CAUTI – scale of the problem:
- UTI = 19% of HCAI
- CAUTI = 43-56% of these
- 20% hospital inpatients have a urinary catheter (higher in ICU)
- Not monitored in the UK – true incidence very high
- coli bacteraemia surrogate marker but not reliable (if no blood cultures taken)
- Huge impact on patient (symptoms, antimicrobial exposure), length of stay. Estimated £99m/year for NHS, £1968/episode
- Colonisation of the catheter with organisms -> increased risk ~5% of developing bacteruria per day. Almost all colonised by 1 month.
- Around 25% of those with bacteruria will develop CAUTI
- Around 4% of those with CAUTI develop a life-threatening infection e.g. bacteraemia (mortality 10-33%)