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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%)