Catheter-Associated Urinary Tract Infections

Cross section of bladder showing catheter in place.

A catheter-associated urinary tract infection (CAUTI) is an infection of the urinary system. CAUTI is caused by bacteria that enter the urinary tract when a urinary catheter is used. This is a tube that’s placed into the bladder to drain urine.

The urinary system

This system includes the kidneys, ureters, bladder, and urethra. The kidneys filter blood and make urine. The ureters carry urine from the kidneys to the bladder. The bladder stores urine. The urethra carries urine from the bladder to the outside of the body.

What is a urinary catheter?

A urinary catheter is a thin, flexible tube. It is placed in the bladder to drain urine. Urine flows through the tube into a collecting bag outside of the body. There are different types of urinary catheters. The most common type is an indwelling catheter. This is also known as a urethral catheter. This is because it’s placed into the bladder through the urethra. This catheter is also called a Foley catheter.

Why is a urinary catheter needed?

A urinary catheter is needed for any of the following:

  • You can’t get up to use the toilet because your mobility is limited. This may be due to surgery, an injury, or illness.

  • You have a blockage in your urinary system.

  • Your healthcare provider needs to measure the amount of urine you pass.

  • The function of your kidneys and bladder is being tested.

  • You’re not able to control your bladder (incontinence).

In most cases, the urinary catheter is temporary. You'll need it only until the problem that requires it is resolved. 

How does a CAUTI develop?

Bacteria can enter the urinary tract as the catheter is put into the urethra. Bacteria can also get into the urinary tract while the catheter is in place. The common bacteria that cause a CAUTI are ones that live in the intestine. These bacteria don’t normally cause problems in the intestine. But when they get into the urinary tract, a CAUTI can result.

Why is a CAUTI of concern?

Left untreated, a CAUTI can lead to health problems. These problems may include bladder infection, prostate infection, and kidney infection. A CAUTI can prolong your hospital stay. If the infection is not treated in time, serious health complications may occur.

What are the symptoms of a CAUTI?

  • A burning feeling, pressure, or pain in your lower abdomen

  • Fever or chills

  • Urine in the collecting bag is cloudy or bloody (pink or red)

  • Burning feeling in the urethra or genital area

  • Aching in the back (kidney area)

  • Nausea and vomiting

  • Person is confused, or is not alert, or has a change in behavior (mainly affects older patients)

  • Note that sometimes a person won’t have any symptoms but may still have a CAUTI.

Tell a healthcare provider right away if you or your loved one has any of these symptoms.

How is CAUTI diagnosed?

If you have symptoms of CAUTI your healthcare provider will order tests. These include a urine test, blood tests, and other tests as needed.

How is CAUTI treated? 

Treatment may involve any of the following:

  • Antibiotics. Your healthcare provider will likely prescribe antibiotics if you have symptoms. Be aware that if you don’t have symptoms, you may not be given antibiotics. This is to prevent an increase in bacteria that resist (can’t be killed by) certain antibiotics.

  • Removing the catheter. The catheter will be removed when your healthcare provider decides it’s no longer needed. This usually helps stop the infection.

  • Changing the catheter. If you still need a catheter, the old one will be removed. A new one will be put in. This may help stop the infection.

How do hospital and long-term facility staff prevent CAUTI?

To keep patients from getting a CAUTI, the staff follow certain procedures:

  • Prescribe a catheter only when it’s needed. It is removed as soon as it’s no longer needed.

  • Use sterile (clean) technique when placing the catheter into the urinary tract. This means before putting the catheter in, the caregiver washes his or her hands with soap and water. He or she then puts on sterile gloves. A sterile catheter kit that has cleansers is used to cleanse the patient’s genital area.

  • Before performing catheter care, caregivers also wash their hands or use an alcohol-based hand cleanser.

  • Hang the bag lower than your bladder. This prevents urine from flowing back into your bladder.

  • Ensure that the bag is emptied regularly.

What you can do as a patient to prevent CAUTI

You can help prevent yourself from getting a CAUTI by doing the following:

  • Every day ask your healthcare provider how long you need to have the catheter. The longer you have a catheter, the higher your chance of getting a CAUTI.

  • If a caregiver doesn’t clean his or her hands and put on gloves before touching your catheter, ask them to do so.

  • If you’ve been taught how to care for your catheter, be sure to wash your hands before and after each session.

  • Make sure your bag is lower than your bladder. If it’s not, tell your caregiver.

  • Don’t disconnect the catheter and drain tube. Doing so allows germs to get into the catheter.

  • Cleansing of the genital and perineal areas is very important to help decrease bacteria in areas surrounding the catheter. Ask your doctor what you should use and how often to clean these areas.

If you are discharged with an indwelling catheter

  • Before you leave the hospital, make sure you understand the instructions on how to care for your catheter at home.

  • Ask your healthcare provider how long you need the catheter. Also ask if you need to make a follow-up appointment to have the catheter removed.

  • Always use sterile (clean) technique when caring for your catheter. Wash your hands before and after doing any catheter care.

  • Call your healthcare provider right away if you develop symptoms of a CAUTI (see above).