A urinary tract infection (UTI) is an infection in any part of the urinary system, which includes the kidneys, ureters, bladder and the urethra. Most infections only involve the lower urinary tract, meaning the bladder and the urethra1 are more commonly affected.
UTIs are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN), accounting for up to 36% of
infections2. Of these UTIs, a notable 80% are
catheter-associated3, where a catheter has been inserted into a patient in order to empty the bladder of urine. This article will explore the causes of Catheter-Associated Urinary Tract Infections (CAUTIs), their impacts not only on patients but on hospital systems and the ways in which instances of these infections can be reduced.
The urinary tract is often exposed to bacteria from outside the body. Comprising of the kidneys, ureters, bladder and urethra, it is sterile and has multiple defensive mechanisms including the flow of urine washing out bacteria. When bacteria is not washed away, it can lead to urinary tract infections.
There are several common causes of CAUTIs, including the following:
Despite the various causes, recent estimates suggest that 34-56% of hospital CAUTIs may be
preventable4.
Urinary tract infections can be uncomfortable for patients. The extent of the impact of a UTI on a patient greatly depends on the individual. Variables and risk factors can include age, socio-economic circumstances and co-morbidities, such as heart or lung disease and diabetes5.
The common symptoms of a UTI include:
CAUTIs have a two-fold impact on hospitals, involving the time patients spend in hospital and the cost associated.
Adults who get infections in hospital end up staying for 2.5 days
longer6. All hospital-acquired infections, not just limited to UTIs, are estimated to cause 3.6 million
unnecessary bed-days7. At a time when waiting lists are at their highest, freeing up bed space is more valuable than ever.
CAUTIs create a large strain on the NHS and can be distressing for patients, so it is important to examine the ways in which patient safety and comfort can be improved and instances of CAUTIs reduced.
A study looking into length of catheter use found that there is an increased risk of infection the longer a catheter stays in
place10. It is recommended that the clinical need for continuing catheterisation should be reviewed daily and the catheter should be removed as soon as possible to minimise the amount of time a patient is
catheterised11.
A suprapubic catheter is a type of catheter that is inserted into the bladder directly through the abdominal wall, rather than the urethra. This reduces the common causes of Catheter-Acquired Urinary Tract Infections. The procedure is performed by a healthcare professional and can be carried out with local anaesthetic.
Suprapubic catheterisation reduces the risk associated with CAUTIs. In a study with 208 participants that had a combined 21,700 device days, it was found that the suprapubic group had a lower incidence of CAUTI
(6.6 vs 8.8 per 1000 device-days; P = 0.05)12.
Standard suprapubic insertion techniques come with some disadvantages including the risk of bowel damage and perforation of the posterior bladder wall. The Mediplus S-Cath™ System helps reduce the risk.
Using the Seldinger technique, the S-Cath™ System offers an alternative to help improve patient outcomes. S-Cath™ System provides greater control and accuracy, is easier to use and helps minimise trauma and tissue damage. For more information about how S-Cath™ System is inserted have a look at our page on the
Seldinger Technique.
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