Cauti Articles


  • A multifaceted quality improvement strategy reduces the risk of catheter-associated urinary tract infection.

    Catheter-associated urinary tract infections (CAUTIs) are common and preventable hospital-acquired infections, yet their rate continues to rise nationwide. We describe the implementation of a multifaceted program to reduce catheter use and CAUTI rates while simultaneously addressing barriers to long-term success.

    Published August 13, 2017
  • A urinary catheter valve is non-inferior to continuous bladder drainage with respect to post-operative UTIs: a randomized controlled trial.

    Urinary tract infections (UTIs) are common with indwelling catheter use. Our primary aim was to compare UTI rates in women sent home after surgery with continuous bladder drainage versus a urinary catheter valve.

    Published August 9, 2020
  • Catheter-Associated Urinary Tract Infection (CAUTI) in the NeuroICU: Identification of Risk Factors and Time-to-CAUTI Using a Case-Control Design.

    Catheter-associated urinary tract infections (CAUTIs) account for 25% of all hospital-acquired infections. Neuro-critically ill patients are at 2-5 times greater risk of developing CAUTI because of increased use of indwelling urinary catheters due to neurogenic urinary retention.

    Published July 5, 2020
  • Catheter-associated urinary tract infection: signs, diagnosis, prevention.

    Catheter-associated urinary tract infection (CAUTI) is one of the most prevalent healthcare-associated infections (HAIs) in the UK and can have implications for both the patient and the health service.

    Published September 12, 2019
  • Correlating incidence densities and point-prevalence for the surveillance of catheter-associated urinary tract infections.

    We aimed to validate the use of point-prevalence to identify catheter-associated urinary tract infections against the gold standard of incidence densities. We did not find a significant association, and hence our findings do not support the common practice of using point-prevalence as a less resource intensive method for catheter-associated urinary tract infections surveillance.

    Published February 23, 2020
  • Do Best Practice Alerts Reduce CAUTIs? The Influence of an Electronic Medical Record Embedded Best Practice Alert on Rate of Hospital Acquired Catheter Associated Urinary Tract Infections.

    To understand if an electronic medical record embedded best practice alert decreased our hospital's Catheter associated urinary tract infections (CAUTIs) and catheter utilization (CU) rates.

    Data from our inpatient prospective CAUTI database, spanning 2011 to 2016, was utilized for our analysis with the BPA starting in 2013.

    Published April 19, 2020
  • Epidemiology and health-economic burden of urinary catheter-associated infection in English NHS hospitals: a probabilistic modelling study.

    Catheter-associated urinary tract infection (CAUTI) and bloodstream infection (CABSI) are leading causes of healthcare-associated infection in England's National Health Service (NHS), but health-economic evidence to inform investment in prevention is lacking.

    Published May 12, 2019
  • Evidence-Based Urinary Catheter Care

    Evaluation of evidence-based urinary catheter care

    Diane K. Newman, DNP, ANP-BC, FAAN

    Published November 1, 2013
  • Fibrinogen release and deposition on urinary catheters placed during urologic procedures.

    Catheter-associated urinary tract infections (CAUTI) account for ∼40% of all hospital-acquired infections worldwide, with more than one million cases diagnosed annually. Recent data from a CAUTI animal model has shown that inflammation induced by catheterization releases host fibrinogen that accumulates on the catheter.

    Published February 9, 2016
  • From Catheter to Kidney Stone: The Uropathogenic Lifestyle of Proteus mirabilis.

    Proteus mirabilis is a model organism for urease-producing uropathogens. These diverse bacteria cause infection stones in the urinary tract and form crystalline biofilms on indwelling urinary catheters, frequently leading to polymicrobial infection.

    Published January 9, 2017
  • Guide to the elimination of catheter-associated urinary tract infections (CAUTIs)

    PURPOSE: The purpose of this document is to provide evidence-based practice guidance for the prevention of catheter-associated urinary tract Infections (CAUTI) in acute and long-term care settings.

    BACKGROUND: Health-care associated infections (HAIs) are infections acquired during the course of receiving treatment for other conditions within a health care setting. HAIs are one of the top 10 leading causes of death in the United States, according to the Centers for Disease Control and Prevention (CDC), which estimates that 1.7 million infections were reported annually among patients. It has long been acknowledged that CAUTI is the most frequent type of infection in acute care settings. In a study that provided a national estimate of health-care associated infections, urinary tract infections comprised 36% of the total HAI estimate.




    Association for Professionals in Infection Control and Epidemiology (APIC)

    Published January 17, 2013
  • Guideline for prevention of catheter-associated urinary tract infections 2009

    This guideline updates and expands the original Centers for Disease Control and Prevention (CDC) Guideline for Prevention of Catheter-associated Urinary Tract Infections (CAUTI) published in 1981. Several developments necessitated revision of the 1981 guideline, including new research and technological advancements for preventing CAUTI, increasing need to address patients in non-acute care settings and patients requiring long-term urinary catheterization, and greater emphasis on prevention initiatives as well as better defined goals and metrics for outcomes and process measures. In addition to updating the previous guideline, this revised guideline reviews the available evidence on CAUTI prevention for patients requiring chronic indwelling catheters and individuals who can be managed with alternative methods of urinary drainage (e.g., intermittent catheterization). The revised guideline also includes specific recommendations for implementation, performance measurement, and surveillance. Although the general principles of CAUTI prevention have not changed from the previous version, the revised guideline provides clarification and more specific guidance based on a defined, systematic review of the literature through July 2007. For areas where knowledge gaps exist, recommendations for further research are listed. Finally, the revised guideline outlines high-priority recommendations for CAUTI prevention in order to offer guidance for implementation.




    Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Published January 17, 2013
  • Healthcare-associated infections in Pennsylvania - 2011 Report

    The 2011 report on the occurrence and patterns of health care-associated infections (HAIs) is the fourth to be released by the Pennsylvania Department of Health (PADOH) since the passage of Act 52 in 2007. The overall findings for 2011 show a continued pattern of steady decline in the incidence of HAIs in Pennsylvania. Declines were also seen in the incidence of each of the three categories of HAIs used by PADOH for hospital benchmarking. These categories are: catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), and selected types of surgical site infections (SSIs). The declining numbers are likely the result of ongoing efforts undertaken by infection preventionists, health care providers and systems, professional societies and governmental agencies to control and prevent HAIs. The impact of these efforts should be improved health status and outcomes of patients cared for in Pennsylvania hospitals, which are the primary motivation for HAI prevention and control, along with reduced health care expenditures.

    pa doh 2011 hai report



    Pennsylvania Department of Health
    August 2012

    Published January 17, 2013
  • High-resolution imaging reveals microbial biofilms on patient urinary catheters despite antibiotic administration.

    Catheter-associated urinary tract infections (CAUTIs) are a significant cause of morbidity worldwide, as they account for 40% of all hospital-associated infections. Microbial biofilm formation on urinary catheters (UCs) limits antibiotic efficacy, making CAUTI extremely difficult to treat.

    Published December 8, 2019
  • How Often Do Clinically Diagnosed Catheter-Associated Urinary Tract Infections in Nursing Homes Meet Standardized Criteria?

    To determine the relationship between clinically diagnosed catheter-associated urinary tract infection (CAUTI) and standardized criteria and to assess microorganism-level differences in symptom burden in a cohort of catheterized nursing home (NH) residents.

    Published November 30, 2016
  • Impact of a change in surveillance definition on performance assessment of a catheter-associated urinary tract infection prevention program at a tertiary care medical center.

    In January 2015, the Centers for Disease Control and Prevention (CDC)/National Health Safety Network (NHSN) changed the definition of catheter-associated urinary tract infection (CAUTI). We evaluated the outcomes of a robust CAUTI prevention program when we performed surveillance using the old definition (before 2015) versus the new definition (after 2015).

    Published May 12, 2018
  • Implementation of a Nurse-Driven CAUTI Prevention Algorithm.

    The cardiovascular thoracic step-down unit of an urban academic medical center had 4 catheter-associated urinary tract infections (CAUTIs) in 2 months compared with 5 in the previous year. The nursing literature showed that the implementation of nurse-driven algorithms for early removal of indwelling urinary catheters (IUCs) decreased the catheter days and risk of CAUTIs.

    Published July 14, 2019
  • Indwelling Urinary Catheters: A Pathway to Health Care-Associated Infections.

    When a urinary catheter is not inserted using proper technique, becomes unclean, or remains in place for too long, microorganisms can travel through the catheter lumen or along the outside of the catheter and infect the bladder or kidneys, resulting in a catheter-associated urinary tract infection (CAUTI).

    Published April 30, 2017
  • Long-term use of noble metal alloy coated urinary catheters reduces recurrent CAUTI and decreases proinflammatory markers.

    The objective of this study was to investigate a case of a permanently (suprapubic) catheterized woman with neurogenic bladder dysfunction. The patient had suffered from recurrent catheter-associated urinary tract infections (CAUTIs) since 2009, despite several prevention approaches and attempts.

    Published July 7, 2019
  • Pathophysiology, Treatment, and Prevention of Catheter-Associated Urinary Tract Infection.

    Urinary tract infections (UTIs) are among the most common microbial infections in humans and represent a substantial burden on the health care system. UTIs can be uncomplicated, as when affecting healthy individuals, or complicated, when affecting individuals with compromised urodynamics and/or host defenses, such as those with a urinary catheter.

    Published September 29, 2019
  • Protocolized Urine Sampling is Associated with Reduced Catheter-Associated Urinary Tract Infections: A Pre- and Post-intervention Study.

    Standard urine sampling and testing techniques do not mitigate against detection of colonization, resulting in false positive catheter-associated urinary tract infections (CAUTI). We aim to evaluate if a novel protocol for urine sampling and testing reduces rates of CAUTI.

    Published August 22, 2020
  • Questionable validity of the catheter-associated urinary tract infection metric used for value-based purchasing.

    Catheter-associated urinary tract infections (CAUTIs) occur in 290,000 US hospital patients annually, with an estimated cost of $290 million.

    Published August 17, 2015
  • Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioural analysis of interventions.

    Reducing the need for antibiotics is crucial in addressing the global threat of antimicrobial resistance. Catheter-associated urinary tract infection (CAUTI) is one of the most frequent device-related infections that may be amenable to prevention.

    Published August 29, 2020
  • Reducing Hospital-Acquired Infections Among the Neurologically Critically Ill.

    Hospital-acquired infections (HAIs) result in excess morbidity, mortality, and resource consumption. Immobilized, ventilator-dependent ICU patients are at the highest risk of HAI.

    Despite broad implementation of relevant bundles, HAI incidence in our neuro ICU remained high, particularly catheter-associated urinary tract infections (CAUTIs) and ventilator-associated events (VAEs).

    Published October 4, 2016
  • Reducing inappropriate urine cultures through a culture standardization program.

    The objective of this study was to evaluate the impact of a urine culture standardization program that included order indications and urinalysis (U/A) with reflexive culture. The program applied to all adult and pediatric inpatients at an academic medical center; emergency department and ambulatory clinic patients were excluded.

    Published December 15, 2019
  • Reduction in catheter-associated urinary tract infections by bundling interventions - Abstract

    OBJECTIVE:Urinary tract infections (UTIs) are the most common type of hospital-acquired infection, and most are associated with indwelling urinary catheters, that is, catheter-associated UTIs (CAUTIs). Our goal was to reduce the CAUTI rate.

    DESIGN/SETTING/INTERVENTIONS:We retrospectively examined the feasibility and cost-effectiveness of a bundle of four evidence-based interventions upon the incidence rate (IR) of CAUTIs in a community hospital. The first intervention was the exclusive use of silver alloy catheters in the hospital's acute care areas. The second intervention was a securing device to limit the movement of the catheter after insertion. The third intervention was repositioning of the catheter tubing if it was found to be touching the floor. The fourth intervention was removal of the indwelling urinary catheter on postoperative Day 1 or 2, for most surgical patients.

    MAIN OUTCOME MEASURE:Rates of CAUTI per 1000 catheter days were estimated and compared using the generalized estimating equations Poisson regression analysis.

    RESULTS: During the study period, 33 of the 2228 patients were diagnosed with a CAUTI. The CAUTI IR for the pre-intervention period was 5.2/1000. For the 7 months following the implementation of the fourth intervention, the IR was 1.5/1000 catheter days, a significant reduction relative to the pre-intervention period (P = 0.03). The annualized projection for the cost of implementing this bundle of four interventions is $23,924.

    CONCLUSION:A bundle of four evidence-based interventions reduced the incidence of CAUTIs in a community hospital. It is relatively simple, appears to be cost-effective and might be sustainable and adaptable by other hospitals.

    Written by:
    Clarke K, Tong D, Pan Y, Easley KA, Norrick B, Ko C, Wang A, Razavi B, Stein J. Are you the author?
    Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, Suite A4326, Atlanta, GA 30322,, USA.

    Reference: Int J Qual Health Care. 2012 Dec 6.



    Published January 17, 2013
  • Restriction of in vivo infection by antifouling coating on urinary catheter with controllable and sustained silver release: a proof of concept study.

    Catheter Associated Urinary Tract Infections are among the most common urological infections world-wide. Bacterial biofilms and encrustation cause significant complications in patients with urinary catheters.

    Published November 5, 2018
  • The use of oral fosfomycin-trometamol in patients with catheter-associated urinary tract infections (CAUTI): new indications for an old antibiotic?

    We present the results of a multicenter retrospective study of 35 difficult-to-treat patients with urinary tract infections associated with indwelling urinary catheters (CAUTIs). All patients received oral administration of 3 g fosfomycin trometamol once a day for two days and then with a dose of 3 g every 48 h for two weeks.

    Published March 10, 2019
  • Use of polyvalent bacteriophages to combat biofilm of Proteus mirabilis causing catheter-associated urinary tract infections.

    Catheter-associated urinary tract infections (CAUTI) caused by Proteus mirabilis are very difficult to treat due to the ability of biofilm formation and drug resistance of these bacteria. The aim of this study was to assess the antibiofilm activity of phages and develop phage cocktail to combat biofilm of P.

    Published December 9, 2018