myChart login

Manage Your Health

Share/Save/Bookmark
Decrease (-) Restore Default Increase (+)

Manage Your Health

Back to Health Library   Print This Page Print    Email to a Friend Email

Catheter-associated UTI

Definition

Acatheter-associated urinary tract infection (UTI) is an infection that occurs in someone who has a tube (called a catheter) in place to drain urine from the body.

Alternative Names

UTI - catheter associated; Urinary tract infection - catheter associated; Nosocomial UTI; Health care associated UTI; Catheter-associated bacteriuria

Causes, incidence, and risk factors

Having a catheter within the urinary tract your chances of an urinary tract infection. It may also make it harder to treat the infection.

If a urinary catheter is left in place for a long time, bacteria will grow in it. A harmful infection may occur if the number of bacteria becomes large or if specific harmful bacteria grow in the urinary tract.

Most catheter-associated UTIs are caused by bacteria. However, the fungus Candida may cause infections of the urinary tract.

Symptoms

Other symptoms that may occur with this disease:

*Often in an elderly person, mental changes or confusion are the only signs of a possible urinary tract infection.

Signs and tests

The health care provider will perform a physical exam. Urine tests are done to check for infection:

  • Urinalysis may show white blood cells (WBCs) or red blood cells (RBCs).
  • Urine culture can help determine the type of bacteria in the urine and the appropriate antibiotic treatment.

Treatment

Mild cases of acute UTI may disappear on their own without treatment. However, because of the risk of the infection spreading to the kidneys (complicated UTI), treatment is usually recommended.

In most cases, treatment can be done on an outpatient basis.

MEDICATIONS

Antibiotics may be used to control the bacterial infection. It is very important that you finish all of your prescribed antibiotics. Commonly used antibiotics include:

  • Cephalosporins (such as ceftriaxone or cefepime)
  • Fluoroquinolones (ciprofloxacin or levaquin)
  • Penicillins (amoxicillin)
  • Quinolones (ciprofloxacin)

Medications to relax the bladder spasms (anticholinergics) may also be given.

Phenazopyridine hydrochloride (Pyridium) may be used to reduce burning and urinary urgency.

SURGERY

Surgery is generally not needed for catheter-related urinary tract infection. However, chronic in-body catheters (Foley or suprapubic tube) should be changed every month. Proper sterile techniques must be used.

DIET

Increasing the amount of fluids to 2,000 - 4,000 cc per day increases urine flow. This flushes bacteria from the bladder. Avoid fluids that irritate the bladder, such as alcohol, citrus juices, and caffeine.

MONITORING

Follow-up may include urine cultures to ensure that bacteria are no longer present in the bladder.

Expectations (prognosis)

Cystitis (bladder infection) associated with catheters is often difficult to treat. Most people who have a catheter in place for any period of time will develop some type of cystitis.

Complications

Calling your health care provider

Call your health care provider if you have symptoms of cystitis or a catheter-related UTI.

If you have cystitis, call if your symptoms get worse if you develop:

Prevention

Urinary catheters should only be used when clearly needed and not just for convenience. They should be removed when they are no longer needed. See: Urinary catheters

Infections occur less often with using intermittent catheterization infections compared to an indwelling catheter.

Routine care of the indwelling catheter must include daily cleansing of the urethral area and the catheter with soap and water. Clean the area thoroughly after all bowel movements to prevent infection. Experts no longer recommend using antimicrobial ointments around the catheter, as they have not been shown to actually reduce infections.

Increase fluid intake to 3,000 cc of fluid per day, unless you have a medical condition that prohibits this increase. Also, always keep the drainage bag lower than the bladder to prevent a backup of urine into the bladder.

Empty the drainage device at least every 8 hours or when it is full. Take care to keep the outlet valve from becoming infected. Wash your hands before and after handling the drainage device.

Your health care provider may prescribe a daily low-dose antibiotic to control bacterial growth in an indwelling catheter. Cranberry juice or vitamin C may also be recommended to help prevent UTIs.

References

Hooton TM. Nosocomial urinary tract infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 304.

Moore KN, Fader M, Getliffe K. Long-term bladder management by intermittent catheterisation in adults and children. Cochrane Database Syst Rev. 2007;4:CD006008.


Review Date: 6/17/2010
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Scott Miller, MD, Urologist in private practice in Atlanta, Georgia.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
 
© WakeMed Health & Hospitals, Raleigh, NC  |  919.350.8000  |