Catheter-Linked Urinary Tract Infections

Cross section of bladder showing catheter in place.

A catheter-linked urinary tract infection (CAUTI) is an infection of the urinary tract. 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 tract

This tract 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 are not able to move around for a long period of time after surgery or injury.

  • 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.

In most cases, the urinary catheter is short term (temporary). You'll need it only until the problem that needs 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 keep you in the hospital longer. If the infection is not treated in time, you may have serious health complications.

What are the symptoms of a CAUTI?

  • A burning feeling, pressure, or pain in your lower belly (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 your back (kidney area)

  • Nausea and vomiting

  • You are confused, or not alert, or have a change in behavior (mainly affects older patients)

Sometimes you may not have any symptoms but may still have CAUTI.

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

How is CAUTI diagnosed?

Your healthcare provider will order tests if you have symptoms of a CAUTI. These include a urine test and blood tests.

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 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 clean (sterile) method 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 your genital area.

  • Before doing 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.

  • Check 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.

  • Ask a caregiver to clean his or her hands and put on gloves before touching your catheter.

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

  • Check that 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.

  • Cleaning the genital and perineal areas is very important to help decrease bacteria in areas around 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, 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 a clean (sterile) method 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).