CAUTI Prevention 101
As reported by NHSN, CAUTI (catheter-associated urinary tract infection) is the most common type of healthcare-associated infection. It is a serious issue for people who regularly practice intermittent catheterization, and for people who are administered foley catheters during their hospital stays.
This article will go over the definition, prevention, and symptoms of this common infection.
CAUTI is short for catheter-associated urinary tract infection, which refers to an infection of the urinary tract—kidneys, ureters, bladder, urethra—that is specifically caused by the use of urinary catheters.
A urinary catheter is a flexible, hollow tube that is inserted into the bladder through the urethra to drain the bladder of urine.
If the urinary catheter is contaminated by bacteria before insertion, it would carry the bacteria into the urinary tract upon insertion, causing an infection.
CAUTI can also be caused by the use of foley catheters. Foley catheters are usually inserted by a medical professional in a hospital setting when the patient is immobile (such as during and immediately after surgery), has urinary retention, or severe incontinence.
For intermittent catheterization, the most important step to prevent CAUTI is to avoid catheter contamination. To do that, you should:
1. Wash your hands with soap and water before self-catheterization
This step may sound simple but a lot of people are doing it wrong. To properly wash your hands, You need to rub vigorously for 20 seconds, scrub the back of your hands, your wrists, in between your fingers, and under your nails. Here is a video showing proper hand-washing.
CDC recommends using hand sanitizers with at least 60% alcohol when soap and water is not available.
2. Use intermittent catheters with a no-touch design
A no-touch catheter simply means that you don’t have to touch the part of the catheter that goes inside your body when you’re inserting the catheter.
Study has found that catheters with a no-touch design have significant lower amounts of bacterial contamination, often falling below the nominal detection limit (undetectable).
3. Disinfect your urethral opening
If you have done a great job cleaning your hands and is using a no-touch catheter, you can still push the bacteria around your urethral opening into your urinary tract when you insert the catheter.
Therefore, wipe the opening of your urethra with an antiseptic wipe. For women, wipe your urethral opening from front to back. It is located below your clitoris and above your vagina. For men, wipe your urethral opening at the tip of your penis in a circular motion.
4. Never reuse catheters that are designed for single-use only
Some catheters are designed to be used multiple times after proper disinfection, but many are designed to be used once and disposed of. Make sure that you’re not reusing single-use catheters and that you are properly disinfecting your reusable catheters.
If you are using reusable catheters and are having frequent CAUTIs, considering switching to sterile, single-use catheters.
One study contaminated reusable intermittent catheters with E. coli and then washed them with antibacterial soap. Researchers found that 44% of catheters were still E. coli ridden. Combining anti-bacterial wash with microwave-treatment also resulted in 26% of catheters having E. coli.
Study has recommended single-use catheters over reusable catheters because proper cleaning techniques may not be executed by each individual between each use.
Here is a more comprehensive guideline published by the CDC on the prevention of CAUTI.
If you use intermittent catheters and suffer frequent CAUTI, you can consider trying catheters that are pre-lubricated with anti-bacterial silicone oil to see if they help with your infections.
For people using foley catheters (indwelling catheter), the best way to prevent CAUTI is to not catheterize unnecessarily and to not let the catheter stay inside your body for longer than what’s needed.
Other prevention practices include: using correct insertion and removal techniques, cleaning the skin around the catheter, keeping the catheter tube from kinking, draining the drainage bag on time, and changing the catheter when necessary.
If you’re staying in a hospital, the hospital staff is likely to be responsible for minimizing your risk of CAUTI.
Catheter-associated UTIs have similar symptoms to UTIs in general. Symptoms include:
- Cloudy, bloody, strong-smelling urine
- Pressure and pain in the pelvic area
- Fever and chills
- Nausea and vomiting
- Unexplained fatigue
- Urine leakage around the catheter
If you notice some or all of these symptoms, you should contact your healthcare provider immediately.
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Please note that this article does not substitute medical advice from your doctor, nor does it serve as formal medical advice.