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Management of catheter-associated urinary tract infection

Trautner, Barbara Wa,b

Current Opinion in Infectious Diseases: February 2010 - Volume 23 - Issue 1 - p 76–82
doi: 10.1097/QCO.0b013e328334dda8
Sexually transmitted diseases and urinary tract infections Edited: by Anton L. Pozniak

Purpose of review: The aim of this article is to review recent publications concerning the management of catheter-associated urinary tract infection (CAUTI), including the issues of diagnosis and prevention. Articles reviewed include the various guidelines concerning CAUTI released recently by multiple organizations.

Recent findings: There has been a recent upsurge of interest in prevention of CAUTI and a proliferation of guidelines in this area. Social changes in US government reimbursement to hospitals and public reporting of hospital-acquired infections may underlie this interest. The awareness that CAUTI and catheter-associated asymptomatic bacteriuria are distinct conditions is increasing, but unnecessary treatment of asymptomatic bacteriuria remains quite prevalent. The focus in recent CAUTI literature is on prevention, often through strategies to minimize urinary catheter use. Very little new evidence is available to guide diagnosis and treatment strategies.

Summary: Interpretation of many studies of CAUTI is impeded by the failure to distinguish between symptomatic CAUTI and asymptomatic bacteriuria in the study outcomes. This distinction currently relies on clinical symptoms and is not easily made, even with the help of various guidelines. Many aspects of the management of CAUTI merit further study, and the current interest in CAUTI is likely to lead to exciting advances in this field.

aSection of Infectious Diseases, Department of Medicine, USA

bDepartment of Molecular Virology and Microbiology, Houston VA Health Services Research and Development Center of Excellence; Baylor College of Medicine; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA

Correspondence to Barbara W. Trautner, MD, PhD, One Baylor Plaza, BCM 286, N1319, Houston, TX 77030, USA Tel: +1 713 798 4264; fax: +1 713 798 8948; e-mail: trautner@bcm.edu

© 2010 Lippincott Williams & Wilkins, Inc.