Catheter-Associated Urinary Tract Infection Prevention in the Oncology Population: An Evidence-Based Approach

Abstract

Urinary catheters have been attributed to almost half of all healthcare-associated infections. Many catheter-associated urinary tract infections (CAUTIs) may be prevented by following recommended guidelines, which would save lives. This article illustrates the use of known guidelines for the prevention of CAUTIs in the oncology population.

Hospital-Acquired Infections in Critically Ill Patients With Cancer

“…Urinary tract infection (UTI) is the most commonly acquired nosocomial infection in the United States, accounting for 30% to 40% of all HAIs. [60][61][62] Data from a survey of US hospitals in 2002 found the annual incidence of nosocomial UTI to be more than 560 000 cases, with an attributable mortality rate of 2.3%, or more than 13 000 deaths, annually. 62,63 The vast majority of nosocomial UTIs are caused by instrumentation of the urinary tract, with indwelling urinary catheters implicated in 80% cases.…”

“…62,63 The vast majority of nosocomial UTIs are caused by instrumentation of the urinary tract, with indwelling urinary catheters implicated in 80% cases. [60][61][62] Data from the NHSN in 2006 demonstrated a pooled mean CAUTI rate ranging from 3.1 to 7.5 infections per 1000 catheter days in acute care hospitals. The highest rates were found in burn ICUs followed by inpatient medical wards and neurosurgical ICUs, and the lowest rates were noted in medical/surgical ICUs.…”

“…This has motivated clinicians and hospital systems to implement policies and practices that limit urinary catheters to appropriate indications and promote early removal as soon as they are no longer required for patient care. 61 Although morbidity and mortality attributable directly to CAUTI are considered low compared to other HAIs, the high frequency of urinary catheter usage has produced a substantial cumulative burden of infections, associated complications, and deaths. Bacteriuria related to indwelling urinary catheters often leads to unnecessary administration of antimicrobials which can promote antibiotic resistance, and urinary drainage systems may act as reservoirs for MDR bacteria, which may then be transmitted to other patients.…”

“…This has motivated clinicians and hospital systems to implement policies and practices that limit urinary catheters to appropriate indications and promote early removal as soon as they are no longer required for patient care. 61…”