RESEARCH STARTER

Catheter-Associated Urinary Tract Infections (CAUTI)

Catheter-Associated Urinary Tract Infections (CAUTI) are infections commonly seen among hospitalized patients, resulting from the use of urinary catheters. These infections are classified as nosocomial, meaning they are acquired in a healthcare setting. CAUTIs arise when microorganisms aggregate around the catheter and form biofilms, which can lead to bacteriuria— the presence of bacteria in urine. Approximately 80 percent of reported nosocomial infections are attributed to CAUTIs, with a significant prevalence in both acute and long-term care facilities.

The risk of CAUTIs correlates with the duration of catheter use, and they can be asymptomatic or symptomatic, depending on the patient’s condition. Prevention strategies focus on minimizing catheter use, ensuring proper insertion and maintenance techniques, and implementing surveillance to monitor infection rates. Evidence-based guidelines and educational efforts for healthcare staff are essential to reducing CAUTI incidence. Innovative catheter designs aimed at preventing biofilm formation are also under exploration. As CAUTIs significantly impact patient health and healthcare costs, effective management and prevention are critical for improving outcomes in medical settings.

Full Article

Urinary tract infections related to the attachment of a urinary catheter are among the most common types of infections that affect patients confined in a hospital or other healthcare settings. They are a type of nosocomial infections (or hospital-acquired infections). Catheter-associated urinary tract infections (CA-UTI) are caused by the aggregation of microorganisms that enter the urinary tract through the catheter and cause infection. These microorganisms subsequently secrete a glue-like substance called a biofilm that serves as a protective matrix enabling microbial growth, becoming resistant to antibiotics and the body’s defense mechanisms. A biofilm also develops around the tubing of the catheter that is inserted into the urinary tract of a patient. An infection due to this medical device is often diagnosed based on the detection of disease-causing bacteria in the urine of the patient.

Background

Urinary catheters are extensively used in healthcare facilities and are the most frequently used indwelling device, with approximately 15 to 25 percent of patients receiving a urinary catheter at some point during their stay. For patients in critical care, this number is far higher, with more than 70 percent of patients receiving urinary catheters. 

Urinary catheters are generally described according to their duration of use. For example, short-term urinary catheters are often utilized for less than 30 days, whereas long-term catheters are attached for more than 30 days. Furthermore, short-term urinary catheters are employed in acute care health facilities, whereas chronic urinary catheters are commonly used for patients admitted to long-term healthcare facilities. In addition, the clinical and microbiologic descriptors for infections associated with urinary catheters also vary in terms of duration of use. For example, patients who have acquired an infection in relation to a urinary catheter but do not manifest any symptoms of infection except for its presence in their urine are diagnosed with catheter-associated asymptomatic bacteriuria (CA-ASB). On the other hand, those who present symptoms of infection that are associated with the use of a urinary catheter are described to have CA-UTI.

Although the number of bacteriuric patients who present symptoms of infection is relatively low, the high utilization rate of urinary catheters indicates that there is a significant burden attributable to these particular infections. CA-UTIs represent a notable proportion of nosocomial infections in acute care health facilities, and a substantial proportion in long-term healthcare facilities. They also represent approximately 75 percent of all UTIs acquired in the hospital, according to the Centers for Disease Control and Prevention. Studies have shown that the most effective approach in preventing bacteriuria and other nosocomial infections is to minimize the use of indwelling catheters. However, when a catheter has been determined to be necessary for the treatment of a patient who is confined in a healthcare facility, this should be discontinued as soon as the patient shows improvement. Healthcare facilities have also designed and implemented strategies to monitor as well as limit the use of catheters, thereby reducing the frequency of CA-UTIs. These monitoring strategies not only include the use of catheters, but also indicators of urinary tract infections that occur during catheter usage, and subsequent complications that develop from the attachment of a catheter on a patient. Developing catheters consisting of novel materials that prevent the formation of biofilms are also envisioned to prevent CA-UTIs.

Impact

Several evidence-based guidelines have now been established to prevent the occurrence of CA-UTI, which include avoiding the use of catheters, implementation of policies regarding the insertion as well as maintenance of catheters, establishment of criteria in selecting the appropriate catheter for a particular patient, surveillance of CA-UTI, proper use of the selected catheter, and identification of indicators of health progress in a patient who has received a catheter. Any changes in the incidence of CA-UTIs after the implementation of these institutional preventative programs are then reported in order to determine whether these guidelines are indeed effective in controlling the incidence of CA-UTI. The prevention program should also be customized according to the conditions of the local environment, features of the population it serves, as well as accessible resources. Effective senior leadership also largely contributes to the success of a CA-UTI preventative program.

Healthcare facilities have also evaluated and improved infrastructure in order to monitor and prevent the occurrence of CA-UTIs. In addition to policies governing the selection, insertion, and maintenance of catheters in a patient, the staff of the healthcare institution should also be educated on the etiology, treatment, and prevention of CA-UTIs. The healthcare facility should also have sufficient staff members who will follow the developed guidelines on preventing the occurrence of catheter-related infections. For example, a 2023–24 study evaluated the effect of following a structured CAUTI prevention care bundle in association with a nursing guidance program, which included checkpoints such as documenting the date of insertion of the catheter in each patient as well as the date of removal may help hospital staff determine whether this particular medical device has been in use for an extended period of time. The adherence to these specific guidelines significantly reduced the incidence of CA-UTIs. It is also therefore assumed that a similar reduction in the number of CA-UTI cases would result from improved criteria for the selection of catheters for each patient.

One activity that has been observed to decrease the number of CA-UTI cases in hospitals is the use of a catheter with the smallest appropriate size. This particular catheter feature not only minimizes the occurrence of CA-UTIs but also decreases urethral trauma in the patient. On the other hand, studies have shown that the major components of catheters have no significant effect on the incidence of urinary tract infections. For example, similar incidence rates for CA-UTIs were observed using catheters consisting of latex and silicone. In addition, the presence of a hydrogel coating has not consistently been shown to reduce the incidence rate of CA-UTIs.


Bibliography

“Catheter-Associated Urinary Tract Infection Basics.” Centers for Disease Control and Prevention, 15 Apr. 2024, www.cdc.gov/uti/about/cauti-basics.html. Accessed 19 Mar. 2026.

“Clinical Safety: Preventing Catheter-Associated Urinary Tract Infections (CAUTIs).” Centers for Disease Control and Prevention, 31 July 2024, www.cdc.gov/uti/hcp/clinical-safety/index.html. Accessed 19 Mar. 2026.

Conway, Laurie J., and E. L. Larson. “Guidelines to Prevent Catheter-Associated Urinary Tract Infection: 1980 to 2010.” Heart Lung, vol. 41, no. 3, 2012, pp. 271–83, doi:10.1016/j.hrtlng.2011.08.001. Accessed 19 Mar. 2026.

Conway, Laurie J., et al. “Risk Factors for Nosocomial Bacteremia Secondary to Urinary Catheter-Associated Bacteriuria: A Systematic Review.” Urologic Nursing, vol. 35, no. 4, 2015, p. 191, pmc.ncbi.nlm.nih.gov/articles/PMC4586038/. Accessed 19 Mar. 2026.

Feneley, R. C., et al. “An Indwelling Urinary Catheter for the 21st Century.” BJU International, vol. 109, no. 12, 2012, pp. 1746–49, doi.org/10.1111/j.1464-410X.2011.10753.x. Accessed 19 Mar. 2026.

Gould, Dinah. “Continuing Professional Development: Preventing Catheter-Associated Urinary Tract Infection.” Nursing Standard, vol. 30, no. 10, 2015, pp. 50–60, doi:10.7748/ns.30.10.50.s48. Accessed 19 Mar. 2026.

Halm, M. A., and N. O’Connor. “Do System-Based Interventions Affect Catheter-Associated Urinary Tract Infection?” American Journal of Critical Care, vol. 23, no. 6, 2014, pp. 505–9, doi:10.4037/ajcc2014689. Accessed 19 Mar. 2026.

Meddings, J., et al. “Reducing Unnecessary Urinary Catheter Use and Other Strategies to Prevent Catheter-Associated Urinary Tract Infection: An Integrative Review.” BMJ Quality and Safety, vol. 23, no. 4, 2014, pp. 277–89, doi:10.1136/bmjqs-2012-001774. Accessed 19 Mar. 2026.

Mladenović, Jovan, et al. “Catheter-Associated Urinary Tract Infection in a Surgical Intensive Care Unit.” Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia, vol. 72, no. 10, 2015, pp. 883–88, doi:10.2298/vsp140624078m. Accessed 19 Mar. 2026.

Quinn, Paul. “Chasing Zero: A Nurse-Driven Process for Catheter-Associated Urinary Tract Infection Reduction in a Community Hospital.” Nursing Economic$, vol. 33, no. 6, 2015, pp. 320–25. Accessed 19 Mar. 2026.

Steiner, Sabrina, et al. “De Novo Expression of Gastrokines in Pancreatic Precursor Lesions Impede the Development of Pancreatic Cancer.” Oncogene, vol. 41, no. 10, 2022, pp. 1507–17, pmc.ncbi.nlm.nih.gov/articles/PMC8897191/. Accessed 19 Mar. 2026.

Tayyib, Nahla, and Fatmah Alsolami. “Assessing the Impact of a Preventive Care Bundle and Nursing Empowerment on Catheter-Associated Urinary Tract Infection (CAUTI) Rates in Saudi Arabia: A Single-Arm Intervention Study.” SAGE Open Nursing, vol. 11, 21 Nov. 2025, doi:10.1177/23779608251399263. Accessed 19 Mar. 2026.

“Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) Events.” National Healthcare Safety Network, Centers for Disease Control and Prevention, Jan. 2025, www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf. Accessed 19 Mar. 2026.

Van Decker, Stephanie G., et al. “Catheter-Associated Urinary Tract Infection Reduction in Critical Care Units: A Bundled Care Model.” BMJ Open Quality, vol. 10, no. 4, 2021, p. e001534, doi.org/10.1136/bmjoq-2021-001534. Accessed 19 Mar. 2026.

Full Article

Urinary tract infections related to the attachment of a urinary catheter are among the most common types of infections that affect patients confined in a hospital or other healthcare settings. They are a type of nosocomial infections (or hospital-acquired infections). Catheter-associated urinary tract infections (CA-UTI) are caused by the aggregation of microorganisms that enter the urinary tract through the catheter and cause infection. These microorganisms subsequently secrete a glue-like substance called a biofilm that serves as a protective matrix enabling microbial growth, becoming resistant to antibiotics and the body’s defense mechanisms. A biofilm also develops around the tubing of the catheter that is inserted into the urinary tract of a patient. An infection due to this medical device is often diagnosed based on the detection of disease-causing bacteria in the urine of the patient.

Background

Urinary catheters are extensively used in healthcare facilities and are the most frequently used indwelling device, with approximately 15 to 25 percent of patients receiving a urinary catheter at some point during their stay. For patients in critical care, this number is far higher, with more than 70 percent of patients receiving urinary catheters. 

Urinary catheters are generally described according to their duration of use. For example, short-term urinary catheters are often utilized for less than 30 days, whereas long-term catheters are attached for more than 30 days. Furthermore, short-term urinary catheters are employed in acute care health facilities, whereas chronic urinary catheters are commonly used for patients admitted to long-term healthcare facilities. In addition, the clinical and microbiologic descriptors for infections associated with urinary catheters also vary in terms of duration of use. For example, patients who have acquired an infection in relation to a urinary catheter but do not manifest any symptoms of infection except for its presence in their urine are diagnosed with catheter-associated asymptomatic bacteriuria (CA-ASB). On the other hand, those who present symptoms of infection that are associated with the use of a urinary catheter are described to have CA-UTI.

Although the number of bacteriuric patients who present symptoms of infection is relatively low, the high utilization rate of urinary catheters indicates that there is a significant burden attributable to these particular infections. CA-UTIs represent a notable proportion of nosocomial infections in acute care health facilities, and a substantial proportion in long-term healthcare facilities. They also represent approximately 75 percent of all UTIs acquired in the hospital, according to the Centers for Disease Control and Prevention. Studies have shown that the most effective approach in preventing bacteriuria and other nosocomial infections is to minimize the use of indwelling catheters. However, when a catheter has been determined to be necessary for the treatment of a patient who is confined in a healthcare facility, this should be discontinued as soon as the patient shows improvement. Healthcare facilities have also designed and implemented strategies to monitor as well as limit the use of catheters, thereby reducing the frequency of CA-UTIs. These monitoring strategies not only include the use of catheters, but also indicators of urinary tract infections that occur during catheter usage, and subsequent complications that develop from the attachment of a catheter on a patient. Developing catheters consisting of novel materials that prevent the formation of biofilms are also envisioned to prevent CA-UTIs.

Impact

Several evidence-based guidelines have now been established to prevent the occurrence of CA-UTI, which include avoiding the use of catheters, implementation of policies regarding the insertion as well as maintenance of catheters, establishment of criteria in selecting the appropriate catheter for a particular patient, surveillance of CA-UTI, proper use of the selected catheter, and identification of indicators of health progress in a patient who has received a catheter. Any changes in the incidence of CA-UTIs after the implementation of these institutional preventative programs are then reported in order to determine whether these guidelines are indeed effective in controlling the incidence of CA-UTI. The prevention program should also be customized according to the conditions of the local environment, features of the population it serves, as well as accessible resources. Effective senior leadership also largely contributes to the success of a CA-UTI preventative program.

Healthcare facilities have also evaluated and improved infrastructure in order to monitor and prevent the occurrence of CA-UTIs. In addition to policies governing the selection, insertion, and maintenance of catheters in a patient, the staff of the healthcare institution should also be educated on the etiology, treatment, and prevention of CA-UTIs. The healthcare facility should also have sufficient staff members who will follow the developed guidelines on preventing the occurrence of catheter-related infections. For example, a 2023–24 study evaluated the effect of following a structured CAUTI prevention care bundle in association with a nursing guidance program, which included checkpoints such as documenting the date of insertion of the catheter in each patient as well as the date of removal may help hospital staff determine whether this particular medical device has been in use for an extended period of time. The adherence to these specific guidelines significantly reduced the incidence of CA-UTIs. It is also therefore assumed that a similar reduction in the number of CA-UTI cases would result from improved criteria for the selection of catheters for each patient.

One activity that has been observed to decrease the number of CA-UTI cases in hospitals is the use of a catheter with the smallest appropriate size. This particular catheter feature not only minimizes the occurrence of CA-UTIs but also decreases urethral trauma in the patient. On the other hand, studies have shown that the major components of catheters have no significant effect on the incidence of urinary tract infections. For example, similar incidence rates for CA-UTIs were observed using catheters consisting of latex and silicone. In addition, the presence of a hydrogel coating has not consistently been shown to reduce the incidence rate of CA-UTIs.


Bibliography

“Catheter-Associated Urinary Tract Infection Basics.” Centers for Disease Control and Prevention, 15 Apr. 2024, www.cdc.gov/uti/about/cauti-basics.html. Accessed 19 Mar. 2026.

“Clinical Safety: Preventing Catheter-Associated Urinary Tract Infections (CAUTIs).” Centers for Disease Control and Prevention, 31 July 2024, www.cdc.gov/uti/hcp/clinical-safety/index.html. Accessed 19 Mar. 2026.

Conway, Laurie J., and E. L. Larson. “Guidelines to Prevent Catheter-Associated Urinary Tract Infection: 1980 to 2010.” Heart Lung, vol. 41, no. 3, 2012, pp. 271–83, doi:10.1016/j.hrtlng.2011.08.001. Accessed 19 Mar. 2026.

Conway, Laurie J., et al. “Risk Factors for Nosocomial Bacteremia Secondary to Urinary Catheter-Associated Bacteriuria: A Systematic Review.” Urologic Nursing, vol. 35, no. 4, 2015, p. 191, pmc.ncbi.nlm.nih.gov/articles/PMC4586038/. Accessed 19 Mar. 2026.

Feneley, R. C., et al. “An Indwelling Urinary Catheter for the 21st Century.” BJU International, vol. 109, no. 12, 2012, pp. 1746–49, doi.org/10.1111/j.1464-410X.2011.10753.x. Accessed 19 Mar. 2026.

Gould, Dinah. “Continuing Professional Development: Preventing Catheter-Associated Urinary Tract Infection.” Nursing Standard, vol. 30, no. 10, 2015, pp. 50–60, doi:10.7748/ns.30.10.50.s48. Accessed 19 Mar. 2026.

Halm, M. A., and N. O’Connor. “Do System-Based Interventions Affect Catheter-Associated Urinary Tract Infection?” American Journal of Critical Care, vol. 23, no. 6, 2014, pp. 505–9, doi:10.4037/ajcc2014689. Accessed 19 Mar. 2026.

Meddings, J., et al. “Reducing Unnecessary Urinary Catheter Use and Other Strategies to Prevent Catheter-Associated Urinary Tract Infection: An Integrative Review.” BMJ Quality and Safety, vol. 23, no. 4, 2014, pp. 277–89, doi:10.1136/bmjqs-2012-001774. Accessed 19 Mar. 2026.

Mladenović, Jovan, et al. “Catheter-Associated Urinary Tract Infection in a Surgical Intensive Care Unit.” Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia, vol. 72, no. 10, 2015, pp. 883–88, doi:10.2298/vsp140624078m. Accessed 19 Mar. 2026.

Quinn, Paul. “Chasing Zero: A Nurse-Driven Process for Catheter-Associated Urinary Tract Infection Reduction in a Community Hospital.” Nursing Economic$, vol. 33, no. 6, 2015, pp. 320–25. Accessed 19 Mar. 2026.

Steiner, Sabrina, et al. “De Novo Expression of Gastrokines in Pancreatic Precursor Lesions Impede the Development of Pancreatic Cancer.” Oncogene, vol. 41, no. 10, 2022, pp. 1507–17, pmc.ncbi.nlm.nih.gov/articles/PMC8897191/. Accessed 19 Mar. 2026.

Tayyib, Nahla, and Fatmah Alsolami. “Assessing the Impact of a Preventive Care Bundle and Nursing Empowerment on Catheter-Associated Urinary Tract Infection (CAUTI) Rates in Saudi Arabia: A Single-Arm Intervention Study.” SAGE Open Nursing, vol. 11, 21 Nov. 2025, doi:10.1177/23779608251399263. Accessed 19 Mar. 2026.

“Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) Events.” National Healthcare Safety Network, Centers for Disease Control and Prevention, Jan. 2025, www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf. Accessed 19 Mar. 2026.

Van Decker, Stephanie G., et al. “Catheter-Associated Urinary Tract Infection Reduction in Critical Care Units: A Bundled Care Model.” BMJ Open Quality, vol. 10, no. 4, 2021, p. e001534, doi.org/10.1136/bmjoq-2021-001534. Accessed 19 Mar. 2026.

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