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Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update

Published online by Cambridge University Press:  10 May 2016

Evelyn Lo
Affiliation:
St. Boniface General Hospital and University of Manitoba, Winnipeg, Manitoba, Canada
Lindsay E. Nicolle
Affiliation:
Health Sciences Centre and University of Manitoba, Winnipeg, Manitoba, Canada
Susan E. Coffin
Affiliation:
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Carolyn Gould
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa L. Maragakis
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Jennifer Meddings
Affiliation:
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
David A. Pegues
Affiliation:
Hospital of the University of Pennsylvania and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Ann Marie Pettis
Affiliation:
University of Rochester Medical Center, Rochester, New York
Sanjay Saint
Affiliation:
Ann Arbor Veterans Affairs Medical Center and theUniversity of Michigan, Ann Arbor, Michigan
Deborah S. Yokoe
Affiliation:
Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates “Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

Type
SHEA/IDSA Practice Recommendation
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

References

1. Lo, E, Nicolle, L, Classen, D, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(suppl 1):S41S50.Google Scholar
2. Yokoe, DS, Anderson, DJ, Berenholtz, SM, et al. Introduction to “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.Infect Control Hosp Epidemiol 2014;35(5):455459 (in this issue).CrossRefGoogle ScholarPubMed
3. Saint, S, Chenoweth, CE. Biofilms and catheter-associated urinary tract infections. Infect Dis Clin North Am 2003;17:411432.CrossRefGoogle ScholarPubMed
4. Weber, DJ, Sickbert-Bennett, EE, Gould, CV, Brown, VM, Huslage, K, Rutala, WA. Incidence of catheter-associated and non-catheter-associated urinary tract infections in a healthcare system. Infect Control Hosp Epidemiol 2011;32:822823.CrossRefGoogle ScholarPubMed
5. Weinstein, JW, Mazon, D, Pantelick, E, Reagan-Cirincione, P, Dembry, LM, Hierholzer, WJ. A decade of prevalence surveys in a tertiary-care center: trends in nosocomial infection rates, device utilization, and patient acuity. Infect Control Hosp Epidemiol 1999;20:543548.CrossRefGoogle Scholar
6. Tambyah, PA, Maki, DG. Catheter-associated urinary tract infection is rarely symptomatic. Arch Intern Med 2000;160:678687.Google Scholar
7. Burton, DC, Edwards, JR, Srinivason, A, Fridkin, SK, Gould, CV. Trends in catheter-associated urinary tract infections in adult intensive care units—United States, 1990-2007. Infect Control Hosp Epidemiol 2011;32:748756.Google Scholar
8. Tambyah, PA, Knasinski, V, Maki, DG. The direct costs of nosocomial catheter-associated urinary tract infection in the era of managed care. Infect Control Hosp Epidemiol 2002;23:2731.Google Scholar
9. Centers for Disease Control and Prevention (CDC). National Healthcare Safety Network (NHSN) Report, Data Summary for 2011, Device-Associated Module. Atlanta: CDC, 2013. http://www.cdc.gov/nhsn/PDFs/dataStat/NHSN-Report-2011-Data-Summary.pdf. Accessed November 28, 2013.Google Scholar
10. Leuck, A-M, Wright, D, Ellingson, L, Kraemer, L, Kuskowski, MA, Johnson, JR. Complications of Foley catheters—is infection the greatest risk? J Uroi 2012;187:16621666.Google Scholar
11. Centers for Disease Control and Prevention (CDC). 2011 National and State Healthcare-Associated Infections Standardized Infection Ratio Report. Atlanta: CDC, 2013. http://www.cdc.gov/hai/pdfs/SIR/SIR-Report_02_07_2013.pdf. Accessed November 28, 2013.Google Scholar
12. Fortin, E, Rocher, I, Frenette, C, Temblay, C, Quach, C. Healthcare-associated bloodstream infections secondary to a urinary focus: the Quebec Provincial Surveillance results. Infect Control Hosp Epidemiol 2012;33:456462.Google Scholar
13. Hollingsworth, SM, Rogers, MA, Krein, SL, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med 2013;159: 401410.Google Scholar
14. Saint, S, Baker, PD, McDonald, LL, Ossenkop, K. Urinary catheters: what type do men and their nurses prefer? J Am Geriatr Soc 1999;47:14531457.CrossRefGoogle ScholarPubMed
15. Chant, C, Smith, DM, Marshall, JC, Friedrich, JO. Relationship of catheter-associated urinary tract infection to mortality and length of stay in critically ill patients: a systematic review and meta-analysis of observational studies. Crit Care Med 2011;39: 11671173.CrossRefGoogle ScholarPubMed
16. Cope, M, Cevallos, ME, Cadle, RM, Daroviche, RO, Musher, DM, Trautner, BW. Inappropriate treatment of catheter associated asymptomatic bacteriuria in a tertiary care hospital. Clin Infect Dis 2009;48:11821188.CrossRefGoogle ScholarPubMed
17. Johnson, JR, Roberts, PL, Olsen, RJ, Moyer, KA, Stamm, WE. Prevention of catheter-associated urinary tract infection with a silver-oxide-coated urinary catheter: clinical and microbiologie correlation, J Infect Dis 1990;162:11451150.Google Scholar
18. Huth, TS, Burke, JP, Larsen, RA, Classen, DC, Stevens, LE. Randomized trial of meatal care with silver sulfadiazine cream for the prevention of catheter-associated bacteriuria. J Infect Dis 1992;165:1418.Google Scholar
19. Riley, DK, Classen, DC, Stevens, LE, Burke, JP. A large, randomized clinical trial of a silver-impregnated urinary catheter: lack of efficacy and staphylococcal superinfection. Am J Med 1995;98: 349356.CrossRefGoogle ScholarPubMed
20. Gould, CV, Umscheid, CA, Agarwal, RK, Kuntz, G, Pegues, DA. Healthcare Infection Control Practices Advisory Committee (HICPAC): guideline for prevention of catheter-associated urinary tract infections, 2009. http://www.cdc.gov/hicpac/cauti/001_cauti.html.Google Scholar
21. Hooton, TM, Bradley, SF, Cardenas, DD, et al. Diagnosis, prevention and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America. Clin Infect Dis 2010;50:625663.Google Scholar
22. Greene, MT, Chang, R, Kuhn, L, et al. Predictors of hospital-acquired urinary tract-related bloodstream infection. Infect Control Hosp Epidemiol 2012;33:10011007.Google Scholar
23. Bukhari, SS, Sanderson, PJ, Richardson, DM, Kaufman, ME, Aucken, HM, Cookson, BD. Endemic cross-infection in an acute medical ward. J Hosp Infect 1993;24:261271.Google Scholar
24. Schaberg, DR, Weinstein, RA, Stamm, WE. Epidemics of nosocomial urinary tract infection caused by multiply resistant gram-negative bacilli: epidemiology and control. J Infect Dis 1976;133: 363366.Google Scholar
25. Jarvis, WR, Munn, VP, Highsmith, AK, Culver, DH, Hughes, JM. The epidemiology of nosocomial infections caused by Klebsiella pneumoniae . Infect Control 1985;6:6874.CrossRefGoogle ScholarPubMed
26. Yoon, HJ, Choi, JY, Park, YS, et al. Outbreaks of Serratici marcescens bacteriuria in a neurosurgical intensive care unit of a tertiary care teaching hospital: a clinical, epidemiologie, and laboratory perspective. Am J Infect Control 2005;33:595601.Google Scholar
27. Stark, RP, Maki, DG. Bacteriuria in the catheterized patient: what quantitative level of bacteriuria is relevant? N Engl J Med 1984; 311:560564.CrossRefGoogle ScholarPubMed
28. Oliver-Wright, M, Kharaseh, M, Beaumont, JL, Peterson, LR, Robicsek, A. Reporting catheter-associated urinary tract infections: denominator matters. Infect Control Hosp Epidemiol 2011;32: 635640.Google Scholar
29. Pratt, RJ, Pellowe, C, Loveday, HP, Robinson, N, Smith, GW; Epic Guideline Development Team. Guidelines for preventing infections associated with the insertion and maintenance of short-term indwelling urethral catheters in acute care, J Hosp Infect 2001;47(suppl):S39S46.Google Scholar
30. Pratt, RJ, Pellowe, CM, Wilson, JA, et al. Epic 2: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 2007;65(suppl):S1S64.Google Scholar
31. Meddings, J, Rogers, MA, Krein, SL, et al. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf 2013. Electronically published ahead of print, doi: 10.1136/bmjqs-2012-001774.Google Scholar
32. Li, L, Wen, J, Wang, L, Li, YP, Li, Y. Is routine indwelling cathe-terization of the bladder for caesarean section necessary? a systematic review. BJOG 2011;118:400409.Google Scholar
33. Hagen, S, Sinclair, L, Cross, S. Washout policies in long-term indwelling urinary catheterization in adults. Cochrane Database Syst Rev 2010;(3):CD004012.Google Scholar
34. Zaouter, C, Wuethrich, P, Miccoli, M, Carli, F. Early removal of urinary catheter leads to greater post-void residuals in patients with thoracic epidural. Acta Anaestheiol Scand 2012;56(8):10201025.Google Scholar
35. Pickard, R, Lam, T, MacLennan, G, et al. Antimicrobial catheters for reduction of symptomatic urinary tract infection in adults requiring short-term catheterisation in hospital: a multicentre randomised controlled trial. Lancet 2012;380:19271935.Google Scholar
36. Pickard, R, Lam, T, MacLennan, G, et al. Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial- and antiseptic-impregnated urethral catheters (the CATHETER trial). Health Technol Assess 2012;16(47). doi: 10.3310/htal6470.Google Scholar
37. Shimoni, Z, Rodrig, J, Kamma, N, Froom, P. Will more restrictive indications decrease rates of urinary catheterization? an historical comparative study. BMJ Open 2012;2:e000473.Google Scholar
38. Fakih, MG, Watson, SR, Greene, MT, et al. Reducing inappropriate urinary catheter use: a statewide effort. Arch Intern Med 2012; 172:255260.Google Scholar
39. Saint, S, Greene, MT, Kowalski, CP, Watson, SR, Hofer, TP, Krein, SL. Preventing catheter-associated urinary tract infection in the United States: a national comparative study. JAMA Intern Med 2013;173(10):874879.CrossRefGoogle ScholarPubMed
40. Dye, NG, Pena, ME, Shemes, SP, Rey, JE, Szpunar, SM, Fakih, MG. The effect of resident peer-to-peer education on compliance with urinary catheter placement indications in the emergency department. Postgrad Med J 2011;87:814818.Google Scholar
41. Marigliano, A, Barbadoro, P, Pennacchietti, L, D’Errico, MM, Prospero, E. Active training and surveillance: 2 good friends to reduce urinary catheterization rate. Am J Infect Control 2012;40:692695.CrossRefGoogle ScholarPubMed
42. Titsworth, WL, Hester, J, Correia, T, et al. Reduction of catheter-associated urinary tract infections among patients in a neurological intensive care unit: a single institution’s success. J Neurosurg 2012;116:911920.Google Scholar
43. Rosenthal, VD, Ramachandran, B, Ducnas, L, et al. Findings of the International Nosocomial Infection Control Consortium (INICC), part I: effectivenesss of a multidimensional infection control approach on catheter-associated urinary tract infection rates in pediatric intensive care units of 6 developing countries. Infect Control Hosp Epidemiol 2012;33:696703.Google Scholar
44. Saint, S, Kowalski, CP, Forman, J, et al. A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals. Infect Control Hosp Epidemiol 2008;29:333341.Google Scholar
45. Saint, S, Olmsted, RN, Fakih, MG, et al. Translating health care-associated urinary tract infection prevention research into practice via the bladder bundle. Jt Comm J Qual Patient Saf 2009; 35:449455.Google ScholarPubMed
46. Krein, SL, Kowalski, CP, Harrod, M, Forman, J, Saint, S. Barriers to reducing urinary catheter use: a qualitative assessment of a statewide initiative. JAMA Intern Med 2013;173(1):881886.Google Scholar
47. Fakih, MG, Greene, MT, Kennedy, EH, et al. Introducing a population-based outcome measure to evaluate the effect of interventions to reduce catheter-associated urinary tract infection. Am J Infect Control 2012;40:359364.Google Scholar
48. Burns, AC, Petersen, NJ, Garza, A, et al. Accuracy of a urinary catheter surveillance protocol. Am J Infect Control 2012;40:5558.Google Scholar
49. Wong, ES, Rupp, ME, Mermel, L, et al. Public disclosure of healthcare-associated infections: the role of the Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol 2005; 26(2):210212.Google Scholar
50. McKibben, L, Horan, TC, Tokars, JI, et al. Guidance on public reporting of healthcare-associated infections: recommendations of the Healthcare Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 2005;26(6):580587.Google Scholar
51. Healthcare-Associated Infection Working Group of the Joint Public Policy Committee. Essentials of Public Reporting of Healthcare-Associated Infections: A Tool Kit. Atlanta: Centers for Disease Control and Prevention, 2007. http://www.cdc.gov/ncidod/dhqp/pdf/ar/06_107498_Essentials_Tool_Kit.pdf. Accessed April 6, 2007.Google Scholar
52. National Quality Forum. National Voluntary Consensus Standards, Endorsed November 15, 2007. Washington, DC: National Quality Forum, 2007. http://www.qualityforum.org/pdf/news/lsCSACMeasures.pdf. Accessed December 20, 2007.Google Scholar
53. Meddings, JA, Reichert, H, Rogers, MA, Saint, S, Stephansky, J, McMahon, LE Effect of nonpayment for hospital-acquired catheter-associated urinary tract infection: a statewide analysis. Ann Intern Med 2012;157:305312.Google Scholar
54. Jain, M, Miller, L, Belt, D, King, D, Berwick, DM. Decline in ICU adverse events, nosocomial infections and cost through a quality improvement initiative focusing on teamwork and culture change. Qual Saf Health Care 2006;15:235239.Google Scholar
55. Elpern, EH, Killeen, K, Ketchem, A, Wiley, A, Patel, G, Lateef, O. Reducing use of indwelling urinary catheters and associated urinary tract infections. Am J Crit Care 2009;18:535541.Google Scholar
56. Apisarnthanarak, A, Thongphubeth, K, Sirinvaravong, S, et al. Effectiveness of multifaceted hospital wide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand. Infect Control Hosp Epidemiol 2012;28:791798.Google Scholar
57. Reilly, L, Sullivan, P, Ninni, S, Fochesto, D, Williams, K, Fetherman, B. Reducing foley catheter device days in an intensive care unit: using the evidence to change practice. AACN Adv Crit Care 2006;17:272283.Google Scholar
58. Wenger, JE. Cultivating quality: reducing rates of catheter-associated urinary tract infection. Am J Nurs 2010;110:4045.Google Scholar
59. Rothfeld, AF, Stickley, A. A program to limit urinary catheter use in an acute care hospital. Am J Infect Control 2010;38:568571.Google Scholar
60. Dumigan, DG, Kohan, CA, Reed, CR, Jekel, JF, Fikrig, MK. Utilizing national nosocomial infection surveillance system date to improve urinary tract infection rates in three intensive-care units. Clin Perform Qual Health Care 1998;6(4):172178.Google Scholar
61. Rhodes, N, McVay, T, Harrington, L, Luquire, R, Winter, M, Helms, B. Eliminating catheter-associated urinary tract infections, part II: limit duration of catheter use. J Healthc Qual 2009;31:1317.Google Scholar
62. van den Broek, P, Wille, JC, van Benthem, BHB, Prenboom, RJM, van den Akker-van Marie, ME, Niel-Weise, BS. Urethral catheters: can we reduce use? BMC Uroi 2011;11:1016.Google Scholar
63. Oman, KS, Flynn Makie, MB, Fink, R, et al. Nurse-directed interventions to reduce catheter-associated urinary tract infections. Am J Infect Control 2012;40:448553.CrossRefGoogle ScholarPubMed
64. Huang, WC, Wann, SR, Lir, SL, et al. Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters. Infect Control Hosp Epidemiol 2004;25:974978.Google Scholar
65. Fakih, MG, Dueweke, C, Meisner, S, et al. Effect of nurse-led multidisciplinary rounds on reducing the unnecessary use of urinary catheterization in hospitalized patients. Infect Control Hosp Epidemiol 2008;29:815819.Google Scholar
66. Venkatram, S, Rachmale, S, Kanna, B. Study of device use adjusted rates in health care-associated infections after implementation of “bundles” in a closed-model medical intensive care unit. J Crit Care 2010;25:174181.Google Scholar
67. Rosenthal, VD, Todi, SK, Alvarez-Moreno, C, et al. Impact of a multidimensional infection control strategy on catheter associated urinary infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium. Infection 2012;40:517526.Google Scholar
68. Goetz, AM, Kedzuf, S, Wagener, M, Mujder, RR. Feedback to nursing staff as an intervention to reduce catheter-associated urinary tract infections. Am J Infect Contol 1999;7:402404.Google Scholar
69. Winter, M, Helms, B, Harrington, L, Luquire, R, McVay, T, Rhodes, N. Eliminating catheter-associated urinary tract infections, part I: avoid catheter use. J Healthc Qual 2009;31:812.Google Scholar
70. Miller, RS, Norris, PR, Jenkins, JM, et al. Systems initiatives reduce healthcare-associated infections: a study of 22,928 device days in a single trauma unit, J Trauma 2010;68:2331.Google Scholar
71. Topal, J, Conklin, S, Camp, K, et al. Prevention of nosocomial catheter-associated urinary tract infections through computerized feedback to physicians and a nurse-directed protocol. Am J Med Qual 2005;20:121126.CrossRefGoogle Scholar
72. Misset, B, Timsit, JF, Dumay, MF, et al. A continuous quality-improvement program reduces nosocomial infection rates in the ICU. Intensive Care Med 2004;30:395400.Google Scholar
73. Crouzet, J, Bertrand, X, Venier, AG, Badoz, M, Husson, C, Talon, D. Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection. J Hosp Infect 2007; 67:253257.Google Scholar
74. Jaggi, N, Sissodia, P. Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India. J Clin Diag Res 2012;6:13721376.Google Scholar
75. Loeb, M, Hunt, D, O’Halloran, K, Carusone, SC, Dafoe, N, Walter, SD. Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: a randomized controlled trial. J Gen Intern Med 2008;23:816820.Google Scholar
76. Guyatt, GH, Oxman, AD, Vist, GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924926.Google Scholar
77. GRADE. Canadian Task Force on Preventive Health Care website. http://canadiantaskforce.ca/methods/grade/. Accessed December 31, 2013.Google Scholar
78. Saint, S, Kaufman, SR, Thompson, M, Rogers, MA, Chenoweth, CE. A reminder reduces urinary catheterization in hospitalized patients. Jt Comm J Qual Patient Saf 2005;31(8):455462.Google Scholar