Catheter associated Urinary Tract Infection | CAUTI Care Bundle | CAUTI BUNDLE

Summary

This video provides an in-depth look at Catheter-Associated Urinary Tract Infections (Coty), exploring the causes, risk factors, symptoms, diagnosis, and prevention strategies. The video explains the role of urinary catheters in healthcare, highlighting situations where their use is necessary and the potential risks they carry, especially in terms of infection. It also covers the pathogenesis of Coty, common pathogens, and offers key insights into effective infection control through evidence-based care bundles. The video emphasizes the importance of proper catheter care to prevent life-threatening complications like Coty, while providing actionable prevention tips and management strategies.

Takeaways

• 😀 A urinary tract infection (UTI) occurs when bacteria infect parts of the urinary system, including kidneys, ureters, bladder, or urethra.
• 😀 Catheter-associated urinary tract infection (CAUTI) is defined as a UTI that occurs in a patient with an indwelling urinary catheter, or within 48 hours of its removal.
• 😀 Urinary catheterization is necessary for patients with urinary retention, need for accurate urinary output measurement, perioperative care, trauma, or altered consciousness.
• 😀 Risk factors for CAUTI include prolonged catheter use, improper catheter insertion, female gender, older age, diabetes, and compromised immune function.
• 😀 CAUTI pathogenesis involves two main routes of infection: extraluminal (through the catheter’s outer surface) and intraluminal (through the catheter's drainage system).
• 😀 Common pathogens causing CAUTI include *Escherichia coli*, *Proteus mirabilis*, *Enterococcus*, *Pseudomonas aeruginosa*, and *Candida* species.
• 😀 Symptoms of CAUTI can include fever, cloudy urine, altered mental status, pelvic or flank pain, and suprapubic tenderness.
• 😀 Diagnosis of CAUTI is based on clinical signs, pyuria, and urine culture with no more than two species of bacteria present.
• 😀 Empiric antibiotic therapy should be initiated for CAUTI, guided by culture results and local resistance patterns.
• 😀 The CAUTI prevention strategy includes the **Cauti Bundle**, which focuses on proper catheter insertion (hand hygiene, sterile equipment) and maintenance (regular assessment, ensuring no obstructions, and maintaining a closed drainage system).

Q & A

What is a urinary tract infection (UTI)?

A urinary tract infection (UTI) is an infection in any part of the urinary system, including the kidneys, ureters, bladder, and urethra. UTIs can occur due to bacterial infections in these areas, leading to symptoms like fever, pain, and cloudy or foul-smelling urine.

What is catheter-associated urinary tract infection (CAUTI)?

Catheter-associated urinary tract infection (CAUTI) is a UTI that occurs in patients with an indwelling urinary catheter, either at the time of infection or within 48 hours prior to the infection's onset. CAUTI is a common healthcare-associated infection.

What are the common indications for urinary catheterization?

Indications for urinary catheterization include urinary retention (acute or chronic), accurate measurement of urinary output in cases like renal failure, perioperative management, trauma or critically ill patients, altered sensorium or unconsciousness, and palliative or end-of-life care.

What is the role of a urinary catheter?

A urinary catheter is a thin tube inserted into the bladder to drain urine. It is commonly known as a Foley catheter and helps collect urine when patients are unable to urinate on their own due to medical conditions or surgery.

What are the risk factors for developing CAUTI?

Risk factors for CAUTI include prolonged catheterization, errors in catheter insertion, female gender or older age, diabetes, immunocompromised status, renal dysfunction, and poor catheter care practices.

How are microbes introduced into the urinary tract in CAUTI?

Microbes can enter the urinary tract in CAUTI through two main routes: extra-luminal (via the external surface of the catheter) or intra-luminal (via the internal surface of the catheter, often due to improper handling or opening of the drainage system).

What are some common pathogens that cause CAUTI?

Common pathogens that cause CAUTI include *Escherichia coli* (E. coli), *Proteus mirabilis*, *Enterococcus* species, *Pseudomonas aeruginosa*, and *Candida* species.

What are the typical signs and symptoms of CAUTI?

Signs and symptoms of CAUTI include fever, chills, altered mental status, hematuria (blood in urine), cloudy or foul-smelling urine, flank or pelvic pain, suprapubic tenderness, and general malaise. In some cases, if the catheter is removed, symptoms like frequency, urgency, and suprapubic pain may occur.

What diagnostic criteria are used to identify CAUTI?

The diagnostic criteria for CAUTI include clinical signs of a urinary tract infection, pyuria (pus in the urine), and positive urinalysis or culture showing no more than two species of microorganisms.

What is the role of the Coty Bundle in preventing CAUTI?

The Coty Bundle consists of evidence-based interventions designed to prevent CAUTI. It includes both an insertion care bundle (to ensure proper catheterization practices) and a maintenance care bundle (to ensure the catheter remains free of infection throughout its use). These measures are designed to improve patient outcomes and reduce the risk of infection.

What are the key components of the Insertion Care and Maintenance Care Bundles?

The Insertion Care Bundle includes ensuring proper catheter indication, using appropriate catheter size, practicing good hand hygiene, following aseptic techniques, and using a closed drainage system. The Maintenance Care Bundle focuses on regular catheter care, hand hygiene, reviewing catheter necessity, ensuring proper drainage, and maintaining a closed drainage system to prevent contamination.