Don’t get “CAUT” Without Knowing the Ins and Outs

The fifth most common type of health-associated infections is urinary tract infection.

What seems to present itself as an easily identified query opportunity can lead to an unnecessary Hospital-Acquired Condition, commonly known as HAC 06: catheter-associated urinary tract infection (CAUTI). The fifth most common type of health-associated infections is urinary tract infection. Knowing how to identify a CAUTI and recognize the clinical criteria for the type of urinary tract infection is imperative before a query is crafted.

The first step in identifying a CAUTI is knowing the definitions. This includes the type of urinary tract infection connected to a CAUTI.

What is a catheter-associated UTI (CAUTI)? National Healthcare Safety Network (NHSN) defines it as a UTI where an indwelling urinary catheter was in place for more than two consecutive days in an inpatient location on the date of the event, with a day of device placement being counted as the first day and the indwelling urinary catheter was in place the date of the event or the day before.

Are all catheters considered indwelling urinary catheters? NHSN states an indwelling catheter is a drainage tube that is inserted into the urinary bladder through the urethra, is left in place, and is connected to a drainage bag (including leg bags), also known as Foley catheters.

What is not considered an indwelling catheter: Condom or straight in-and-out catheters are not included nor are nephrostomy tubes, ileoconduits, or suprapubic catheters unless an indwelling urinary catheter (IUC) is also present.

What is the type of urinary tract infection that meets CAUTI criteria? A symptomatic UTI. What is a symptomatic UTI? One where at least one of these signs/symptoms are present:

• Fever (>38.0C)
• Suprapubic tenderness (with no other cause)
• Urinary urgency (cannot be with a catheter is in place)
• Urinary frequency (cannot be with a catheter is in place)
• Dysuria (cannot be with a catheter is in place)

Urine culture has no more than two species of organisms identified, at least one of which is a bacterium of >10⁵ CFU/ml.

Clarification that a UTI is due to an indwelling catheter is a common query practice. It’s so common that we must be able to identify the definitions of a CAUTI before presenting a query to a provider. Don’t get CAUT querying without knowing the ins and outs.

Reference: 

https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf