Guidelines
Catheter-Associated UTI (CA-UTI)

Catheter-Associated UTI (CA-UTI)

Microbiology

Diagnosis

New Onset:

  • Fever
  • Rigors
  • Malaise
  • Lethargy
  • Altered mental status with no other cause
  • Flank pain
  • CVA tenderness
  • Acute hematuria
  • Pelvic discomfort

Additional Symptoms if Catheter Recently Removed (48 hrs):

  • Dysuria, urgency or frequency
  • Suprapubic pain/tenderness

Spinal Cord Injury Patients:

  • Increased spasticity
  • Sense of unease or autonomic dysreflexia

PLUS

Positive urinalysis

PLUS

Growth of 1 or more bacterial species in a single catheter urine specimen or midstream void within 48hrs of catheter removal

Clinical Key Points

  • Do NOT treat a positive culture
  • Do NOT collect urine culture
  • DISCONTINUE catheter as soon as appropriate; assess continued need for catheter and remove if possible
  • If catheter still indicated and has been in place for greater than 2 weeks, replace and repeat urine culture prior to starting antibiotics
  • Obtain urine sample for analysis and culture from new catheter prior to antimicrobial therapy
  • If catheter removed, collect sample voided mid-stream