Catheter-associated urinary tract infection (CAUTI) is among the most common types of healthcare-associated infection (HAI), which is associated with poor outcomes and prolonged hospitalization in critically ill patients. Previous studies have mentioned that patients admitted to neurological ICUs are at higher risk of CAUTI compared to patients in other ICU settings. This review paper aims to review studies published during the last decade that evaluated the incidence, risk factors, causative pathogens, and preventive strategies and treatment in neuro-critically ill patients.
DespotovicAMilosevicBMilosevicI, et al.Hospital-acquired infections in the adult intensive care unit—Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. Am J Infect Control. 2020;48(10):1211-1215. doi:10.1016/j.ajic.2020.01.009
2.
ClarkeKHallCLWileyZ, et al.Catheter-associated urinary tract infections in adults: Diagnosis, treatment, and prevention. J Hosp Med. 2020;15(9):552-556. doi:10.12788/jhm.3292
3.
DudeckMAHoranTCPetersonKD, et al.National healthcare safety network report, data summary for 2011, device-associated module. Am J Infect Control. 2013;41(4):286-300. doi:10.1016/j.ajic.2013.01.002
4.
LindnerAKoflerMRassV, et al.Early predictors for infectious complications in patients with spontaneous intracerebral hemorrhage and their impact on outcome. Front Neurol. 2019;10:817. doi:10.3389/fneur.2019.00817
5.
DudeckMAHoranTCPetersonKD, et al.National healthcare safety network (NHSN) report, data summary for 2010, device-associated module. Am J Infect Control. 2011;39(10):798-816. doi:10.1016/j.ajic.2011.10.001
6.
DudeckMAEdwardsJRAllen-BridsonK, et al.National healthcare safety network report, data summary for 2013, device-associated module. Am J Infect Control. 2015;43(3):206-221. doi:10.1016/j.ajic.2014.11.014
7.
HootonTMBradleySFCardenasDD, 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(5):625-663. Mar 1. doi:10.1086/650482
8.
LeoneMPerrinASGranierI, et al.A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients. Intensive Care Med. 2007;33(4):726-729. doi:10.1007/s00134-007-0534-1
9.
RosenthalVDAl-AbdelyHMEl-KholyAA, et al.International nosocomial infection control consortium report, data summary of 50 countries for 2010-2015: Device-associated module. Am J Infect Control. 2016;44(12):1495-1504. doi:10.1016/j.ajic.2016.08.007
10.
RosenthalVDBat-ErdeneIGuptaD, et al.International nosocomial infection control consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control. 2020;48(4):423-432. doi:10.1016/j.ajic.2019.08.023
11.
RosenthalVDDuszynskaWIderBE, et al.International nosocomial infection control consortium (INICC) report, data summary of 45 countries for 2013-2018, adult and pediatric units, device-associated module. Am J Infect Control. 2021;49(10):1267-1274. doi:10.1016/j.ajic.2021.04.077
12.
LeblebiciogluHErbenNRosenthalVD, et al. International nosocomial infection control consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012. Ann Clin Microbiol Antimicrob. 2014;13:51. doi:10.1186/s12941-014-0051-3
13.
AbulhasanYBAbdullahAAShettySARamadanMAYousefWMokaddasEM. Health care-associated infections in a neurocritical care unit of a developing country. J Neurocrit Care. 2020;32(3):836-846. doi:10.1007/s12028-019-00856-8.
14.
PerrinKVatsAQureshiA, et al.Catheter-associated urinary tract infection (CAUTI) in the NeuroICU: Identification of risk factors and time-to-CAUTI using a case-control design. J Neurocrit Care. 2021;34(1):271-278. doi:10.1007/s12028-020-01020-3
15.
MehtaYJaggiNRosenthalVD, et al.Device-associated infection rates in 20 cities of India, data summary for 2004-2013: Findings of the international nosocomial infection control consortium. Infect Control Hosp Epidemiol. 2016;37(2):172-181. doi:10.1017/ice.2015.276
16.
DudeckMAWeinerLMAllen-BridsonK, et al.National healthcare safety network (NHSN) report, data summary for 2012, device-associated module. Am J Infect Control. 2013;41(12):1148-1166. doi:10.1016/j.ajic.2013.09.002
17.
PodkovikSToorHGattupalliM, et al.Prevalence of catheter-associated urinary tract infections in neurosurgical intensive care patients - the overdiagnosis of urinary tract infections. Cureus. 2019;11(8):e5494. doi:10.7759/cureus.5494
18.
AbulhasanYBRachelSPChâtillon-AngleMO, et al.Healthcare-associated infections in the neurological intensive care unit: Results of a 6-year surveillance study at a major tertiary care center. Am J Infect Control. 2018;46(6):656-662. doi:10.1016/j.ajic.2017.12.001
19.
HagertyTKerteszLSchmidtJM, et al.Risk factors for catheter-associated urinary tract infections in critically ill patients with subarachnoid hemorrhage. J Neurosci Nurs. 2015;47(1):51-54. doi:10.1097/jnn.0000000000000111
20.
AbulhasanYBAlabdulraheemNSchillerI, et al.Health care-associated infections after subarachnoid hemorrhage. World Neurosurgery. 2018;115:e393-e403. doi:10.1016/j.wneu.2018.04.061
21.
DaytsO. Evidence-based protocol: Diagnosis and treatment of catheter-associated urinary tract infection within adult neurocritical care patient population. Nurs Clin. 2014;49(1):29-43. doi:10.1016/j.cnur.2013.11.008.
22.
Centers for Disease Control Prevention. Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection [UTI]) events. Accessed August 2021. https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf
23.
BammigattiCDoradlaSBelgodeHNKumarHSwaminathanRP. Healthcare associated infections in a resource limited setting. J Clin Diagn Res. 2017;11(1):OC01-OC04. doi:10.7860/jcdr/2017/23076.9150.
LiFSongMXuLDengBZhuSLiX. Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies. J Adv Nurs. 2019;75(3):517-527. doi:10.1111/jan.13863.
26.
HirjiIGuoZAnderssonSWHammarNGomez-CamineroA. Incidence of urinary tract infection among patients with type 2 diabetes in the UK general practice research database (GPRD). J Diabetes Complicat. 2012;26(6):513-516. doi:10.1016/j.jdiacomp.2012.06.008
27.
KennellyMThiruchelvamNAverbeckMAKonstatinidisCChartier-KastlerETrøjgaardP, et al.Adult neurogenic lower urinary tract dysfunction and intermittent catheterisation in a community setting: Risk factors model for urinary tract infections. Adv Urol. 2019;2019:1-13. doi:10.1155/2019/2757862
28.
National Spinal Cord Injury Statistical Center. Spinal cord injury facts and figures at a glance. J Spinal Cord Med. 2014;36(1):1-2. doi:10.1179/1079026813Z.000000000136
29.
KasperDLFauciASHauserSLLongoDLJamesonJLLoscalzoJ. Harrison’s Principles of Internal Medicine 20/E. New York, NY: McGraw Hill Professional; 2018.(ebook)
30.
GinsbergD. The epidemiology and pathophysiology of neurogenic bladder. Am J Manag Care. 2013;19(10 suppl l):s191-s196.
31.
SerlinDCHeidelbaughJJStoffelJT. Urinary retention in adults: Evaluation and initial management. Am Fam Physician. 2018;98(8):496-503.
32.
TsaiCHChouECChouLW, et al.The evaluation of bladder symptoms in patients with lumbar compression disorders who have undergone decompressive surgery. Spine. 2010;35(17):E849-E854. doi:10.1097/BRS.0b013e3181d55ad8
33.
ManackAMotskoSPHaag-MolkentellerC, et al.Epidemiology and healthcare utilization of neurogenic bladder patients in a US claims database. Neurourol Urodyn. 2011;30(3):395-401. doi:10.1002/nau.21003
34.
VasudevaPMadersbacherH. Factors implicated in pathogenesis of urinary tract infections in neurogenic bladders: some revered, few forgotten, others ignored. Neurourol Urodyn. 2014;33(1):95-100. doi:10.1002/nau.22378.
35.
KayeD. Host defense mechanisms in the urinary tract. Urol Clin. 1975;2(3):407-422.
36.
TrautnerBWDarouicheRO. Role of biofilm in catheter-associated urinary tract infection. Am J Infect Control. 2004;32(3):177-183. doi:10.1016/j.ajic.2003.08.005
37.
MenonGSubramanianABabyP, et al.Incidence of device associated-healthcare associated infections from a neurosurgical intensive care unit of a tertiary care center: A retrospective analysis. Anesth Essays Res. 2020;14(3):454-460. doi:10.4103/aer.AER_112_20
38.
DjordjevicZJankovicSGajovicODjonovicNFolicNBukumiricZ. Hospital infections in a neurological intensive care unit: incidence, causative agents and risk factors. J Infect Dev Ctries. 2012;6(11):798-805. doi:10.3855/jidc.2659.
39.
JaradatRWLahlouhABAlshogranOYAldabbourBABalushaAA. Nosocomial infections among patients with intracranial hemorrhage: A retrospective data analysis of predictors and outcomes. Clin Neurol Neurosurg. 2019;182:158-166. doi:10.1016/j.clineuro.2019.05.016.
40.
TitsworthWLHesterJCorreiaT, 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(4):911-920. doi:10.3171/2011.11.jns11974
41.
AgarwalRMohapatraSRathGPKapilA. Active surveillance of health care associated infections in neurosurgical patients. J Clin Diagn Res. 2017;11(7):DC01-DC04. doi:10.7860/jcdr/2017/26681.10146.
42.
LiangJWCifreseLOstojicLVShahSODhamoonMS. Preventable readmissions and predictors of readmission after subarachnoid hemorrhage. J Neurocrit Care. 2018;29(3):336-343. doi:10.1007/s12028-018-0557-1.
43.
MiHLiSLiHHuW. The effects of infection on severe stroke patients in the neurological intensive care unit in China. Int J Neurosci. 2018;128(8):715-720. doi:10.1080/00207454.2017.1412966.
44.
MurthySBMoradiyaYShahJ, et al.Nosocomial infections and outcomes after intracerebral hemorrhage: A population-based study. J Neurocrit Care. 2016;25(2):178-184. doi:10.1007/s12028-016-0282-6
45.
MuehlschlegelSCarandangROuilletteCHallWAndersonFGoldbergR. Frequency and impact of intensive care unit complications on moderate-severe traumatic brain injury: Early results of the outcome prognostication in traumatic brain injury (OPTIMISM) study. J Neurocrit Care. 2013;18(3):318-331. doi:10.1007/s12028-013-9817-2.
GaliczewskiJM. Interventions for the prevention of catheter associated urinary tract infections in intensive care units: An integrative review. Intensive Crit Care Nurs. 2016;32:1-11. doi:10.1016/j.iccn.2015.08.007.
48.
SoundaramGVSundaramurthyRJeyashreeKGanesanVArunagiriRCharlesJ. Impact of care bundle implementation on incidence of catheter-associated urinary tract infection: A comparative study in the intensive care units of a tertiary care teaching hospital in south India. IJCCM. 2020;24(7):544-550. doi:10.5005/jp-journals-10071-23473.
49.
ErshovaKSavinIKurdyumovaN, et al.Implementing an infection control and prevention program decreases the incidence of healthcare-associated infections and antibiotic resistance in a Russian neuro-ICU. Antimicrob Resist Infect Control. 2018;7:94. doi:10.1186/s13756-018-0383-4
50.
MullinKMKovacsCSFaticaC, et al.A multifaceted approach to reduction of catheter-associated urinary tract infections in the intensive care unit with an emphasis on “stewardship of culturing”. Infect Control Hosp Epidemiol. 2017;38(2):186-188. doi:10.1017/ice.2016.266.
51.
SchellingKPalamoneJThomasK, et al.Reducing catheter-associated urinary tract infections in a neuro-spine intensive care unit. Am J Infect Control. 2015;43(8):892-894. doi:10.1016/j.ajic.2015.04.184
52.
ChengWYLinHLLinYHLaiCCChaoCM. Achieving zero catheter-associated urinary tract infections in a neurosurgery intensive care unit. Infect Control Hosp Epidemiol. 2014;35(6):746-747. doi:10.1086/676440.
53.
SticklerDJFeneleyRCL. The encrustation and blockage of long-term indwelling bladder catheters: A way forward in prevention and control. Spinal Cord. 2010;48(11):784-790. doi:10.1038/sc.2010.32.
54.
HanCSKimSRadadiaKD, et al.Comparison of urinary tract infection rates associated with transurethral catheterization, suprapubic tube and clean intermittent catheterization in the postoperative setting: A network meta-analysis. J Urol. 2017;198(6):1353-1358. doi:10.1016/j.juro.2017.07.069.
55.
KangMSLeeBSLeeHJHwangSWHanZA. Prevalence of and risk factors for multidrug-resistant bacteria in urine cultures of spinal cord injury patients. Ann Rehabil Med. 2015;39(5):686-695. doi:10.5535/arm.2015.39.5.686.
56.
MeddingsJRogersMAKreinSLFakihMGOlmstedRNSaintS. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: An integrative review. BMJ Quality & Safety. 2014;23(4):277-289. doi:10.1136/bmjqs-2012-001774.
57.
KreinSLKowalskiCPHarrodMFormanJSaintS. Barriers to reducing urinary catheter use: A qualitative assessment of a statewide initiative. JAMA Internal Medicine. 2013;173(10):881-886. doi:10.1001/jamainternmed.2013.105.