Urinary Tract Infection

Author(s):
Carlee Hoxworth MPH, CIC Infection Preventionist

St. Louis, MO

Revised:
January 26, 2024
Published:
October 2, 2014
Declarations of Conflicts of Interest:
  • Carlee Hoxworth reports no conflicts of interest.

Abstract

Urinary tract infections (UTIs) are the most common type of healthcare-associated infection (HAI), the majority of which are associated with an indwelling urinary catheter (IUC). Rates of healthcare-associated UTIs have decreased over time, but they remain the most frequently identified HAI. Susceptibility to these infections is common in all individuals, though specific groups are more susceptible than others, including pregnant people, spinal cord injury patients, and long-term care (LTC) residents. There is a growing trend of antibiotic resistance in the causative organisms of UTIs, making treatment options fewer and highlighting the need for effective and evidence-based prevention efforts.

Most UTIs are caused by Escherichia coli and other gram-negative Enterobacterales that colonize the gastrointestinal tract and eventually migrate into the genitourinary tract or catheter. The use of IUCs, especially during a hospital stay, is a known risk factor for infection; the rate of bacteriuria development increases 3 to 7 percent per subsequent day of catheterization. Various professional organizations, such as The Society for Healthcare Epidemiology of America (SHEA), the Centers for Disease Control and Prevention (CDC), and the Institute for Healthcare Improvement (IHI), have released guidelines and best practice documents. These aim to help the infection preventionist (IP) design and implement initiatives to reduce UTIs, such as device removal protocols and care bundles.