Guidelines for preventing infections associated with the insertion and maintenance of short-term indwelling urethral catheters in acute care.

There is consistent evidence that a significant number of hospital-acquired infections are related to urinary catheterisation.1–4 The risk of infection is associated with the method and duration of catheterisation, the quality of catheter care and host susceptibility. The prevalence of catheterised patients in hospitals in England is 12.6 percent.5 The highest incidence of infection is associated with indwelling urethral catheterisation.6 Many of these infections are serious and lead to significant morbidity. Between 20 and 30 percent of catheterised patients develop bacteriuria, of whom 2–6 percent develop symptoms of urinary tract infection (UTI).6 The risk of acquiring bacteriuria is approximately 5 percent for each day of catheterisation.7,8 Of patients with a UTI, 1–4 percent develops bacteraemia and, of these, 13–30 percent die.1,2 Duration of catheterisation is strongly associated with risk of infection, i.e., the longer the catheter is in place, the higher the incidence of urinary tract infection.6 Advice from best practice emphasises the importance of documenting all procedures involving the catheter or drainage system in the patient’s records1 and providing patients with adequate information in relation to the need, insertion, maintenance and removal of their catheter.1