Catheter-associated urinary tract infections in the community

An estimated 90 000 people in community settings have long-term indwelling urinary catheters (Gage et al, 2017). Urinary catheters are invasive medical devices, and there are risks and benefits associated with their use. This article examines the clinical indications for indwelling urinary catheterisation and the diagnosis and treatment of catheter-associated urinary tract infections (CAUTI). There is little data on the number of people with long-term urinary catheters being cared for in the community. A UK study extrapolated data from the south and west of England of people who had indwelling catheters for 90 days. They estimated that over 90 000 people in the UK had long-term catheters. They found most people were initially catheterised in hospital and that prevalence increased with age. Catheterisation was more common in people with neurological disease, and suprapubic catheterisation was more common in women (Gage et al, 2017). An Irish study found that 31% of patients aged 85 years and over who were receiving community nursing care had an indwelling catheter (Forde and Barry, 2018). In some instances, initial catheterisation is inappropriate; in other cases, it was appropriate at one point during the person's hospital stay but is no longer clinically appropriate (Nazarko, 2017).