A urinary catheter-associated UTI (CAUTI) is suspected in a catheterised patient. Urine culture from a freshly collected catheter sample grows E. coli >10^5 CFU/mL with pyuria (>10 WBC/µL). The patient has fever and costovertebral angle tenderness. Which of the following is the most important preventive measure proven to reduce CAUTI rate in ICU settings?
- A Silver alloy-coated urinary catheters for all ICU patients
- B Systemic antibiotic prophylaxis during catheterisation
- C Regular antiseptic bladder irrigation with chlorhexidine
- D Daily reassessment and prompt removal of urinary catheter when no longer clinically indicated ✓
Explanation
The single most effective, evidence-based intervention to reduce CAUTI is daily review and early removal of indwelling urinary catheters using nurse-driven or electronic reminder protocols — every day of catheterisation adds a 3–7% risk of bacteriuria. Catheter-days reduction is the cornerstone of CAUTI prevention bundles. Silver alloy catheters have modest benefit in short-term catheterisation (≤7 days) but are costly and not recommended for routine use. Prophylactic antibiotics increase resistance without reducing symptomatic CAUTI. Bladder irrigation with antiseptics is not recommended and can cause mucosal irritation.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.