A urinary catheter-associated UTI (CAUTI) is diagnosed when a catheterised patient has symptoms AND urine culture grows ≥10³ CFU/mL of a uropathogen. However, asymptomatic bacteriuria (ASB) in a catheterised patient should be treated with antibiotics in which ONE situation?

• A Elderly ICU patient on broad-spectrum antibiotics
• B Diabetic patient with neurogenic bladder and long-term catheter
• C Catheterised patient with urine culture growing ≥10⁵ CFU/mL of E. coli
• D Patient undergoing urological surgery with mucosal breach expected ✓

Explanation

IDSA guidelines recommend treating ASB only before urological procedures where mucosal bleeding is anticipated (e.g., transurethral resection of the prostate, ureteroscopy with stone fragmentation) to prevent post-procedure bacteraemia. ASB in all other catheterised patients — including elderly, ICU, diabetic, and long-term catheterised patients — should NOT be treated with antibiotics, as treatment does not reduce symptomatic infections but increases antimicrobial resistance and adverse drug effects. High colony counts alone without symptoms are not an indication for therapy in cathetered patients.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.