Consider Changing the Foley Catheter when Patient has a Urinary Tract Infection
Melissa S. Camp MD
Urinary tract infections (UTIs) are one of the most common nosocomial infections in intensive care unit (ICU) patients. They almost always occur in the setting of a Foley catheter and the risk of developing a UTI increases with the length of time the Foley catheter is left in place. The risk of UTI is approximately 5% per day with a Foley catheter.
The diagnosis of a urinary tract infection is made based on urinalysis and urine culture. Findings on the urinalysis that are suggestive of a UTI include pyuria and bacteriuria. A urine culture with greater than 105 bacteria per mL is consistent with a diagnosis of a UTI. The most common organism responsible for UTIs is Escherichia coli. Other common organisms include Proteus, Klebsiella, Pseudomonas, Enterococcus, Staphylococcus epidermidis, Staphylococcus aureus, and Candida. Antibiotic treatment for a UTI should be based on the sensitivities from culture results, and recommended duration of therapy is 7 to 14 days depending on the severity of the infection. Urosepsis, for example, should be aggressively treated with a 14-day course of antibiotics.