​*(Key Resources recommended by Dr. Jerome Leis, **recommend Dr. Shaun Morris)

Professional Associations and Helpful Websites

• Centers for Disease Control and Prevention
• Association for Professional in Infection Control and Epidemiology
• Institute for Healthcare Improvement

UTI Clinical Practice Guidelines

Andreessen L, Wilde MH, Herendeen P. Preventing catheter-associated urinary tract infections in acute care: the bundle approach. J Nurs Care Qual. 2012; 27 (3): 209-217. doi: 10.1097/NCQ.0b013e318248b0b1.

Association for Professionals in Infection Control and Epidemiology (APIC). APIC Implementation Guide: Guide to preventing catheter-associated urinary tract infections. Washing DC: API; 2014.

Centers for Disease Control and Prevention (CDC). Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection [UTI]) and other urinary system infection [USI]) events. CDC; 2016.

Clarke K, Tong D, Pan Y, et al. Reduction in catheter-associated urinary tract infections by bundling interventions.Int J Qual Health Care. 2013; 25 (1): 43-49.

Conway LJ, Larson EL. Guidelines to prevent catheter-associated urinary tract infection: 1980 to 2010. Heart Lung. 2012; 41 (3): 271-283. doi: 10.1016/j.hrtlng.2011.08.001.

*Epp A, LaRochelle A. SOGC Clinical Practice Guideline: Recurrent urinary tract infection. J Obstet Gynaecol Can. 2010; 32 (11): 1082–1090.

Flodgren G, Conterno LO, Mayhew A, Omar O, Pereira CR, Shepperd S. Interventions to improve professional adherence to guidelines for prevention of device-related infections. Cochrane Database Syst Rev. 2013; 3: CD006559. doi: 10.1002/14651858.CD006559.pub2.

Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for prevention of catheter-associated urinary tract infections 2009. Centers for Disease Control and Prevention (CDC); 2010.

Hill TC, Baverstock R, Carlson KV, et al. Best practices for the treatment and prevention of urinary tract infection in the spinal cord injured population: The Alberta context. Can Urol Assoc.J. 2013; 7 (3-4): 122-130. doi: 10.5489/cuaj.337.

*Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50 (5): 625-663.

Institute for Healthcare Improvement (IHI). How-to Guide: Prevent catheter-associated urinary tract infections. Cambridge, MA: IHI; 2011.

The Joint Commission. Surgical Care Improvement Project (SCIP). SCIP-Inf-9: Urinary catheter removed on postoperative day 1 (POD 1) or postoperative day 2 (POD 2) with day or surgery being day zero. Specifications manual for national hospital inpatient quality measures. Joint Commission; 2013.

Saskatchewan Infection Prevention and Control Program. Guidelines for the prevention and treatment of urinary tract infections (UTIs) in continuing care settings. Government of Saskatchewan Ministry of Health; 2013.

Toward Optimized Practice (TOP). Diagnosis and management of urinary tract infection in long term care facilities: Clinical practice guideline. Edmonton, AB: TOP; 2015.

Additional Resources for Prevention of UTI

Barnoiu OS, Sequeira-Garcia Del Moral J, Sanchez-Martinez N, Diaz-Molina P, Flores-Sirvent L, Baena-Gonzalez V. American cranberry (proanthocyanidin 120mg): Its value for the prevention of urinary tracts infections after ureteral catheter placement. Actas Urol Esp. 2015; 39 (2): 112-117. doi: 10.1016/j.acuro.2014.07.003.

Chenoweth CE, Gould CV, Saint S. Diagnosis, management, and prevention of catheter-associated urinary tract infections. Infect Dis Clin North Am. 2014; 28 (1): 105-119. doi: 10.1016/j.idc.2013.09.002.

Chenoweth CE, Saint S. Urinary tract infections. Infect Dis Clin North Am. 2011; 25 (1): 103-115. doi: 10.1016/j.idc.2010.11.005.

Dieter AA, Amundsen CL, Edenfield AL, et al. Oral antibiotics to prevent postoperative urinary tract infection: a randomized controlled trial. Obstet Gynecol. 2014; 123 (1): 96-103. doi: 10.1097/AOG.0000000000000024. [Erratum, Obstet Gynecol. 2014; 123 (3): 669.]

Dumas AM, Girard R, Ayzac L, et al. Effect of intrapartum antibiotic prophylaxis against group B streptococcal infection on comparisons of rates of endometritis and urinary tract infection in multicenter surveillance. Infect Control Hosp Epidemiol. 2008; 29 (4): 327-332. doi: 10.1086/529210.

Evron S, Dimitrochenko V, Khazin V, et al. The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial. J Clin Anesth. 2008; 20 (8): 567-572. doi: 10.1016/j.jclinane.2008.06.009.

*Fakih, MG, George C, Edson BS, Goeschel CA, Saint, S. Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies. Infect Control Hosp Epidemiol. 2013; 34 (10): 1048-1054. doi: 10.1086/673149.

Fakih MG, Krein SL, Edson B, Watson SR, Battles JB, Saint S. Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm. Am J Infect Control. 2014; 42 (10 Suppl): S223-S229. doi: 10.1016/j.ajic.2014.03.355.

Fink R, Gilmartin H, Richard A, Capezuti E, Boltz M, Wald H. Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in Nurses Improving Care for Healthsystem Elders hospitals. Am J Infect Control. 2012; 40 (8): 715-720. doi: 10.1016/j.ajic.2011.09.017.

Gamage B, Varia M, Litt M, Pugh S, Bryce E. Finding the gaps: an assessment of infection control surveillance needs in British Columbia acute care facilities. Am J Infect Control. 2008; 36 (10): 706-710. doi: 10.1016/j.ajic.2008.06.004.

Hsu V. Prevention of health care-associated infections. Am Fam Physician. 2014; 90 (6): 377-82.

Kachare SD, Sanders C, Myatt K, Fitzgerald TL, Zervos EE. Toward eliminating catheter-associated urinary tract infections in an academic health center. J Surg Res. 2014; 192 (2): 280-285. doi: 10.1016/j.jss.2014.07.045

Maharaj D. Puerperal pyrexia: a review. Part I. Obstet Gynecol Surv. 2007; 62 (6): 393-399.

Maharaj D. Puerperal Pyrexia: a review. Part II. Obstet Gynecol Surv. 2007; 62 (6): 400-6.

Saint S, Fowler KE, Sermak K, et al. Introducing the No Preventable Harms campaign: Creating the safest health care system in the world, starting with catheter-associated urinary tract infection prevention. Am J Infect Control. 2015; 43 (3): 254-259. doi: 10.1016/j.ajic.2014.11.016.

Saint S, Gaies E, Fowler KE, Harrod M, Krein SL. Introducing a catheter-associated urinary tract infection (CAUTI) prevention guide to patient safety (GPS). Am J Infect Control. 2014; 42 (5): 548-50. doi: 10.1016/j.ajic.2013.12.019.

Salvatore S, Salvatore S, Cattoni E, et al. Urinary tract infections in women. Eur J Obstet Gynecol Reprod Biol. 2011; 156 (2): 131-136. doi: 10.1016/j.ejogrb.2011.01.028.

Shuman EK, Chenoweth CE. Recognition and prevention of healthcare-associated urinary tract infections in the intensive care unit. Crit Care Med. 2010; 38 (8 Suppl): S373-S379. doi: 10.1097/CCM.0b013e3181e6ce8f.

Wagenlehner FM, Cek M, Naber KG, Kiyota H, Bjerklund-Johansen TE. Epidemiology, treatment and prevention of healthcare-associated urinary tract infections. World J Urol. 2012; 30 (1): 59-67. doi: 10.1007/s00345-011-0757-1.

Nursing Interventions for the Prevention of UTI

Alexaitis I, Broome B. Implementation of a nurse-driven protocol to prevent catheter-associated urinary tract infections. J Nurs Care Qual. 2014; 29 (3): 245-252. doi: 10.1097/NCQ.0000000000000041.

Fuchs MA, Sexton DJ, Thornlow DK, Champagne MT. Evaluation of an evidence-based, nurse-driven checklist to prevent hospital-acquired catheter-associated urinary tract infections in intensive care units. J Nurs Care Qual. 2011; 26 (2): 101-109. doi: 10.1097/NCQ.0b013e3181fb7847.

Oman KS, Makic MB, Fink R, et al. Nurse-directed interventions to reduce catheter-associated urinary tract infections. Am J Infect Control. 2012; 40 (6): 548-553. doi: 10.1016/j.ajic.2011.07.018.

*Parry MF, Grant B, Sestovic M. Successful reduction in catheter-associated urinary tract infections: focus on nurse-directed catheter removal. Am J Infect Control. 2013; 41 (12): 1178-1181. doi: 10.1016/j.ajic.2013.03.296.

Willson M, Wilde M, Webb ML, et al. Nursing interventions to reduce the risk of catheter-associated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009; 36 (2): 137-154. doi: 10.1097/01.WON.0000347655.56851.04.

Wan H, Hu S, Thobaben M, Hou Y, Yin T. Continuous primary nursing care increases satisfaction with nursing care and reduces postpartum problems for hospitalized pregnant women. Contemp Nurse. 2011; 37 (2): 149-59. doi: 10.5172/conu.2011.37.2.149.

Catheter Use

Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009; 110 (5): 1139-1157. doi: 10.1097/ALN.0b013e31819f7aea.

Bernard MS, Hunter KF, Moore KN. A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urol Nurs. 2012; 32 (1): 29-37.

Chenoweth C, Saint S. Preventing catheter-associated urinary tract infections in the intensive care unit. Crit Care Clin. 2013; 29 (1): 19-32. doi: 10.1016/j.ccc.2012.10.005.

Feneley RC, Kunin CM, Stickler DJ. An indwelling urinary catheter for the 21st century. BJU Int. 2012; 109 (12): 1746-1749. doi: 10.1111/j.1464-410X.2011.10753.x. 

Healy EF, Walsh CA, Cotter AM, Walsh SR. Suprapubic compared with transurethral bladder catheterization for gynecologic surgery: a systematic review and meta-analysis. Obstet Gynecol. 2012; 120 (3): 678-687. doi: 10.1097/AOG.0b013e3182657f0d.

*Loeb, M, Hunt D, O'Halloran K, Carusone SC, Dafoe N, Walter SD. Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: a randomized controlled trial.J Gen Intern Med. 2008; 23 (6): 816-820. doi: 10.1007/s11606-008-0620-2.

Lusardi G, Lipp A, Shaw C. Antibiotic prophylaxis for short-term catheter bladder drainage in adults. Cochrane Database Syst.Rev. 2013; 7: CD005428. doi: 10.1002/14651858.CD005428.pub2.

Marschall J, Carpenter CR, Fowler S, Trautner BW, CDC Prevention Epicenters Program. Antibiotic prophylaxis for urinary tract infections after removal of urinary catheter: meta-analysis. BMJ. 2013; 346: f3147. [Erratum in BMJ. 2013; 347: f5325].

*Meddings J, Rogers MA, Macy M, Saint S. Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clin Infect Dis. 2010; 51 (5): 550-560. doi: 10.1086/655133.

Newman DK, Willson MM. Review of intermittent catheterization and current best practices. Urol Nurs. 2011; 31 (1): 12-28, 48.

Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control. 2014; 3: 23. doi: 10.1186/2047-2994-3-23.

Nicolle LE. Catheter-acquired urinary tract infection: the once and future guidelines. Infect Control Hosp Epidemiol. 2010; 31 (4): 327-329. doi: 10.1086/651092.

Niel-Weise BS, van den Broek PJ, da Silva EM, Silva LA. Urinary catheter policies for long-term bladder drainage. Cochrane Database Syst Rev. 2012; 8: CD004201. doi: 10.1002/14651858.CD004201.pub3.

Owen RM, Perez SD, Bornstein WA, Sweeney JF. Impact of surgical care improvement project inf-9 on postoperative urinary tract infections: do exemptions interfere with quality patient care? Arch Surg. 2012; 147 (10): 946-953. doi: 10.1001/archsurg.2012.1485.

Pickard R, Lam T, Maclennan G, et al. Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial- and antiseptic-impregnated urethral catheters (the CATHETER trial). Health Technol Assess. 2012; 16 (47): 1-197. doi: 10.3310/hta16470.

Pickard R, Lam T, Maclennan G, et al. Antimicrobial catheters for reduction of symptomatic urinary tract infection in adults requiring short-term catheterisation in hospital: a multicentre randomised controlled trial. Lancet. 2012; 380 (9857): 1927-1935. doi: 10.1016/S0140-6736(12)61380-4.

Rebmann T, Greene LR. Preventing catheter-associated urinary tract infections: An executive summary of the Association for Professionals in Infection Control and Epidemiology, Inc, Elimination Guide. Am J Infect Control. 2010; 38 (8): 644-646. doi: 10.1016/j.ajic.2010.08.003.

Regev-Shoshani G, Ko M, Crowe A, Av-Gay Y. Comparative efficacy of commercially available and emerging antimicrobial urinary catheters against bacteriuria caused by E. coli in vitro. Urology. 2011; 78 (2): 334-339. doi: 10.1016/j.urology.2011.02.063.

Siddiq DM, Darouiche RO. New strategies to prevent catheter-associated urinary tract infections. Nat Rev Urol. 2012; 9 (6): 305-314. doi: 10.1038/nrurol.2012.68.

Tambyah PA, Oon J. Catheter-associated urinary tract infection. Curr Opin Infect Dis. 2012; 25 (4): 365-370. doi: 10.1097/QCO.0b013e32835565cc.

Tenke P, Koves B, Johansen TE. An update on prevention and treatment of catheter-associated urinary tract infections. Curr Opin Infect Dis. 2014; 27 (1): 102-107. doi: 10.1097/QCO.0000000000000031.

Weber DJ, Kang J, Brown VM, Sickbert-Bennett EE, Rutala WA. Preventing catheter-associated urinary tract infections: hospital location of catheter insertion. Infect Control Hosp Epidemiol. 2012; 33 (10): 1057-1058. doi: 10.1086/667771.

Wyndaele JJ, Brauner A, Geerlings SE, Bela K, Peter T, Bjerklund-Johanson TE. Clean intermittent catheterization and urinary tract infection: review and guide for future research. BJU Int. 2012; 110 (11 Pt C): E910-E917. doi: 10.1111/j.1464-410X.2012.11549.x.

Zaouter C, Kaneva P, Carli, F. Less urinary tract infection by earlier removal of bladder catheter in surgical patients receiving thoracic epidural analgesia. Reg Anesth Pain Med. 2009; 34 (6): 542-548.

Newborn References

Bizzarro MJ. Health care-associated infections in the neonatal intensive care unit: barriers to continued success. Semin Perinatol. 2012; 36 (6): 437-44. doi: 10.1053/j.semperi.2012.06.006.

**Bonadio W, Maida G. Urinary tract infection in outpatient febrile infants younger than 30 days of age: a 10-year evaluation. Pediatr Infect Dis J. 2014; 33 (4): 342–344. doi: 10.1097/INF.0000000000000110.

**Braga LH, Farrokhyar F, D'Cruz J, Pemberton J, Lorenzo AJ. Risk factors for febrile urinary tract infection in children with prenatal hydronephrosis: A prospective study. J Urol. 2015; 193 (5 Suppl): 1766–1771. doi: 10.1016/j.juro.2014.10.091.

Davis KF, Colebaugh AM, Eithun BL, et al. Reducing catheter-associated urinary tract infections: a quality-improvement initiative. Pediatrics. 2014; 134 (3): e857-e864. doi: 10.1542/peds.2013-3470.

**Goldman M, Lahat E, Strauss S, et al. Imaging after urinary tract infection in male neonates. Pediatrics. 2000;105 (6): 1232–1235.

Graham PL, 3rd. Simple strategies to reduce healthcare associated infections in the neonatal intensive care unit: line, tube, and hand hygiene. Clin Perinatol. 2010; 37 (3): 645-653. doi: 10.1016/j.clp.2010.06.005.

**Herz D, Merguerian P, McQuiston L. Continuous antibiotic prophylaxis reduces the risk of febrile UTI in children with asymptomatic antenatal hydronephrosis with either ureteral dilation, high-grade vesicoureteral reflux, or ureterovesical junction obstruction. J Pediatr Urol. 2014; 10 (4): 650–654.

Jagannath VA, Fedorowicz Z, Sud V, Verma AK, Hajebrahimi S. Routine neonatal circumcision for the prevention of urinary tract infections in infancy. Cochrane Database Syst Rev. 2012; 11: CD009129. doi: 10.1002/14651858.CD009129.pub2.

Kacker S, Frick KD, Gaydos CA, Tobian AA. Costs and effectiveness of neonatal male circumcision. Arch Pediatr Adolesc Med. 2012; 166 (10): 910-8.

**Ismaili K, Lolin K, Damry N, Alexander M, Lepage P, Hall M. Febrile urinary tract infections in 0- to 3-month-old infants: a prospective follow-up study. J Pediatr. 2011; 158 (1): 91–94. doi: 10.1016/j.jpeds.2010.06.053.

**Levy I, Comarsca J, Davidovits M, Klinger G, Sirota L, Linder N. Urinary tract infection in preterm infants: the protective role of breastfeeding. Pediatr Nephrol. 2009; 24 (3): 527–531. doi: 10.1007/s00467-008-1007-7.

**Sastre JB, Aparicio AR, Cotallo GD, Colomer BF, Hernández MC, Grupo de Hospitales Castrillo. Urinary tract infection in the newborn: clinical and radio imaging studies. Pediatr Nephrol. 2007; 22 (10):1735–1741.

**Tullus K. Vesicoureteric reflux in children. Lancet. 2015; 385 (9965): 371–379. doi: 10.1016/S0140-6736(14)60383-4.