Healthcare providers are becoming very aware of the risks of urinary tract infections. These infections are often associated with a fever of greater than or equal to 100.4° F, urgency, frequency, pain when urinating or suprapubic tenderness, and a positive urine culture finding of greater than or equal to 100,000 microorganisms/cm3.

Urinary tract infections (UTIs) are the most common type of nosocomial (hospital acquired) infection and have been estimated to account for 40 percent of all nosocomial infections. UTIs are usually the result of tubes in the urinary tract, primarily indwelling or Foley catheters. The bacteria most commonly include: E. coli, Enterococci, and staphylococci. Less common causes include Klebsiella, Enterobacter, Proteus, and even Corynebacteria, yeasts, and fungi.

Many of these organisms come from the patient’s own bacteria, which primarily reside in the bowel. The organisms get into the bladder through several routes. Healthcare providers may contaminate the patient’s catheter.

The infecting organisms gain entry to the bladder by traveling up the outside of an indwelling catheter which is introduced at the time of catheterization. The bacteria can also drain into the bladder if the staff member raises the drainage collection bag higher than the bladder. Contaminating microorganisms can gain access to the bladder if the staff member opens the catheter drainage bag junction.

Urinary tract infections can cause significant illness and even death. Bacteria can travel from the urine into the blood stream infections. UTIs can lead to other serious complications including infection of male genitalia, endocarditis, osteomyelitis, septic arthritis, and meningitis.

Urinary tract infections can spread between patients. The causative organisms often are resistant to the usual antibiotics, leaving less choice for treatment or the need to use more broad-spectrum drugs, which can lead to further infectious complications or development of resistant organisms.

Factors contributing to outbreaks of hospital-acquired urinary infections include: bladder catheters, contaminated antiseptics used for irrigation of catheters, transmission on the hands of healthcare workers, and environmental contamination.

Modified from “Infections in Hospitals and Nursing Homes” in Nursing Malpractice, Fourth Edition 2011

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