As an infection preventionist who is addressing this issue on a daily basis, I agree with Dr. Gould’s interpretation.
Despite the fact that urinary tract infections( UTI’s) are the most common healthcare-associated infection (HAI’s), they have traditionally not received the same level of attention as have other HAI’s. Most UTI’s are associated with the presence of a urinary catheter. Urinary catheters are used frequently in healthcare settings, however many of these catheters are not necessary and are sometimes inserted without appropriate justification. Often, this leads to overuse and misuse of antibiotics to treat these infections, which can lead to the emergence of drug-resistant bacteria. Because UTI’s can compromise one of the largest reservoirs of multidrug-resistant bacteria in healthcare settings, it is essential that we find ways to minimize their occurrence.
What are we doing about this? The Association of Professionals in Infection Control and Epidemiology (APIC) continues to work on ways to bring science to the bedside. In 2008, we developed a catheter-associated urinary tract infection (CAUTI) elimination guide. This CAUTI guide was developed to serve as a comprehensive tool to questions posed by our members. The APIC elimination guides are developed in sync with guidelines released by CDC, thereby helping to translate evidence into clinical practice and sharing strategies and tools which others have found to be successful.
How do we deal with the problem going forward? Well, it’s important to remember that sometimes the answer can be attention to simple processes such as the UTI bundle. These bundles are groups of care processes which, when taken as a whole, can reduce the risk of infection. They also require healthcare workers to function as a team, working together to improve patient care. For example, the UTI bundle focuses on proper technique when a catheter is inserted, checking to make sure that a catheter is needed, looking at alternatives to a catheter and always removing the catheter when it is no longer needed.