Urinary Tract Infections and Urinary Catheter Care
Introduction
On this page you will find useful information and resources for the management of Urinary Tract Infections and Urinary Catheter Care.
A urinary tract infection (UTI) is an infection that affects any part of the urinary tract. The urinary tract is the group of internal organs that makes urine (kidneys), stores it (bladder) and removes urine from the body (urethra). When an infection affects the lower urinary tract, it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as kidney infection (pyelonephritis).
You are more likely to develop a UTI if you have:
- a condition that obstructs or blocks your urinary tract, like kidney stones
- a condition that prevents you fully emptying your bladder (it’s easier for bacteria to multiply if urine stays in the bladder for too long)
- a weakened immune system, such as patients having chemotherapy
- a urinary catheter in place.
UTI Decision Aid Tools
The UK Health Security Agency (UKHSA) have developed a structured assessment form as a clinical decision-support tool to aid the diagnosis of urinary tract infection (UTI) in older adults, including both catheterised and non-catheterised patients. The tool has been adopted, with permission from UKHSA, for use in Northern Ireland and is designed to support antimicrobial stewardship and reduce inappropriate antibiotic prescribing by promoting a systematic assessment of clinical signs and symptoms, while recognising the high prevalence of asymptomatic bacteriuria in older populations. It encourages clinicians to consider alternative causes for non-specific symptoms such as confusion or functional decline and aligns with current IPC and stewardship principles by supporting evidence-based diagnosis rather than reliance on urine dipsticks or culture results alone. The tool was developed to help and guide an assessment in the patient with urinary symptoms.
The tools aim to provide a simple, effective, economical and empirical approach to the diagnosis of UTI’s, and minimise the risk of treatment failure and the emergence of antibiotic resistance, thus improving safe care and should lead to improved diagnosis of UTI and more appropriate antibiotic use.
The reference tools are not all-encompassing – they are meant to be used as a ‘quick reference’. Clinicians should rely on their clinical judgement and use it alongside other recommended resources.
These quick reference tools for primary care providers describe when to consider a urinary tract infection (UTI) in:
- women aged under 65 years
- adults aged over 65 years
- adults with a urinary catheter who have a suspected catheter-associated UTI (CAUTI)
The text explains the flowcharts and supplies further information about diagnosis in different groups and about urine sampling.
Skip the dip
Dipstick urinalysis has long been routine in many clinical settings – but does a positive dipstick really mean a urinary tract infection in every patient?
In people aged over 65, it’s common to have bacteria in the urine with no symptoms of infection. This is known as asymptomatic bacteriuria – where bacteria are present but not causing harm. It’s even more common in people living in care homes, and can be found in nearly everyone with a long‑term catheter.
When bacteria are present a dipstick test will usually show positive for nitrites and leukocytes. That will be whether there is an infection or not. To decide between asymptomatic bacteriuria and a true urinary tract infection, we need to Skip the Dip and focus on the patient’s signs and symptoms.