Spinal Cord Injury Creates Unique Challenges in Diagnosis and Management of Catheter-Associated Urinary Tract Infection

Catheter-associated urinary tract infections (CAUTI) pose significant challenges for individuals with spinal cord injuries (SCI) due to difficulties in diagnosis and management. This review explores the unique aspects of CAUTI in the SCI population, focusing on surveillance, prevention, diagnosis, and treatment. The review highlights that standard CAUTI surveillance methods, primarily designed for acute care settings, may not accurately capture the scope of the problem in individuals with SCI who use various catheter types. Additionally, SCI patients often experience impaired sensation, making it difficult to detect typical UTI symptoms. The paper suggests refining current CAUTI metrics, emphasizing patient-centered care, and exploring non-antibiotic treatments such as bacteriophages to combat multidrug-resistant organisms, ultimately aiming to improve the quality of life for SCI patients.

• 1
  Surveillance of CAUTI is challenging in the SCI population because the ability to detect symptoms typically used to diagnose CAUTI, such as suprapubic pain and dysuria, is often impaired.
• 2
  Diagnosing CAUTI after SCI is difficult, frequently leading to overdiagnosis when asymptomatic bacteriuria exists, which contributes to unnecessary antibiotic use and the rise of multidrug-resistant organisms.
• 3
  Current prevention strategies, which focus on appropriate catheter insertion and early removal, may not be feasible for many SCI patients, highlighting the need for SCI-specific evidence to inform catheter management and CAUTI treatment guidelines.