AcknowledgementHICPAC thanks the following members who served on the HICPAC <strong>CAUTI</strong> Guidelinesubcommittee during the guideline development process: Russell N. Olmsted, MPH, Yvette S.McCarter, PhD, Barbara M. Soule, RN, MPA, CIC, <strong>and</strong> Nalini Singh, MD, MPH.HICPAC thanks the following outside experts <strong>for</strong> reviewing a draft of this guideline: Edward S.Wong, MD, Lindsay E. Nicolle, MD, Anthony J. Schaeffer, MD, <strong>and</strong> Harriett M. Pitt, RN, MS,CIC. The opinions of the reviewers might not be reflected in all the recommendations containedin this document.HICPAC would also like to thank the many individuals <strong>and</strong> organizations who provided valuablefeedback on the guideline during the public comment period.Disclosure of Financial Interests <strong>and</strong> RelationshipsThe authors C.V.G., C.A.U., R.K.A., <strong>and</strong> G.K. report no actual or potential conflicts of interest.D.A.P. is on the Speakers Bureau of Merck, Pfizer, Schering, <strong>and</strong> Cubist <strong>and</strong> is a consultant <strong>for</strong>Dow Pharmaceuticals, DaVita, <strong>and</strong> Vasonova. C.A.U. <strong>and</strong> R.K.A. received funding from theCDC to support the guideline development process.4
Table of ContentsAbbreviations ............................................................................................................. 6I. Executive Summary ................................................................................................... 8II. Summary of Recommendations ............................................................................... 10III. Implementation <strong>and</strong> Audit ........................................................................................ 18IV. Recommendations <strong>for</strong> Further Research ................................................................. 20V. Background .............................................................................................................. 22VI. Scope <strong>and</strong> Purpose ................................................................................................. 25VII. Methods ................................................................................................................... 26VIII. Evidence Review ..................................................................................................... 34References .................................................................................................................... 495
- Page 6 and 7: AbbreviationsADLAPACHE IIASAASBBUNC
- Page 8 and 9: I. Executive SummaryThis guideline
- Page 10 and 11: II. Summary of RecommendationsTable
- Page 12 and 13: II. Proper Techniques for Urinary C
- Page 14 and 15: 1. If obstruction is anticipated, c
- Page 16 and 17: a. Procedure-specific guidelines fo
- Page 18 and 19: III. Implementation and AuditPriori
- Page 20 and 21: IV. Recommendations for Further Res
- Page 22 and 23: V. BackgroundUrinary tract infectio
- Page 24 and 25: acteriuria inevitably occurs over t
- Page 26 and 27: VII. MethodsThis guideline was base
- Page 28 and 29: Figure 2: Results of the Study Sele
- Page 30 and 31: After determining the GRADE of the
- Page 32 and 33: Category I recommendations are defi
- Page 34 and 35: VIII. Evidence ReviewQ1. Who should
- Page 36 and 37: Evidence Review Table 1B. What are
- Page 38 and 39: Very low-quality evidence suggested
- Page 40 and 41: Q2B.2. Hydrophilic catheters vs. st
- Page 42 and 43: For all comparisons, we considered
- Page 44 and 45: a. Clamping vs. free drainage prior
- Page 46 and 47: studies. 3,25,260-276 The findings
- Page 48 and 49: 2D.5. Maintain unobstructed urine f
- Page 50 and 51: 15. Jain P, Parada JP, David A, Smi
- Page 52 and 53:
44. Chaudhuri P, Vengadasalam D. Ur
- Page 54 and 55:
71. Kelleher RE, Meeropol E, Parks
- Page 56 and 57:
101. Hirsh DD, Fainstein V, Musher
- Page 58 and 59:
132. Van Nagell, JR, Penny RM, Rodd
- Page 60 and 61:
163. Lai KK, Fontecchio SA, Lai KK,
- Page 62 and 63:
193. Waites KB, Canupp KC, Armstron
- Page 64 and 65:
222. Cohen A. A microbiological com
- Page 66 and 67:
253. Chavigny KH. The use of polymi