Catheters are a common feature of hospital care, used by about four million hospital patients a year some time during their stay. Inserted into the urethra, they collect urine from patients who can't use a bathroom or need to have their urine output monitored.
The chances of getting a UTI from a catheter are pretty high. Overall, such infections account for more than a third of all hospital-acquired infections - more than 600,000 in all each year.
A national survey by the Centers for Disease Control and Prevention found as many as 10 UTIs for every 1,000 days that catheters are used.
UTIs don't always produce symptoms. Usually, an individual with a UTI will feel an overwhelming urge to urinate frequently, accompanied by a burning sensation. Rarely, UTIs can cause bleeding during urination, high fever and accompanying abdominal and back pain. Worse yet is bacteremia, in which the bacteria enter the bloodstream and can cause fever, low blood pressure, confusion and life-threatening symptoms.
The risk of an infection, and the potential for a more serious one, increases with the number of days the catheter is in. Some patients, like women who have just given birth, use them only for several hours. But many more, including surgery and intensive care patients, use them for days at a time, increasing the chance that bacteria will travel up the catheter and into the bladder.
Saint and his colleagues looked at those who used catheters for 2 to 10 days, in hospital units for intensive care, post-surgical care, general medical care, and urology care. They tallied data from numerous studies of infection rates, catheter effectiveness and the kinds of treatments used for infections. Then, they used cost information from the U-M and other hospitals to estimate how much it would cost to detect, test for and treat infections, and how much longer an infection would keep a patient in the hospital.