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Catheter-Associated Urinary Tract Infections in Children: An Evidence-Informed Narrative Review of Diagnosis,
Simon P Paget1,2,3,4, Robert McCusker5, Suzanne Simpson2
1Department of Paediatrics, Gold Coast University Hospital, Southport, Queensland, Australia.
Insights
Catheter-associated urinary tract infections (CAUTI) are a significant concern in pediatric care. Evidence-informed strategies effectively reduce CAUTI in hospitalized children, though more research is needed for long-term catheter users.
Area of Science:
- Pediatric Infectious Diseases
- Healthcare Epidemiology
Background:
- Catheter-associated urinary tract infections (CAUTI) are a prevalent healthcare-associated infection in children.
- CAUTI contributes to increased morbidity, extended hospital stays, and elevated healthcare expenses in pediatric populations.
Purpose of the Study:
- To provide a comprehensive overview of CAUTI in children, covering epidemiology, pathophysiology, management, and prevention.
- To highlight recent advancements and evidence from pediatric literature (2000-2025).
Main Methods:
- A narrative review approach was employed, synthesizing recent pediatric literature.
- Focus on two distinct pediatric populations: short-term and long-term catheterization.
Main Results:
- Diagnostic challenges for CAUTI in children include asymptomatic bacteriuria, non-specific symptoms, and unreliable bedside tests.
- Established prevention strategies like judicious catheter use, aseptic technique, and CAUTI bundles significantly decrease hospital-acquired CAUTI incidence.
- Limited evidence exists for optimal CAUTI risk reduction in children requiring long-term catheterization.
Conclusions:
- Effective prevention strategies exist for hospital-associated CAUTI in children.
- Further research and specialized guidelines are essential for managing CAUTI in pediatric patients with long-term catheter needs.
Abstract:
Catheter-associated urinary tract infections (CAUTI) are a common healthcare-associated infection in children and a major contributor to increased morbidity, prolonged hospital stays and higher healthcare costs. This narrative review uses an evidence-informed approach highlighting recent paediatric literature (2000-2025) to provide an overview of epidemiology, pathophysiology, management and prevention of CAUTI in children. Two populations are considered: children requiring short-term catheterisation (typically peri-procedural or during hospitalisation) and those requiring long-term (continuous/intermittent) catheterisation for conditions such as neurogenic bladder and/or children who have had surgery for urogenital abnormalities. Diagnosis of CAUTI can be challenging due to the high prevalence of asymptomatic bacteriuria (particularly in long-term catheterisation), non-specific symptoms and the lack of specificity of bedside tests. Prevention strategies, including judicious catheter use, adherence to aseptic technique, staff training, and implementation of CAUTI bundles, have been shown to substantially reduce the incidence of hospital CAUTI. For children with long-term catheterisation, evidence on optimal approaches to reduce risk of CAUTI remains limited, highlighting the need for further research and tailored guidelines.
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