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Female sex
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Poor hygiene
Prolonged catheterization
Steroid use
Trauma
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This patient who presents with leukocytosis and positive nitrites on urinalysis in the setting of prolonged urinary catheterization most likely has a catheter-associated urinary tract infection (CAUTI). The greatest risk factor for CAUTI is prolonged catheterization. Nosocomial infections can cause a high level of morbidity in patients who are hospitalized for a prolonged period of time. Among the most common nosocomial infections are CAUTIs, which can present with fever, altered mental status, dysuria, leukocytosis, and positive nitrites on urinalysis. Risk factors for the development of CAUTIs are female sex, poor hygiene, steroid use, trauma, and prolonged catheterization. Of these risk factors, prolonged catheterization is the most important risk factor, so prompt discontinuation of Foley catheters (when no longer necessary) is imperative. Nicolle summarizes the evidence regarding CAUTIs and finds that the duration of catheterization is the most important factor leading to infections, at the rate of around 5% per day. Incorrect Answers: Answers 1, 2, 4, & 5: Female sex, poor hygiene, steroid use, and trauma have all been identified as risk factors for the development of CAUTIs; however, according to numerous studies as well as the Centers for Disease Control and Prevention, prolonged catheterization is the most important risk factor for CAUTI development. Bullet Summary: Prolonged catheterization is the greatest risk factor for the development of catheter-associated urinary tract infections.
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