Catheter-Associated Urinary Tract Infections in Children: An Evidence-Informed Narrative Review of Diagnosis, Management and Prevention.

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.