June 23, 2009 - CDC Guideline on the Prevention of Catheter-Associated Urinary Tract Infections 2008

Centers for Disease Control and Prevention
Division of Healthcare Quality Promotion
Attn: Resource Center
1600 Clifton Road, NW
Mailstop A-31
Atlanta, GA 30333

To Whom It May Concern:

The American Society for Microbiology (ASM) appreciates the opportunity to review and comment on the Centers for Disease Control and Prevention (CDC) draft Guideline, “Prevention of Catheter-Associated Urinary Tract Infections 2008.” The Committees on Laboratory Practices and Professional Affairs of ASM’s Public and Scientific Affairs Board (PSAB) have reviewed the draft Guideline and would like to submit the following comments:

  • The PSAB Laboratory Practices and Professional Affairs Committees support the statements that refer to the studies that define Catheter-Associated Urinary Tract Infections on pp. 23-24, as follows: “The clinical significance of asymptomatic bacteriuria (ASB) in catheter patients is undefined. Approximately 75% - 90% of patients with ASB do not develop a systemic inflammatory response or other signs or symptoms to suggest infection. Monitoring and treatment of ASB is also not an effective prevention measure for symptomatic urinary tract infections (SUTI), as most case of SUTI are not proceeded by bacteriuria for more than a day." We agree that ASB should not be used as a guideline for determining a Catheter-Associated Urinary Tract Infection. Pre-admission cultures for ASBare not appropriate and are not a cost-effective use of health care dollars, particularly in patients that do not present with any signs or symptoms.
  • Q2D.3 Bacteriologic monitoring (p. 44) and Table 2D, 2D.2 (page 45): ASM’s Committees support CDC’s statement that there is no benefit of bacteriologic monitoring by culture to prevent or determine Catheter-Associated Urinary Tract Infections. Performing urine cultures to screen for ASB in asymptomatic patients would be over-burdensome and not cost-effective for most clinical laboratories and health care clinics/hospitals.

Thank you for the opportunity to comment.

Susan E. Sharp, Ph.D., Committee on Laboratory Practices
Vickie S. Baselski, Ph.D., Committee on Professional Affairs