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Thought Leader Session

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Aging Adult Track

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Research Snapshot Theater: Epidemiology - Outcomes/Quality and Patient Safety, Adult

Intermittent Straight Catheterization Associated With Fewer UTIs Than Foley Catheters

Tuesday, March 24, 2026

10:00 AM - 11:00 AM Central Time

Location: Connections Central - RST 01

Vinaya R. Sermadevi, MD (she/her/hers)

Mercy Hospital Saint Louis, Missouri

Disclosure(s): No relevant financial relationship(s) to disclose.
GD

Gil Diesel, RN

Infection Prevention Manager
Mercy Hospital St Louis

Disclosure information not submitted.
KK

Kendra Kelly, RN

Quality Specialist
Mercy Hospital St Louis

Disclosure information not submitted.
CK

Chaitanya Karlapalem, MD

MERCY HOSPITAL, Missouri

Disclosure(s): No relevant financial relationship(s) to disclose.
JS

Johnny Soter, MD

Critical Care Fellow
Mercy Hospital St Louis/St Louis University, Missouri

Disclosure information not submitted.
RD

Rachel Dutton, RN

RN
Mercy Hospital St Louis

Disclosure information not submitted.
HA

Haley Allard, RN

RN
Mercy Hospital St Louis

Disclosure information not submitted.
EG

Elizabeth Glidewell, RN

RN
Mercy Hospital St Louis

Disclosure information not submitted.
KK

Kelley Kornfeld, RN

RN
Mercy Hospital St Louis

Disclosure information not submitted.
AT

Alayna Titus, APP

APP
Mercy Hospital St Louis

Disclosure information not submitted.
AS

Anil Srivastava, MD, FACS

Trauma Surgeon
Mercy Hospital Saint Louis

Disclosure information not submitted.
CV

Chakradhar Venkata, MD

Critical Care Physician
Mercy Hospital Saint Louis

Disclosure information not submitted.
Melinda Miller, MD (she/her/hers)

Mercy Hospital Saint Louis, Missouri

Disclosure(s): No relevant financial relationship(s) to disclose.
SG

Sarah Gastman, RN

Quality Management-Director
Mercy Hospital St Louis

Disclosure information not submitted.
FS

Farid Sadaka, MD

Mercy Heart and Vascular Hospital St. Louis, Missouri

Disclosure(s): No relevant financial relationship(s) to disclose.

Introduction: Catheter-associated urinary tract infections (CAUTIs) are a common and preventable complication in ICU patients. As part of hospital-wide efforts to reduce CAUTIs, strategies such as early Foley catheter removal and the use of intermittent straight catheterization (ISC) are emphasized. This review aimed to evaluate the relative association of positive urine cultures with ISC versus indwelling Foley catheter use.

Methods: A retrospective review of 573 inpatients with positive urine cultures over a 12-month period was conducted. Only cultures collected after hospital admission and meeting National Healthcare Safety Network (NHSN) criteria for non-contaminated specimens (≤2 organisms) were included. Catheterization history prior to the culture time was analyzed. Urine collected during the insertion process was excluded. Our Foley utilization protocol is as follows: Remove the Foley catheter and place a Foley removal order on all patients except those who are (1) post-GU procedure, (2) prone position, (3) have chronic Foley use (changed regularly), or (4) require replacement only if ISC is needed more than 3 times in 24 hours.

Results: Among the 573 patients, 404 (71%) had no history of ISC or Foley prior to the positive urine culture. Of the remaining 169 patients: 81 (14%) had only a Foley catheter, 45 (8%) had both a Foley and at least one ISC, and 33 (5.8%) had only ISC. Patients with only ISC had significantly fewer positive urine cultures compared to those with Foley catheters (p = 0.01). Similarly, patients with both Foley and ISC had higher culture positivity compared to those with ISC alone (p = 0.01).

Conclusions: Intermittent straight catheterization is a safe urinary management approach and is associated with significantly fewer positive urine cultures than indwelling Foley catheterization. These findings support the broader use of ISC, alongside early Foley removal, as effective strategies in CAUTI reduction efforts.