Closing the loop on catheter-associated urinary tract infections: A prospective risk assessment and scoring system for the early prediction and prevention of catheter-associated urinary tract infection

Background: Catheter-associated urinary tract infections (CAUTI) are among the most common healthcare-associated infections, particularly in hospitalised patients requiring prolonged catheterisation. Despite standard protocols, preventable lapses in catheter care and clinical practices contribute to the incidence of these infections. Aims and Objectives: This study aimed to identify significant risk factors and develop a point-based CAUTI Risk Scoring System for early prediction and intervention. Materials and Methods: A prospective observational study was conducted over six months at a tertiary care hospital, including 100 catheterized adult inpatients. Demographic data, Clinical variables, and catheter practices were documented. CAUTI was confirmed by urine culture. A risk stratification model was developed by assigning weighted scores to statistically significant variables, categorising patients into low, moderate, and high CAUTI risk groups. A domain-wise heatmap visually represented the novelty and interdisciplinary relevance of the study's contributions across ten clinical research domains. Results: Among the 26% of study participants who had CAUTI overall, the important procedural predictors were open-type drainage systems (p < 0.00001), kinking of catheter tubing (p < 0.00001), and raised urobag placement (p < 0.00001). Clinical risk variables included diabetes mellitus (p = 0.00001), catheter duration greater than 7 days (p = 0.0043), female sex (p = 0.0023), and immobility (p = 0.0014). Strong early signals included turbid urine (p = 0.00004) and unexplained fever (p = 0.00001). A cumulative risk rating system placed patients into low (0-3), moderate (4-6), and high-risk (≥7) categories. Conclusions: This study presents the first validated CAUTI Risk Scoring System, including clinical, procedural, and early bedside indicators. The scoring tool enables proactive intervention and serves as a necessary adjunct to infection prevention plans in hospital environments.