Research Identifies At-Risk Individuals for Catheter-Associated UTIs and Sepsis

Urinary catheters are commonly used in hospitals, especially during surgeries. However, one of the biggest challenges for healthcare providers is figuring out which patients are more likely to develop catheter-associated urinary tract infections (CAUTIs) and how these infections can sometimes become life-threatening.

A recent study from the University of Notre Dame has identified a group of patients who are more vulnerable to CAUTIs and sepsis (a severe, body-wide infection).

How Does the Body’s Healing Process Contribute to Infection?

Researchers discovered that patients with fibrinolytic deficiencies—conditions that affect the body’s ability to break down blood clots—are at a higher risk for severe and long-lasting CAUTIs. These patients were also more likely to develop sepsis.

Fibrin is a protein that helps form blood clots, which are essential for healing wounds. However, in people with fibrinolytic deficiencies, the body overproduces fibrin, creating net-like structures inside the bladder. When a catheter is inserted, it constantly rubs against the bladder, causing irritation and damage. The body responds by sending fibrinogen (a protein that turns into fibrin) to the bladder to help with healing. Unfortunately, bacteria use these fibrin "nets" to attach and grow, making infections harder to treat.

Why Does This Matter?

The study, published in Nature Communications, found that the more fibrin the body produces, the more likely it is for bacteria to spread beyond the bladder. In severe cases, the infection can enter the bloodstream and cause sepsis, a life-threatening condition.

However, researchers also found that when fibrin production was blocked, the infections became less severe. This suggests that certain patients—especially those taking antifibrinolytic medications (drugs that help stop bleeding)—may be at a greater risk of developing CAUTIs. These medications are often used after childbirth, major injuries, or surgeries where catheters are commonly needed.

What’s Next?

The study's lead researcher, Dr. Ana Lidia Flores-Mireles, hopes these findings will improve guidelines for catheter use in hospitals and intensive care units. She and her team are also working on designing a new type of catheter that reduces inflammation and tissue damage, preventing fibrin build-up and lowering the risk of infection.

These discoveries could lead to better protection for patients, fewer complications, and an overall improvement in healthcare practices.

Reference:

Molina JJ, Kohler KN, Gager C, et al. Fibrinolytic-deficiencies predispose hosts to septicemia from a catheter-associated UTI. Nat Commun. 2024;15(1):2704. doi: 10.1038/s41467-024-46974-6