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CAUTIon — not all UTIs are the same

Nature Reviews Urology volume 22, pages 799–814 (2025)Cite this article

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Abstract

Urinary tract infections are one of the most common infections, accounting for ~400 million diagnoses per year worldwide. Uncomplicated urinary tract infections (uUTIs) occur in healthy individuals with no structural or functional abnormalities of the urinary system and primarily affect women. Catheter-associated urinary tract infections (CAUTIs) are a type of complicated UTI affecting patients who have a urinary catheter in place, often hospitalized patients or patients with conditions that prevent them from urinating naturally. Both infections share common symptoms, diagnostics and treatment options but also differ greatly in pathophysiology, aetiology, risk factors and comorbidities. These differences could explain why antibiotic treatments — which generally lead to positive outcomes in patients with uUTIs — often fail in patients with CAUTIs. Understanding these differences could guide evidence-based insights into why treatments for CAUTIs should be different from those for uUTIs, specifically, by modifying catheters, which initiate the damage-induced segue for UTIs.

Key points

  • Urinary tract infections (UTIs) are an extremely common diagnosis in the USA and globally.

  • Uncomplicated and catheter-associated UTIs differ greatly in pathogen diversity, pathophysiology and propensity towards secondary bloodstream infections.

  • New treatments for catheter-associated UTIs should be specifically designed for these infections, rather than simply adapted from therapies for uncomplicated UTIs To reduce antibiotic resistance among urinary pathogens, modern treatments and preventative strategies can be designed to target specific mechanisms used by uropathogens to cause different types of UTI.

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Fig. 1: Comparison of crucial clinical characteristics between uncomplicated catheter-associated urinary tract infections.
Fig. 2: Pathophysiology of uncomplicated and catheter-associated urinary tract infections.

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    Jonathan J. Molina & Ana L. Flores-Mireles

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    Jonathan J. Molina & Ana L. Flores-Mireles

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Molina, J.J., Flores-Mireles, A.L. CAUTIon — not all UTIs are the same. Nat Rev Urol 22, 799–814 (2025). https://doi.org/10.1038/s41585-025-01065-z

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