Developing an early warning system for catheter-associated urinary tract infections

Catheter-associated urinary tract infections, or CAUTIs, account for up to 40% of all hospital-acquired infections and around 75% of urinary tract infections that develop during a hospital stay. 

“For patients, these infections are painful, frightening and potentially dangerous,” said UTS microbiologist Dr Parisa Noorian, whose research at the Australian Institute for Microbiology & Infection (AIMI) is focused on predicting, preventing and treating CAUTIs before they escalate. 

CAUTIs can provide a direct gateway for bacteria to form biofilms and enter the bloodstream, leading to secondary bacteraemia or even sepsis, a life-threatening condition. 

“Repeated catheter use can trap people in a cycle of painful, hard-to-treat infections that are often not diagnosed until symptoms are severe. That’s why we want to detect infection earlier, target treatment more effectively and stop CAUTIs from becoming life-threatening,” Parisa explained. 

“People with spinal cord injury, multiple sclerosis, spina bifida, dementia and other conditions that expose them to long-term urinary catheters are especially vulnerable,” said spinal cord physician Dr Bonne Lee, a staff specialist at the Prince of Wales Spinal Injuries Unit. 

Bonne is collaborating with researchers at the Australian Institute for Microbiology & Infection to develop a system that can detect infection earlier and help predict when these urinary tract infections are likely to occur. 

Backed by a $1.95 million NSW Health grant to develop microbiome-based diagnostics for prediction and management, the team is exploring how microbiome monitoring could give clinicians an early warning before infection takes hold. 

For patients, these infections are painful, frightening and potentially dangerous.

By combining clinical sampling, sequencing, biofilm modelling and machine learning, the team is building an early-warning diagnostic system designed to identify infection sooner and support faster, more precise clinical decisions. 
 
“Our system will also help clinicians target treatments more precisely and reduce the pain, complications and hospital burden experienced by patients living with CAUTIs,” Parisa said. 

The team is also developing a preventative vaccine using mRNA technology, drawing on the wide range of research expertise at UTS, from microbiology and DNA sequencing to machine learning as well as user experience.

Meeting the needs of patients and clinicians 

For Parisa, the science is only part of the challenge. Any technology designed for a hospital setting also needs to work for the nurses, clinicians and patients who will use it, and that’s where collaboration with end users is critical. 
 
“Through our partnership, the hospital benefits from our scientific knowledge while we have access to essential clinical knowledge about how systems work and how patients experience care. We work closely with end users to get their feedback early on to ensure our system will work well in the clinic,” she said. 

Bonne agreed that consumer perspectives are central to changing how infections are detected, managed and prevented inside the hospital system. “Our patients inspire everything that we do. Without their ideas and participation none of this research would be possible,” he said. 

We work closely with end users to get their feedback early on to ensure our system will work well in the clinic.

Beyond the Prince of Wales Spinal Injuries Unit, Parisa and Bonne work across multiple hospital departments and with UTS teams including Rapido for prototyping and user experience input. 

“Through the Research to Impact Validate initiative, Rapido has enabled us to bridge discovery and deployment and translate our research insights into a workable prototype,” Parisa explained. 

Rapido helped translate the science into a clinically usable system by mapping hospital workflows, gathering feedback from nurses, clinicians and patients and pressure-testing the prototype against the practical realities of care. 
 
“Rapido helped us move beyond the question of whether the technology can work, to whether it can work for the people who need it,” Parisa added. “This involved listening early, testing ideas with end users and designing a system that can fit into real clinical practice.” 

Through this rigorous validation process, the team has built an evidence base for a solution that is desirable, feasible and ready for future translation. 

Support from the Prince of Wales Hospital Foundation is also helping the team progress the clinical trial pathway, providing an important link between hospital-based research, patient participation and the real-world testing needed to move the early-warning system closer to clinical use.