A patient with an indwelling urinary catheter for more than 30 days develops fever and abdominal tenderness. How should the infection preventionist instruct the nurse to collect a urine sample to determine whether the patient has a UTI?

• A. Collect the urine sample from the sample port and deliver the specimen as soon as possible to the lab.
• B. Collect the urine sample from the drainage bag.
• C. Collect the urine sample from the bladder with a needle through the catheter.
• D. Collect a clean-catch midstream sample after removing the catheter.

Answer: (A)

In this situation, obtaining the urine from the catheter’s sampling port with sterile technique provides the most accurate reflection of bladder urine while minimizing contamination. Clean the port, insert a sterile syringe, and withdraw a small amount of urine to send to the lab promptly. This method avoids introducing external contaminants from the drainage bag or tubing and reduces the risk of false results.

Sampling from the drainage bag is unreliable because the bag contents can be contaminated by the catheter environment and may not represent bladder urine. Puncturing the bladder through the catheter is invasive and not standard practice for diagnosing a UTI. Removing the catheter to obtain a clean-catch midstream sample is unnecessary and can disrupt care, making it impractical and potentially harmful for a patient with a long-term catheter.