To the best of our knowledge, this is the first study to compare the incidences of CAUTI in ICU patients with four different perineal care agents at the same time. Most studies on the perineal care agents investi- gated the association of bacteriuria between daily and twice-daily application of antiseptic solution or creams, such as povidone-iodine or chlorhexidine (Willson et al., 2009), but no studies reported the incidences of CAUTI in ICU patients with skin clean- ing foam or normal saline as perineal care agents. Presently, we strove to minimize the effect of the exogenous factors on the incidences of CAUTI and control the consistency of perineal care of attending nurses by developing protocols and checklists on the insertion and management of indwelling urinary
catheters based on the UTI prevention guideline (Gould et al., 2010), letting every nurse strictly follow the protocols, and ensuring the completion of the checklist every shift.