Surveillance criteria may not be equally sensitive for all patient populations.  Patient populations in which the UTI criteria may not be as sensitive include spinal cord injury patients, those with brain injuries, and heavily sedated patients. NHSN constructed its Surveillance definitions to balance sensitivity and specificity along with feasibility. A set of criteria that covered every subpopulation with high specificity and sensitivity would be too complicated to employ consistently across different facilities.  Simply follow the criteria as written in locations in which you are performing CAUTI surveillance. Mechanical ventilation or sedation does not always mean that patients will not be able to verbalize pain.  Facilities should always perform physical examination and assess patients for non-verbal communication of pain or tenderness.