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The primary reason a resident with an indwelling urinary catheter is at an increased risk for infection is that bacteria have a direct tract into the body. An indwelling urinary catheter is inserted into the bladder through the urethra, which creates a pathway for bacteria to enter. The presence of a catheter increases the likelihood of pathogens being introduced into the urinary tract, as it bypasses the body's natural defenses.

While the material of the catheter or frequency of changing it can contribute to potential complications, the most significant risk comes from the direct access to the urinary system, which facilitates the movement of bacteria from the external environment into the bladder, leading to urinary tract infections. Additionally, immobility can exacerbate the risk of infections, but it is not the primary factor in the context of a catheter; rather, it is the direct pathway created by the catheter itself that poses the most significant threat.