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Greener, Mark. "Recent insights into catheter-related urinary tract infections." British Journal of Community Nursing 27, no. 4 (April 2, 2022): 162–64. http://dx.doi.org/10.12968/bjcn.2022.27.4.162.
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Urinary tract infections (UTIs) commonly develop in people with urinary catheters. Inserting a catheter can damage the urothelial barrier and trigger the formation of a biofilm on the catheter that allows bacteria direct access to the bladder. Biofilms also protect bacteria from the immune system and reduce antibiotic effectiveness. In addition, a growing literature suggests that the urinary tract harbours bacteria even in people with negative conventional cultures. The urinary microbiome is highly individual. Nevertheless, changes in the urinary microbiome may identify individuals at risk of UTIs and, for example, suggest that a catheter should be replaced more frequently and, in turn, avoid the need for antibiotics. This article outlines the importance of biofilms in the development of catheter-related UTIs and introduces the urinary microbiome.
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Lobão, Maria João, and Paulo Sousa. "Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department." Acta Médica Portuguesa 30, no. 9 (September 29, 2017): 608. http://dx.doi.org/10.20344/amp.8606.
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Introduction: Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital.Material and Methods: Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department.Results: One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria.Discussion: These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments.Conclusion: The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.
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Paras, Molly L., Erica S. Shenoy, Heather E. Hsu, Rochelle P. Walensky, and David C. Hooper. "Housestaff Knowledge Related to Urinary Catheter Use and Catheter-Associated Urinary Tract Infections." Infection Control & Hospital Epidemiology 36, no. 11 (August 17, 2015): 1355–57. http://dx.doi.org/10.1017/ice.2015.189.
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Despite published catheter-associated urinary tract infection prevention guidelines, inappropriate catheter use is common. We surveyed housestaff about their knowledge of catheter-associated urinary tract infections at a teaching hospital and found most are aware of prevention guidelines; however, their application to clinical scenarios and catheter practices fall short of national goals.Infect. Control Hosp. Epidemiol. 2015;36(11):1355–1357
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Hameed, Ammar, Frank Chinegwundoh, and Ali Thwaini. "Prevention of catheter-related urinary tract infections." British Journal of Hospital Medicine 71, no. 3 (March 2010): 148–52. http://dx.doi.org/10.12968/hmed.2010.71.3.46978.
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Shadle, Holly N., Valerie Sabol, Amanda Smith, Heather Stafford, Julie A. Thompson, and Margaret Bowers. "A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit." Critical Care Nurse 41, no. 2 (April 1, 2021): 62–71. http://dx.doi.org/10.4037/ccn2021934.
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Background Catheter-associated urinary tract infections are the second most common health care–associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs. Local Problem The targeted institution for this improvement project reported 13 catheter-associated urinary tract infections in 2018, exceeding the hospital’s benchmark of 4 or fewer such events annually. Six of the events occurred in the intensive care unit. Project objectives included a 30% reduction in reported catheter-associated urinary tract infections, 20% reduction in urinary catheter days, and 75% compliance rating in catheter-related documentation in the intensive care unit during the intervention phase. Methods This project used a pre-post design over 2 consecutive 4-month periods. The targeted population was critically ill patients aged 18 and older who were admitted to the intensive care unit. A set of bundled interventions was implemented, including staff education, an electronic daily checklist, and a nurse-driven removal protocol for indwelling urinary catheters. Data were analyzed using mixed statistics, including independent samples t tests and Fisher exact tests. Results No catheter-associated urinary tract infections were reported during the intervention period, reducing the rate by 1.33 per 1000 catheter days. There was a 10.5% increase in catheter days, which was not statistically significant (P = .12). Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention (P = .01). Conclusions This bundled approach shows promise for reducing catheter-associated urinary tract infections in critical care settings. The concept could be adapted for other health care–associated infections.
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Kim, Young-Joo, Kyung-kgi Park, Jung-Sik Huh, and Sung Dae Kim. "Treatment, Management and Prevention of Catheter-associated Urinary Tract Infection." Journal of Medicine and Life Science 10, no. 3 (February 1, 2014): 240. http://dx.doi.org/10.22730/jmls.2014.10.3.240.
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Catheter-associated urinary tract infection (CAUTI) is the most commonly occurring nosocomial infection worldwide, accounting for approximately 40% of all hospital acquired infections. A lot of hospitalized patients undergo insertion of a urinary catheter at some time during their hospital days, and the use of indwelling urinary catheters appears to be increasing. And 80% of urinary tract infection is related to urinary catheterization. Unfortunately, many physicians don' t know about appropriate indications for use of indwelling urethral catheters as well as accurate criteria of CAUTI. Therefore, these could result in a potential source of CAUTI, leading to unnecessary use of antibiotics for treatment of asympk)matic bacteriuria, inducing of resistant organisms. Most CAUTI are derived from the patient's own colonic flora and the catheter predisposes to UTI in several ways. The most important risk factor for the development of CAUTI is the duration of catheterization. The clinician should be aware of two priorities： the catheter system should remain closed and the duration of catheterization should be minimal. While the catheter is in place, systemic antimicrobial treatment of asymptomatic catheter-associated bacteriuria is not recommended, except for some special cases.
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Nicolle, Lindsay E. "Catheter-Related Urinary Tract Infection." Drugs & Aging 22, no. 8 (2005): 627–39. http://dx.doi.org/10.2165/00002512-200522080-00001.
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Anwar, Ghuzala, Ghalib Nawaz, Muhammad Afzal, Iram Majeed, and Ali Waqas. "Assessment of Perceptions and Practices of the Nurses to Prevent Indwelling Catheter Associated Infection; Jinnah Hospital Lahore, Pakistan." International Journal of Applied Sciences and Biotechnology 5, no. 2 (June 29, 2017): 150–58. http://dx.doi.org/10.3126/ijasbt.v5i2.17317.
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Nursing is an art science and an essential health care profession in which the skilled knowledgeable persons are committed to provide care to sick peoples and strive for the, protection and promotion of health and prevention against diseases and helps to minimize the risk and risk related injuries. Urinary tract infections are very common infection in the hospital settings almost responsible for 40% nosocomial infections. All the urinray tract infection is expected that approximately more than 70% infection reported because of indewelling cathters.Objectives: To assess the perceptions of nurses regarding indwelling urinary catheter and its care. To assess the practices of nurses to prevent the indwelling catheter related urinary tract infection. Methodology: Descriptive cross sectional design and data was collected through a five point Likert scale questioner. Study population was the nursing staff from the Jinnah hospital Lahore. Sample size was 184 nurses from all indoor departments of the Jinnah Hospital Lahore. Results: The findings show that the practice and perceptions scores of the registered nurses’ in the study group are insignificant with age, qualification and experience (i.e., p-value > 0.05) with the evidence-based guidelines for prevention of catheter associated urinary tract infection. Results of study indicated insignificant relationship between registered nurses’ practice and perceptions regarding the indwelling urinary catheter associated infection.Int. J. Appl. Sci. Biotechnol. Vol 5(2): 150-158
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Septimus, Edward J., and Julia Moody. "Prevention of Device-Related Healthcare-Associated Infections." F1000Research 5 (January 14, 2016): 65. http://dx.doi.org/10.12688/f1000research.7493.1.
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Healthcare-associated infections (HAIs) are a leading cause of morbidity and mortality in hospitalized patients. Up to 15% of patients develop an infection while hospitalized in the United States, which accounts for approximately 1.7 million HAIs, 99,000 deaths annually and over 10 billion dollars in costs per year. A significant percentage of HAIs are preventable using evidenced-based strategies. In terms of device-related HAIs it is estimated that 65-70% of catheter-line associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) are preventable. To prevent CLABSIs a bundle which includes hand hygiene prior to insertion and catheter manipulation, use of chlorhexidene alcohol for site preparation and maintenance, use of maximum barrier for catheter insertion, site selection, removing nonessential lines, disinfect catheter hubs before assessing line, and dressing changes are essential elements of basic practices. To prevent CAUTIs a bundle that includes hand hygiene for insertion and catheter or bag manipulation, inserting catheters for appropriate indications, insert using aseptic technique, remove catheters when no longer needed, maintain a close system keeping bag and tubing below the bladder are the key components of basic practices.
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Madeo, M., B. Barr, and E. Owen. "A study to determine whether the use of a preconnect urinary catheter system reduces the incidence of nosocomial urinary tract infections." Journal of Infection Prevention 10, no. 2 (March 2009): 76–80. http://dx.doi.org/10.1177/1757177408093500.
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Nosocomial urinary tract infection (NUTI) is a common problem in the UK and is often related to the use of urinary catheters. In the UK urinary catheters account for approximately 25% of all healthcare associated infections and can have a considerable financial burden on the health service. Bacteria may gain entry into the bladder of a catheterised patient via the intra-luminal route especially if accidental disconnection arises. A prospective study was undertaken to determine the NUTI rates in patients using a preconnected catheter system compared to a traditional bag and catheter system on three medical wards. A total of 205 patients were included in the study. The catheter-associated urinary tract infection rate (CAUTI) in the baseline was 37.8 per 1,000 catheter days and 22.4 per 1,000 catheter days in the intervention group. The rates of CAUTI were 41% lower in the intervention group. The data in this sample group suggests the use of the preconnected catheter offers some protection against infection. The use of the preconnected system is a new concept in the UK and further studies are required to evaluate its effectiveness. The results from this study suggest their use may help to reduce the risk of CAUTI in certain clinical areas.
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Ercole, Flávia Falci, Tamara Gonçalves Rezende Macieira, Luísa Cristina Crespo Wenceslau, Alessandra Rocha Martins, Camila Cláudia Campos, and Tânia Couto Machado Chianca. "Integrative review: evidences on the practice of intermittent/indwelling urinary catheterization." Revista Latino-Americana de Enfermagem 21, no. 1 (February 2013): 459–68. http://dx.doi.org/10.1590/s0104-11692013000100023.
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OBJECTIVE: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.
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Jo, Jung Ki, Dong Seob Kim, Younghun Sim, Soorack Ryu, and Kyu Shik Kim. "A Comparative Study of Urinary Tests and Cultures for the Effectiveness of Fosfomycin in Catheter-Related Urinary Tract Infections." Journal of Clinical Medicine 11, no. 23 (December 5, 2022): 7229. http://dx.doi.org/10.3390/jcm11237229.
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As the elderly population increases due to an aging society, the number of patients with catheters is increasing, and treatment for urinary infections is needed. The current study analyzed the effectiveness of fosfomycin, the primary antibiotic used to treat urinary tract infections (UTIs), in these patients. Patients who received fosfomycin as the primary antibiotic for a UTI were selected, and the results of urine tests and cultures before and after fosfomycin administration were compared and analyzed. The degree of UTI in patients with a catheter was found to be more severe (p = 0.020), and the infecting strains were found to be different depending on whether a catheter was present (p = 0.014). There was a difference in the treatment success rate depending on whether or not a catheter was present (53.6% vs. 70.4%), but it was found that the treatment rate was more than 50% regardless of whether a catheter was present. The bacterial type, as well as the treatment rate based on the bacterium, differed depending on the presence of a catheter. Fosfomycin has a success rate of more than 50%, even in patients with catheters; therefore, it can be considered the primary antibiotic for treating UTIs.
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Long, Carol O., Chrys Anderson, Edward A. Greenberg, and Nancy Woomer. "Defining and Monitoring Indwelling Catheter-Related Urinary Tract Infections." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 20, no. 4 (April 2002): 255–62. http://dx.doi.org/10.1097/00004045-200204000-00012.
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Kusbaryanto, Kusbaryanto, and Diana. "The relationship between catheter placement and the incidence of urinary tract infections in Condong Catur Hospital, Yogyakarta." Bali Medical Journal 11, no. 1 (April 17, 2022): 256–58. http://dx.doi.org/10.15562/bmj.v11i1.3091.
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Introduction: Catheter-related urinary tract infections for one-third of all health-care related infections in the United States, and have also been shown to increase morbidity, mortality, and length of stay. Various problems are associated with urinary catheter insertion, namely trauma, complications, and patient discomfort. The purpose of this study was to analyze the relationship between catheter placement and the incidence of urinary tract infections in hospitalized patients in Condong Catur Hospital Yogyakarta. Methods: The design of this study was an analytic observational study using a cross sectional design. The sample was patients diagnosed with UTI for 12 months from August 2019 to July 2020 and inclusion and exclusion criteria. The sample selection was done by consecutive sampling. There were 98 samples of inpatients at the Condong Catur Hospital. The data were taken from the medical records of patients who had UTIs or those with a catheter installed. Results: There are 98 patients in the Condong Catur Hospital, 18 of them have had UTIs, ten of which were caused by catheter insertion. In this study, bivariate analysis was used to compare the two groups with partners and found a significant association between catheter use and urethral infection, with a p-value of 0.001. Conclusion: There is a significant relationship between catheter placement and the incidence of urinary tract infections in hospitalized patients in Condong Catur Hospital.
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Garna, Herry. "Catheter Related Infections in Pediatric Patients." Paediatrica Indonesiana 33, no. 5-6 (January 21, 2019): 108–14. http://dx.doi.org/10.14238/pi33.5-6.1993.108-14.
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During a 9-month prospective study, from August, 1988 to April, 1989, a total number of 4328 hospitalized pediatric patients at the Department of Child Health, Padjadjaran University, Hasan Sadikin General Hospital Bandung, were observed to identify skin and soft tissue nosocomial infections (not included postoperative), especially catheter related injections.
The gastroentestinal tract was the most frequent site of nosocomial infections (44.3%), then subsequently followed by skin infection (22.6%), bacteremia (16.3%) and urinary tract infection (14.1%). The most frequent cause of nosocomial skin infections like phlebitis was IVFD occurring in 82 out of 93 patients (88.2%). The overall phlebitis attact rate was 4.2% . When the duration of infusion is devided into 3 groups of 0-36 hours, 37-72 hours and ≥ 73 hours, then it becomes clear that the longer the duration of infusion, the higher the attack rate (x2=8.07, p<0.05).
Klebsiella pneumonia seemed to be the pathogen most frequently associated with nosocomial skin infections (26. 7%), followed by Enterobacter aerogenes (20.0%), and then E. coli, Ps. aeruginosa and S. aureus 13.3% each. It could be concluded that the risk of contracting phlebitis from JVFD with a duration of ≥ 73 hours was. 1.9 times higher than that of less than 72 hours.
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Zimakoff, Jette, David J. Stickler, Birgitte Pontoppidan, and Severin O. Larsen. "Bladder Management and Urinary Tract Infections in Danish Hospitals, Nursing Homes, and Home Care: A National Prevalence Study." Infection Control & Hospital Epidemiology 17, no. 4 (April 1996): 215–21. http://dx.doi.org/10.1017/s0195941700003775.
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AbstractObjective:To establish the prevalence of urinary tract infection in patients undergoing various forms of bladder management.Design:A nationwide descriptive point-prevalence survey with logistic regression analysis of the data relating infection to bladder management.Setting:Fifteen hospitals, 21 nursing homes, and 13 home care districts throughout Denmark.Patients:Information was collected on 3,665 patients. On the day of the study, 349 patients had indwelling catheters and 1,150 were using external urine drainage systems (condoms or diapers) for bladder management.Results:The prevalence of urinary tract infections in catheterized patients and those using external drainage systems was 13.2% and 8.1%, respectively. The prevalence of hospital-acquired urinary tract infection (4.2%) had not changed from that reported in 1978. The proportion of these infections related to the indwelling catheter, however, had reduced from 66% to 30%. Logistic regression analysis confirmed that, when corrected for the patient-related confounders (female gender, age >60 years, incontinence, immobility, and stay in hospital for longer than 15 days), condoms (odds ratio [OR], 5.94; 95% confidence interval [CI95], 2.8 to 12.5), indwelling catheters (OR, 3.3; CI95, 2.3 to 4.8), and diapers (OR, 1.5; CI95, 1.1 to 2.1) were significantly (P<.001, P<.001, and P=.008, respectively) related to infection.Conclusions:Prevalence surveys have revealed that over the period 1978 to 1991, during which efforts have been made to restrict the use of indwelling catheters and to encourage the care of catheterized patients according to guidelines recommended by the Danish National Centre for Hospital Hygiene, the percentage of hospital-acquired urinary tract infections associated with indwelling catheters has been halved. External urine drainage systems, however, have emerged as significant risk factors for urinary tract infection.
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Sukarwan, Agus, and Ratna Wardani. "Peran Perawat Dalam Pencegahan dan Pengendalian Infeksi Pada Pemasangan Kateter Urin." Journal of Nursing Care and Biomoleculer 7, no. 1 (June 29, 2022): 1–14. http://dx.doi.org/10.32700/jnc.v7i1.252.
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Introduction: Catheter-related urinary tract infections are the most common, but preventable, health-related infections and occur mostly in patients with indwelling urinary catheters. This study aims to determine the role of nurses in infection prevention and control in urinary catheter placement. Method: The preparation of the literature review went through several stages: making a research question according to the PICOS method, and conducting a literature review using diagrams, such as identification, eligibility, screening, selection of eligibility and determination of articles according to inclusion criteria. The last stage, the review is carried out systematically using tables and taking into account the value (Joanna Brigg Institution check list) JBI. Result: Search articles using Google Scholar, PubMed and Science Direct databases. Screening results of 9 Google Scholar articles, 3 PubMed articles and 5 Science Direct articles. The results of a review of 17 journals on the role of nurses obtained 10 prevention journals, 4 control journals and 3 infection prevention and control journals in urinary catheter insertion. Discussion: The nurse's role in infection prevention and control in urinary catheter insertion is to make direct observations throughout the day and night shifts. Implement nurse education programs on catheter and perineal care. Evaluate the knowledge and attitudes of nurses about the catheterization procedure. Identify multidrug-resistant organisms, and remove catheters according to standards and protocols. The nurse must maintain the patient's psychological stability during catheter insertion. The bundle catheter education technique is a method of increasing the knowledge, skills and experience of nurses on infection prevention and control in catheter placement.
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Harmon, Christian, and Ali Hassoun. "Antibiotic Bladder Irrigation in Preventing and Reducing Chronic Urinary Catheter-Related Urinary Tract Infections (UTI)." Open Forum Infectious Diseases 4, suppl_1 (2017): S347. http://dx.doi.org/10.1093/ofid/ofx163.833.
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Abstract Background Recurrent UTI is a common complication of chronic urinary catheter use. We report our experience with the use of antibiotic bladder irrigation to reduce catheter associated UTI and systemic antibiotics use. Methods Retrospective chart review of patients treated with antibiotic bladder irrigation for recurrent UTI related to chronic urinary catheter (2013–2016). Data collected include demographic, co-morbidities, urological anomalies, symptoms, documented pathogens during episodes of infection, and irrigation medication used. Antibiotic regimen included: gentamicin, gentamicin alternated with piperacillin-tazobactam, or tobramycin once weekly. Parameters for successful therapy and alleviation of symptoms included complete relief of symptoms for six months and no systemic antibiotics use for six months post initiation of therapy, or reduced frequency of infections for one year post initiation of therapy. Results 39 patients were enrolled, all were patients who had been referred to infectious disease physicians after persistence of symptoms despite multiple rounds of systemic antibiotics and had at least 6 episode of documented UTI despite following guideline for aseptic urinary catheter insertion and care. Mean age 66.5 y (range 27–92), 69% male. Most common urologic problem was neurogenic bladder in 48% and prostate or bladder surgery. 5 self-catheterize, 12 had suprapubic catheter and 22 had chronic indwelling catheter. Most common co-morbidities include: DM, BPH, paraplegia, spina bifida and multiple sclerosis. Most common presenting symptoms were abdominal pain 49% and fever 34%. Most common organisms were Escherichia coli 38%, Pseudomonas aeruginosa 23% and Enterococcus faecalis 18%. 67% used gentamicin bladder irrigation. 26 (66.67%) met the criteria for alleviation of symptoms and success with antibiotic irrigation therapy, and a further four featured improvement of frequency of symptoms despite not successfully meeting the study’s pre-set criteria for full improvement. Patient did not report any associated side effect. Conclusion Use of antibiotic bladder irrigation was successful in reducing symptom frequency and requirement of systemic antibiotics. Further Studies needed to assess the benefit of this mode of therapy. Disclosures All authors: No reported disclosures.
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Kennelly, Michael, Nikesh Thiruchelvam, Márcio Augusto Averbeck, Charalampos Konstatinidis, Emmanuel Chartier-Kastler, Pernille Trøjgaard, Rikke Vaabengaard, Andrei Krassioukov, and Birte Petersen Jakobsen. "Adult Neurogenic Lower Urinary Tract Dysfunction and Intermittent Catheterisation in a Community Setting: Risk Factors Model for Urinary Tract Infections." Advances in Urology 2019 (April 2, 2019): 1–13. http://dx.doi.org/10.1155/2019/2757862.
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A risk factor model for urinary tract infections in patients with adult neurogenic lower urinary tract dysfunction performing clean intermittent catheterisation was developed; it consists of four domains, namely, (1) general (systemic) conditions in the patient, (2) individual urinary tract conditions in the patient, (3) routine aspects related to the patient, and (4) factors related to intermittent catheters per se. The conceptual model primarily concerns patients with spinal cord injury, spina bifida, multiple sclerosis, or cauda equina where intermittent catheterisation is a normal part of the bladder management. On basis of several literature searches and author consensus in case of lacking evidence, the model intends to provide an overview of the risk factors involved in urinary tract infections, with specific emphasis to describe those that in daily practice can be handled and modified by the clinician and so come to the benefit of the individual catheter user in terms of fewer urinary tract infections.
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HEKİMOĞLU, Can Hüseyin, and Selda ŞAHAN. "Investigation of death related factors in urinary catheter-associated urinary tract infections." Turkish Bulletin of Hygiene and Experimental Biology 77, no. 3 (2020): 325–32. http://dx.doi.org/10.5505/turkhijyen.2020.13549.
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NAGAI, Yuka, Hitomi MAENO, Yoko HOSHI, Mayumi SATO, and Satomi YUHARA. "Standardization of Prophylactic Measures Against Catheter-related Urinary Tract Infections." JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 63, no. 1 (2014): 70–75. http://dx.doi.org/10.2185/jjrm.63.70.
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Pinn, Stephen. "Preventing catheter-related urinary tract infections: a clinical governance imperative." British Journal of Infection Control 3, no. 4 (August 2002): 22–24. http://dx.doi.org/10.1177/175717740200300408.
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T his is a report from a pilot workshop for nurses, held in London on 8 May 2002, sponsored by the ICNA in conjunction with Thames Valley University, and supported by an educational grant from BARD Ltd.
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Grgar, Luka. "Prevention of catheter-related urinary tract infections: The octenidine hypothesis." Medical Hypotheses 137 (April 2020): 109561. http://dx.doi.org/10.1016/j.mehy.2020.109561.
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Sanderson, P. J. "Prophylaxis for catheter related urinary tract infection." Journal of Hospital Infection 18, no. 1 (May 1991): 1–3. http://dx.doi.org/10.1016/0195-6701(91)90087-o.
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Sepúlveda, Luis, Miguel Vaz, Íris Brito, Catarina Chaves, Luís Cabral, Jorge Lima, and Filipe Rodrigues. "Catheter-Associated Urinary Tract Infections in a Burn Unit: Epidemiological Study." Acta Urológica Portuguesa 34, no. 1-2 (July 20, 2017): 33–39. http://dx.doi.org/10.24915/aup.34.1-2.4.
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Introduction: Besides burn wound infections, burned patients are also more susceptible to other types of nosocomial infections. Catheter-associated urinary tract infections (CA-UTI) are one of the most common infections in this context, responsible for high morbidity, increased hospital stay and associated costs. The aim of this study was to characterize catheter-associated urinary tract infections in hospitalized burn patients and evaluate the frequency of microbiologic agents responsible for these infections.
Material and Methods: Retrospective study, performed in a Burn Center (Coimbra Burns Unit) of a University Hospital (Centro Hospitalar e Universitário de Coimbra, Portugal – CHUC), based in the clinical data and urine cultures of burned patients who have performed at least once this exam between 1 January 2010 and 31 December 2014. Different variables such as date of infection, general characteristics of the population and the responsible pathogen were analyzed. Infections were further categorized taking into account the existence of previous episodes of CA-UTI, thereby defining primary infection, re- infection, relapse and over-infection.
Results: Between January 2010 and December 2014, 213 CA-UTI were diagnosed in 143 patients. The most common uropathogens were E. coli (27.2%), Enterococcus faecalis (20.2%), Pseudomonas spp. (13.1%), Candida spp. (12.1%), Klebsiella spp. (10.8%) and Acinetobacter baumannii (9.9%). The most common microorganisms varied significantly depending on the gender of the patient. The CA-UTI analyzed corresponded to 143 primary infections, 44 reinfections, 17 relapses and nine over-infections. Relapse corresponded to 11% of infections in males and 5.7% in females and was significantly more frequent in infections due to Acinetobacter baumannii.
Discussion/Conclusion: Catheter-associated urinary infections are common in intensive care units, particularly at Burn Units. The most common pathogens identified were similar to those reported in the literature. Pathogens responsible for polymicrobial infections were similar to those in monomicrobial infections, probably due to the short-term nature of urinary catheterization. Infections by Acinetobacter baumannii showed high susceptibility to relapse, which is probably related to its multi-drug resistance, common in this pathogen. The high relapse rate detected in males is probably related to the greater frequency of Acinetobacter baumannii infections in this gender. Candiduria was more frequent in the context of reinfection and over-infection, probably due to disruption of bacterial flora secondary to previous systemic antibiotics.
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Dedeić-Ljubović, Amela, and Mirsada Hukić. "Catheter-Related Urinary Tract Infection in Patients Suffering from Spinal Cord Injuries." Bosnian Journal of Basic Medical Sciences 9, no. 1 (February 20, 2009): 2–9. http://dx.doi.org/10.17305/bjbms.2009.2849.
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Urinary tract infection is commoner in patients with spinal cord injuries because of incomplete bladder emptying and the use of catheters that can result in the introduction of bacteria into the bladder. 145 patients suffering from spinal cord injuries, admitted to the Institute for physical medicine and rehabilitation, Centre for paraplegia of the Clinical Centre of the University of Sarajevo, were included. The patients were divided in three groups according to the method of bladder drainage: Group A (n=61) consisted of patients on clean intermittent catheterization; Group B (n=54) consisted of patients with indwelling catheters; Group C (n=30) consisted of patients who had performed self-catheterization. From a total of 4539 urine samples, 3963 (87,3%) were positive and 576 (12,7%) were sterile. More than 90% of the infected patients were asymptomatic.The overall rate of urinary infection amounted to about 2,1 episodes, and bacteriuria to 8,1 episodes per patient. 77% of infections (113/145) were acquired within seven days from catheterization.Infection was usually polymicrobial; the greatest number of urine samples 1770/3943 (44,9%) included more than one bacterium.The vast majority of cases of urinary tract infection and bacteriuria are caused by Gram-negative bacilli and enterococci, commensal organisms of the bowel and perineum, representative of those from the hospital environment. Providencia stuarti (18,9%) being the most common, followed by Proteus mirabilis (16,3%), Escherichia coli (11,8%), Pseudomonas aeruginosa (10,2%), Klebsiella pneumoniae (8,1%), Morganella morgani (5,4%), Acinetobacter baumannii (4,6%), Providencia rettgeri (3,5%). 15,7% of isolates were Gram-positive with Enterococcus faecalis (8,6%) as the most common. 55,3% of isolates were multidrug-resistant, and the highest rates of resistance were found among Acinetobacter baumannii (87,8%), Providencia rettgeri (86,7%), Pseudomonas aeruginosa (85,4%), Providencia stuarti (84,3%) and Morganella morgani (81,0%). Lower rates of resistance were found in Group C, i.e. patients on intermittent self- catheterisation. Eradication of organisms was achieved in only 53 (10,05%) of patients; hence, antibiotic therapy had no or very low effect.Significant correlations were found between the method of catheterization and the frequency of bacteriuria and urinary tract infections. The analysis of Group C showed a rate of lower urinary tract infection and bacteriuria than the other two Groups of patients. The objective of this study is the update of etiology and antimicrobial susceptibility in urinary tract infections in this group of patients. In addition, possible correlations between UTI and the type of bladder management were examined.
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Judha, Mohamad. "Factors Related To The Standard Of Care And Installation Of A Dower Cateter In A Hospital." Jurnal Ilmiah Cerebral Medika 2, no. 1 (September 22, 2020): 8. http://dx.doi.org/10.53475/jicm.v2i1.5.
Full textAbstract:
Background: Urethral catheter placement is a form of nursing care performed by nurses, a standard for catheter placement is required. Urinary tract infections often occur around 40% of all hospital infections each year. In addition, from some researchers, 80% of urinary tract infections occur due to the use of catheterization instruments, because almost 10% of all hospitalized patients, at Bantul Hospital in 2017 There are 21% of patients are infected with the urinary tract. Nurse compliance uses standards based on various factors.
Research Objectives: To determine the factors associated with the participation of nurses in the implementation of the standard installation of urethral catheters
Research Methods: Descriptive analytic research by discussing the cross-sectional study. The sample used was total sampling with a sample of 43 nurses according to inclusion criteria. Data collection tools using questionnaires and observation sheets. Chi-Square data analysis with α <0.05.
Results: The gender of female respondents was 76.7%. Age of respondents received 18-40 years 76.7%. The level of knowledge of respondents in the good category is 65.1%. The attitude of respondents in the positive category was 83.7%. The working period of respondents <5 years 51.2%. There is a significant relationship to age with the implementation of the standard implementation of urethral catheters, (P = 0.003 with an OR value of 2.54). There is a significant relationship between knowledge and the implementation of standard urethral catheter placement (P = 0,000 with an OR value of 19.50). There is a significant relationship between attitude with the agreement on the implementation of the standard urethral catheter installation (P = 0.007 with an OR value of 0.361). There is a significant relationship between a work period and the implementation of the standard implementation of urethral catheters (P = 0,000 with an OR value of 20.40).
Conclusion: There is a significant relationship between age, knowledge, attitudes, and years of service to the approval of nurses in the implementation of the standard installation of urethral catheters in care in Bantul Hospitall
Keywords: Working period of a nurse, and catheter installation standards
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Pockaj, B. A., S. L. Topalian, S. M. Steinberg, D. E. White, and S. A. Rosenberg. "Infectious complications associated with interleukin-2 administration: a retrospective review of 935 treatment courses." Journal of Clinical Oncology 11, no. 1 (January 1993): 136–47. http://dx.doi.org/10.1200/jco.1993.11.1.136.
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PURPOSE To determine if interleukin-2 (IL-2)-treated patients are prone to develop clinically significant infections, a retrospective review of 519 patients who received 935 treatment courses over a 38-month period was conducted. MATERIALS AND METHODS Treatment records of patients receiving intravenous (IV) bolus IL-2 were reviewed. Clinically significant infectious episodes were identified by retrieving data on antibiotic usage and cross-referencing this with microbiology records and chart review. RESULTS One hundred thirty-nine documented infectious episodes occurred in 122 treatment courses (13.0%); 11 courses were associated with more than one episode of infection. Predominantly urinary tract infections (6.8%) and infections related to IV catheters (5.3%) were encountered. Fifty-eight percent of the catheter-related infections were associated with bacteremia. Other infections included respiratory tract infections (1.0%), skin/muscle infections (0.9%), and miscellaneous infections (0.9%). Bacteria were isolated from the majority of infections. Almost all patients were successfully treated for their infection, with only two septic deaths (0.2%). No difference was noted in infected versus non-infected patients with regard to diagnosis or previous therapy. There was a significant tendency for those patients who developed infection to be older (P2 = .002, Mantel test for trend). Risk factors for the development of infection included vascular access catheters, open wounds, biliary obstruction, or incomplete treatment of previous infections. Over the 3-year study period, the incidence of infection declined from 23% to 7% (P2 < .0001, Mantel test for trend) due to rigorous patient screening, vigilant monitoring for infection, liberal use of antibiotics for suspected infection, and use of prophylactic antibiotics for central venous catheter placement. CONCLUSION Although treatment with IL-2 may be associated with a slightly increased incidence of bacterial infections, these infections can be successfully managed in the great majority of cases.
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Chen, Dafna, Elizabeth Temkin, Ester Solter, Amir Nutman, Yehuda Carmeli, Mitchell Schwaber, and Debby Ben-David. "A National Intervention to Reduce Undesirable Urinary Tract Events in Internal Medicine Wards." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s98. http://dx.doi.org/10.1017/ice.2020.598.
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Background: Catheter-associated urinary tract infection (CAUTI) is considered a preventable healthcare-associated infection. Many local and national interventions using multimodal prevention measures have targeted CAUTI incidence as the primary outcome. Other undesirable events related to urinary catheters and infections such as overuse of urine culturing and antimicrobial prescribing for asymptomatic bacteriuria, are not captured by CAUTI surveillance, and may not be the targets of such interventions. The aim of this study was to assess the impact of expanded national surveillance targeting various aspects of urinary tract infections, culturing and treatment practices, and catheter use in internal medicine wards. Methods: The Israeli National Center for Infection Control (NCIC) issued CAUTI prevention guidelines and initiated in 2016 a urinary tract event surveillance system that targets the incidence of CAUTI, urinary catheter utilization ratio, and the proportion of urine cultures sent and patients treated in the absence of symptoms. The surveillance is conducted for 1 month 3 times per year. Hospitals are required to report all positive urine cultures (>100,000 CFU) collected in internal medicine wards, along with the following data: admission date, symptoms of infection, dates of urinary catheter use, and antibiotic treatment. These data enable the NCIC to validate hospital classifications of each event. In addition, during each surveillance month, hospitals conduct point-prevalence surveys of compliance with CAUTI prevention measures. An electronic data collection form with built-in algorithms supports the local teams during the surveillance process. Results: Between 2016 and 2019, a total of 3,028 positive urine cultures not present on admission were reported by internal medicine wards in 30 hospitals. A significant decrease was observed in the incidence of CAUTI (from 4.7 to 2.9; P < .001) and in the proportion of asymptomatic bacteriuria treated with antibiotics (from 31% to 20%; P = .02) (Table 1). The catheter utilization ratio decreased from 0.25 to 0.23 (P < .001). The rate of cultures sent from asymptomatic patients decreased from 1.5 to 1.1 (P < .01). Point-prevalence surveys in internal medicine wards detected a significant increase in the use of closed urinary drainage systems (from 79% to 97% in 2018, P < .001) and documentation of a daily nurse assessment of the need for a catheter (from 74% to 81%, P < .001). Conclusions: National surveillance of undesirable urinary tract events resulted in a significant reduction in CAUTI, antibiotic treatment for ASB, and the rate of cultures sent from asymptomatic patients. A small decrease was observed in catheter utilization ratio. CAUTI surveillance programs should include other undesirable urinary tract events.Funding: NoneDisclosures: None
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Jain, Mudita, Rituja Kaushal, and Malini Bharadwaj. "Infection surveillance analysis of catheter associated urinary tract infections in obstetrics and gynecology department of a tertiary care hospital of Central India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 1 (December 25, 2017): 215. http://dx.doi.org/10.18203/2320-1770.ijrcog20175848.
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Background: The prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. As device related hospital acquired infections are imposing major threats in surgical realm of medical sciences, this study was undertaken with the objective to asses catheter related urinary tract infections magnitude.Methods: This study was undertaken in a tertiary care setting of Obstetrics and Gynecology Department of a Central Indian city. It is a prospective study conducted over a full year span from April 2016 to March 2017.Results: CAUTI was calculated as 8.95 per thousand catheter days for the whole study period. Out of the total number of 18 urinary isolates, E. Coli and Enterococcus species were more commonly implicated.Conclusions: In order to restraint the enigma, a multidisciplinary integrated approach including periodic training sessions for all health care workers based on bundled care interventions supervisory checklists etc. is needed. Aseptic techniques along with IDSA (Infectious disease society of America) guidelines/other similar protocols are recommended to bring down overall prevalence. Prudent use of antibiotics is to be accorded as per antibiotic stewardship program to combat drug resistance.
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DeGroot-Kosolcharoen, Jane, Rhonda Guse, and Jeffrey M. Jones. "Evaluation of a Urinary Catheter with a Preconnected Closed Drainage Bag." Infection Control & Hospital Epidemiology 9, no. 2 (February 1988): 72–76. http://dx.doi.org/10.1086/645788.
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AbstractThe incidence of hacteriuria, significant urinary tract infection, and cost associated with the use of two urinary catheter drainage systems were evaluated in a population of hospitalized adult males. A commercially available device comprised of a Foley catheter attached with a heat-shrunk plastic seal to the tubing of a closed drainage hag (preconnected system) was compared with a standard system that had the Foley catheter attached to the closed drainage hag after it had been inserted. Using a randomized prospective design, the performance of the preconnected system in 97 patients was compared with that of the standard system in 105 patients. Catheters were left in place a mean of 6.4 and 7.6 days in the respective groups. Bacteriuria occurred after catheter insertion in 11.3% of patients receiving the preconnected system and 13.3% of patients receiving the standard system (not statistically significant). When bacteriuria developed, it occurred within seven days of catheter insertion in 50% of instances, irrespective of drainage system employed, suggesting that manipulations related to catheter insertion were important in initiating bacteriuria. Significant urinary tract infections occurred in only 2% of all patients studied. The higher cost for purchasing the preconnected system was not warranted for the population of patients studied.
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Pellowe, Carol. "Using evidence-based guidelines to reduce catheter related urinary tract infections in England." Journal of Infection Prevention 10, no. 2 (March 2009): 44–48. http://dx.doi.org/10.1177/1757177408096889.
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Acquiring a healthcare associated infection (HCAI) in hospital remains a significant threat to patient safety, and catheter associated urinary tract infections (CAUTI) account for the majority of these infections. This review focuses on the complementary and continuing influence of central policy, evidence for practice, and educational support on strategies to reduce the incidence of CAUTI in the National Health Service (NHS). The development of the Department of Health's (DH) national guidelines for preventing HCAI (the `epic' guidelines) (Pratt et al, 2001, 2007) became the evidence base for the development of the DH Saving Lives strategy (DH, 2007). This initiative provides the tools and resources for NHS trusts to embed clinically effective HCAI prevention and control measures into everyday practice that are applied consistently to everyone. The national guidelines are also providing the evidence base for various educational initiatives designed to support guideline implementation, including the NHS Core Learning Unit's (CLU) Infection Control Programme.
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Advani, Sonali D., Rachael A. Lee, Martha Long, Mariann Schmitz, and Bernard C. Camins. "The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center." Infection Control & Hospital Epidemiology 39, no. 07 (April 18, 2018): 878–80. http://dx.doi.org/10.1017/ice.2018.78.
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The 2015 changes in the catheter-associated urinary tract infection definition led to an increase in central line-associated bloodstream infections (CLABSIs) and catheter-related candidemia in some health systems due to the change in CLABSI attribution. However, our rates remained unchanged in 2015 and further declined in 2016 with the implementation of new vascular-access guidelines.Infect Control Hosp Epidemiol 2018;878–880
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Weber, David J., Emily E. Sickbert-Bennett, Vickie Brown, and William A. Rutala. "Comparison of Hospitalwide Surveillance and Targeted Intensive Care Unit Surveillance of Healthcare-Associated Infections." Infection Control & Hospital Epidemiology 28, no. 12 (December 2007): 1361–66. http://dx.doi.org/10.1086/523868.
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Objectives.To assess the surveillance coverage obtained with Centers for Disease Control and Prevention (CDC)-recommended surveillance of healthcare-associated infections (HAIs), which is focused on intensive care units (ICUs) and emphasizes device-related infections (ie, those associated with central venous catheters, ventilators, and/or urinary catheters), compared with the surveillance coverage achieved by comprehensive hospitalwide surveillance. In addition, we assessed whether the infection rates in step-down units more resemble those in wards or ICUs.Methods.Review of prospectively obtained, comprehensive hospitalwide surveillance data from 2004 through 2005 for an acute care tertiary care hospital with approximately 700 beds. Surveillance data was obtained by trained infection control professionals using standard CDC criteria for HAIs.Results.CDC-recommended ICU surveillance for catheter-related bloodstream infection (BSI) and ventilator-associated pneumonia would have detected only 87 (21.4%) of 407 catheter-related BSIs and only 66 (37.9%) of 174 respiratory tract infections that occurred in the medical and surgical services. Only 31 (34.8%) of 89 infections caused by methicillin-resistant Staphylococcus aureus and 7 (31.8%) of 22 infections caused by vancomycin-resistant Enterococcus occurred in our adult ICUs.Conclusions.Rates of HAIs were highest in the ICUs, intermediate in step-down units, and lowest in the wards. The rates of infections in the step-down units were more similar to those in the wards than to those in the ICUs. To prevent HAIs, more comprehensive surveillance may be indicated.
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Wałaszek, Marta, Małgorzata Kołpa, and Zdzisław Wolak. "The analysis of hospital-acquired urinary tract infections. A 10 year longitudinal study in Małopolska (the Lesser Poland province)." Health Promotion & Physical Activity 2, no. 3 (June 30, 2017): 141–54. http://dx.doi.org/10.5604/01.3001.0010.7730.
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Introduction: Hospital-acquired infections are one of the most serious health threats during a patient’s stay in hospital, including healthcare associated infections (HAI). The most typical form of hospital-acquired infections is urinary tract infection (UTI). Objective: To examine the frequency of appearing UTIs, the structure of UTIs in in-patients in the department of internal medicine and nephrology at Saint Lucas’s general hospital in Tarnów was analysed. Materials and methods: Data analysis of 13 965 in-patients staying in the department of internal medicine and nephrology from 2006 to 2015 was carried out. To investigate these data epidemiological methods and standard definitions of hospital- acquired infections issued by European Center for Disease Prevention as well as Control and Centers for Disease Control and Prevention were used. Results: 237 hospital-acquired UTIs were revealed, which is 33% of all UTIs revealed in the investigated ward. The UTI incidence rate was 1.7% including 1.5% for microbiologically confirmed symptomatic UTIs and 0.2% not microbiologically confirmed symptomatic UTIs. The incidence density rate per 1 000 person-days was 0.2 over 1 000. The number of revealed catheter-related cases was 168, and not catheter-related cases – 69. The incidence density rate of UTIs associated with urinary catheters was 3.3 per 1 000 person-days. The dominant etiological factors, which were taken to be detected from the infected patients’ specimens, were: Escherichia coli 63 (29%), Enterococcus spp. 37(16%), Klebsiella spp. 23 (11%). Conclusions: A 10 year observation of UTIs, which have appeared in the department of internal medicine and nephrology, allowed to conduct the accurate analysis of these infections. The comparison of urinary tract infection rates done in the investigated ward, and recorded in the Research Participation Programs at the Centers for Disease Control and Prevention (CDC), allows to draw the conclusion that the presented epidemiological situation does not differ significantly from other countries.
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Elkhafifi, Muftah H. "Purple Urine Bag Syndrome: Uncommon Clinical Entity Associated with Common Infection, Case Report." Al-Mukhtar Journal of Sciences 35, no. 3 (September 30, 2020): 205–11. http://dx.doi.org/10.54172/mjsc.v35i3.250.
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Purple urine bag syndrome (PUBS) is a rare medical syndrome where purple discoloration of urine occurs predominantly in chronically constipated bedridden elderly women, chronically catheterized and associated with urinary tract infections (UTIs). The etiology is related to UTIs with specific bacteria that produce sulphatase and phosphatase enzymes which lead tryptophan metabolism to produce two pigments: Indigo (blue) and indirubin (red), mixtures of which become purple in color. Several risk factors are associated with PUBS; including female gender, increased dietary tryptophan, alkaline urine, constipation, catheterization, high urinary bacterial load, renal failure and use of polyvinyl chloride plastic catheters. Herein, I present this rare benign interesting condition on a 78 years old lady with purple discoloration of her urine bag due to urinary tract infection caused by Escherichia coli that was successfully treated by culture guided antibiotic (Ciprofloxacin). The purple urine disappeared after antibiotic therapy and change of the urine catheter and bag.
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Gauhar, Vineet, Daniele Castellani, Jeremy Yuen-Chun Teoh, Carlotta Nedbal, Giuseppe Chiacchio, Andrew T. Gabrielson, Flavio Lobo Heldwein, et al. "Catheter-Associated Urinary Infections and Consequences of Using Coated versus Non-Coated Urethral Catheters—Outcomes of a Systematic Review and Meta-Analysis of Randomized Trials." Journal of Clinical Medicine 11, no. 15 (July 30, 2022): 4463. http://dx.doi.org/10.3390/jcm11154463.
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Coated urethral catheters were introduced in clinical practice to reduce the risk of catheter-acquired urinary tract infection (CAUTI). We aimed to systematically review the incidence of CAUTI and adverse effects in randomized clinical trials of patients requiring indwelling bladder catheterization by comparing coated vs. non-coated catheters. This review was performed according to the 2020 PRISMA framework. The incidence of CAUTI and catheter-related adverse events was evaluated using the Cochran–Mantel–Haenszel method with a random-effects model and reported as the risk ratio (RR), 95% CI, and p-values. Significance was set at p < 0.05 and a 95% CI. Twelve studies including 36,783 patients were included for meta-analysis. There was no significant difference in the CAUTI rate between coated and non-coated catheters (RR 0.87 95% CI 0.75–1.00, p = 0.06). Subgroup analysis demonstrated that the risk of CAUTI was significantly lower in the coated group compared with the non-coated group among patients requiring long-term catheterization (>14 days) (RR 0.82 95% CI 0.68–0.99, p = 0.04). There was no difference between the two groups in the incidence of the need for catheter exchange or the incidence of lower urinary tract symptoms after catheter removal. The benefit of coated catheters in reducing CAUTI risk among patients requiring long-term catheterization should be balanced against the increased direct costs to health care systems when compared to non-coated catheters.
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Rearigh, Lindsey, Mark Rupp, Trevor Craig Van Schooneveld, Gayle Gillett, Adrienne Sy, Luana Evans, Kelly Goetschkes, Terry Micheels, and Elizabeth Lyden. "Effect of an External Urinary Collection Device on Catheter Associated Urinary Tract Infections in Hospitalized Women." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s199. http://dx.doi.org/10.1017/ice.2020.741.
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Background: Catheter-associated urinary tract infections (CAUTIs) are a common hospital-acquired infection (HAI) resulting in excess morbidity, mortality, and cost. Urine management can be a challenging issue, particularly in women, due to limited options for control of urinary incontinence. Issues with urinary leakage and worry for subsequent skin break down often leads to indwelling catheter insertion. In the spring of 2018, our facility implemented a female external urine collection device (EUCD) in efforts to decrease catheter days and to limit CAUTIs. Methods: Retrospective, 32-month (January 2017–August 2019), quasi-experimental, before-and-after study. Catheter use and CAUTI were defined according to CDC NHSN criteria. Poisson regression was used to model the rate of CAUTI (per 1,000 patient days [PD] and per 1,000 catheter days [CD]) comparing the 14 months prior to EUCD introduction with the 14 months after introduction and allowing a 3-month introduction period. Results: The CAUTI rate did not change significantly. The overall CAUTI rate per 1,000 PD decreased slightly from 0.24 to 0.20 (P = 0.44; model risk, 0.86; 95% CI, 0.58–1.26) whereas the rate per 1,000 CD increased slightly 1.5 to 1.6 (P = 0.76; model risk, 1.06; 95% CI, 0.73-–1.56). The CAUTI rate for men increased from 0.09 to 0.11 per 1,000 PD (P = 0.42; model risk, 1.29) and from 0.99 to 1.55 per 1,000 CD (P = 0.17; model risk, 1.56). For women, the rate of CAUTI decreased from 0.15 to 0.09 per 1,000 PD (P = 0.10; model risk, 0.61) and from 2.12 to 1.65 per 1,000 CD (P = 0.38; model risk, 0.38). A significant decrease in catheter days (CD per 1,000 PD; P < .0001) was observed for all hospitalized patients (from 158.56 to 128.3; model risk, 0.81), for men (from 87.06 to 72.15; model risk, 0.83), and for women (from 71.49 to 56.15; model risk, 0.79). Of 2,347 adverse events, 5 (0.2%) involved perineal skin breakdown and redness. Three events were related to malposition of the ECUD or inappropriate level of suction and 1 event was related to latex allergy and EUCD use. Conclusions: The introduction of a EUCD for women was associated with a significant decrease in indwelling catheter usage. A trend toward a decrease in CAUTI per 1,000 PD for women was observed (P = .10). Additional studies on whether the EUCD is associated with changes in UTI rates (both CAUTIs and noncatheter UTIs) as well as cost implications of EUCD are warranted.Funding: NoneDisclosures: None
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Hariati, Hariati, Dewi Elizadiani Suza, and Rosina Tarigan. "Risk Factors Analysis for Catheter-Associated Urinary Tract Infection in Medan, Indonesia." Open Access Macedonian Journal of Medical Sciences 7, no. 19 (September 12, 2019): 3189–94. http://dx.doi.org/10.3889/oamjms.2019.798.
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BACKGROUND: Catheter-associated urinary tract infection (CAUTI) are one of the most common infections in health care caused by several risk factors.
AIM: This study aims at analysing the risky factors triggering CAUTI.
METHODS: This research was designed by applying prospective study. It was conducted from July to November 2018 by involving 82 patients attached to the catheter and treated in the General Hospital of Medan as the sample. The study instrument used observational sheets by measuring the occurrence of urinary tract infection using urine culture analysis ≥ 105 CFU/ml.
RESULTS: The results showed that there was a relationship (p < 0.05) amongs age (p = 0.01; RR = 0.51), diabetes mellitus (p = 0.00; RR = 7.61), duration of catheterization (p = 0.00; RR = 0.01), indications for catheter use (p = 0.00; RR = 0.34) with CAUTI, and there were not significant relationship (p > 0.05) amongs genre (p = 0.06; RR = 1.72), drainage system (p = 0.43; RR = 0.43) and catheter care (p = 0.08; RR = 0.50) with CAUTI. Diabetes mellitus (p = 0.00; OR = 8.92 95% CI = 1.02-11.83) and duration of catheterization (p = 0, 00; OR = 32.84 95% CI = 3.81-322.74) were the most significant factor related to CAUTI.
CONCLUSION: CAUTI is influenced by various factors, and it can be controlled by understanding those factors so that the right interventions to prevent the infections can be taken and the quality of nursing care can be increased as well.
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Iftimie, Simona, Anna Hernández-Aguilera, Ana F. López-Azcona, Helena Castañé, Elisabet Rodríguez-Tomàs, Gerard Baiges-Gaya, Jordi Camps, Antoni Castro, and Jorge Joven. "Measurement of Plasma Galectin-3 Concentrations in Patients with Catheter Infections: A Post Hoc Retrospective Cohort Study." Diagnostics 12, no. 10 (October 6, 2022): 2418. http://dx.doi.org/10.3390/diagnostics12102418.
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Catheter-related infections (CRIs) include catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs), and they are associated with high morbidity, mortality, and healthcare costs. The diagnosis of a CRI is made difficult by its non-specific symptoms. We aimed to investigate the factors influencing the plasma concentration of galectin-3 in catheter-bearing patients and to explore its potential usefulness as an index for CRIs. Circulating the concentrations of galectin-3, we measured the chemokine (C-C) motif ligand 2, procalcitonin, and C-reactive protein in 110 patients with a central catheter, in 165 patients with a urinary catheter, and in 72 control subjects. Catheter-bearing patients had higher concentrations (p < 0.001) of galectin-3 than the control group [central catheter: 19.1 (14.0–23.4) µg/L; urinary catheter: 17.1 (12.7–25.4) µg/L; control group: 6.1 (5.0–8.7) µg/L]. We identified chronic kidney disease as an independent determinant of galectin-3 concentrations in patients with a central catheter, and serum creatinine, cardiovascular disease, and number of days that the catheter was indwelling were identified as determinants in urinary catheter patients. We found that measuring galectin-3 concentrations in urinary catheter patients with a CRI was more accurate for diagnosis than the other parameters. We conclude that the measurement of galectin-3 concentration may be useful for assessing the inflammatory status of catheter-bearing patients and may contribute to the diagnosis of CRIs in those with a urinary catheter.
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Bentvelsen, Robbert Gerard, Karin Ellen Veldkamp, and Niels H. Chavannes. "A Smartphone App for Engaging Patients With Catheter-Associated Urinary Tract Infections: Protocol for an Interrupted Time-Series Analysis." JMIR Research Protocols 10, no. 3 (March 23, 2021): e28314. http://dx.doi.org/10.2196/28314.
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Background Catheter-associated urinary tract infections (CAUTIs) are the main cause of health care–associated infections, and they increase the disease burden, antibiotic usage, and hospital stay. Inappropriate placement and unnecessarily prolonged usage of a catheter lead to an elevated and preventable risk of infection. The smartphone app Participatient has been developed to involve hospitalized patients in communication and decision-making related to catheter use and to control unnecessary (long-term) catheter use to prevent CAUTIs. Sustained behavioral changes for infection prevention can be promoted by empowering patients through Participatient. Objective The primary aim of our multicenter prospective interrupted time-series analysis is to reduce inappropriate catheter usage by 15%. We will evaluate the efficacy of Participatient in this quality improvement study in clinical wards. Our secondary endpoints are to reduce CAUTIs and to increase patient satisfaction, involvement, and trust with health care services. Methods We will conduct a multicenter interrupted time-series analysis—a strong study design when randomization is not feasible—consisting of a pre- and postintervention point-prevalence survey distributed among participating wards to investigate the efficacy of Participatient in reducing the inappropriate usage of catheters. After customizing Participatient to the wards’ requirements, it will be implemented with a catheter indication checklist among clinical wards in 4 large hospitals in the Netherlands. We will collect clinical data every 2 weeks for 6 months in the pre- and postintervention periods. Simultaneously, we will assess the impact of Participatient on patient satisfaction with health care services and providers and the patients’ perceived involvement in health care through questionnaires, and the barriers and facilitators of eHealth implementation through interviews with health care workers. Results To reduce the inappropriate use of approximately 40% of catheters (currently in use) by 15%, we aim to collect 9-12 data points from 70-100 patients per survey date per hospital. Thereafter, we will conduct an interrupted time-series analysis and present the difference between the unadjusted and adjusted rate ratios with a corresponding 95% CI. Differences will be considered significant when P<.05. Conclusions Our protocol may help reduce the inappropriate use of catheters and subsequent CAUTIs. By sharing reliable information and daily checklists with hospitalized patients via an app, we aim to provide them a tool to be involved in health care–related decision-making and to increase the quality of care. Trial Registration Netherlands Trial Register NL7178; https://www.trialregister.nl/trial/7178 International Registered Report Identifier (IRRID) DERR1-10.2196/28314
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Ln, Khandare, and Barate Dl. "INCIDENCES OF CANDIDA ALBICANS AND NON-ALBICANS AMONG CATHETER-ASSOCIATED URINARY TRACT INFECTION PATIENTS OF AKOLA CITY." Asian Journal of Pharmaceutical and Clinical Research 10, no. 11 (November 1, 2017): 115. http://dx.doi.org/10.22159/ajpcr.2017.v10i11.19769.
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Objective: Candida spp. is the third leading cause of catheter-related infections. Candida species is a part of human microflora and it becomes pathogenic when certain conditions are present and cause an opportunistic infections. The present study was undertaken to determine incidences of Candida albicans and non-albicans among catheterized urinary tract infection (UTI) patients of Akola city.Methods: A total 60 catheter urine samples were collected from patient of all the age group and both sex who had indwelling urinary catheter. The collected catheterized urine samples of patients from various hospitals of Akola city were used for isolation using HiCrome Candida differential agar.Results: It was found that highest frequency of isolation of Candida spp. was from age group 61-70 years. The predominance of male candidate was more than female having Candida spp. in catheter-associated UTI (C-UTI). Among the Candida spp. C. albicans (64.81%) was predominant over non-albicans spp. while in non-albicans Candida krusei and Candida glabrata were predominant showing 11.11% incidences. It was followed by Candida tropicalis (9.2%) and Candida parapsilosis (3.7%).Conclusion: The incidences of C. albicans and non-albicans were high among catheter-associated UTI patients.
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Lesho, Emil, Robert Clifford, Kelly Vore, Jennifer Fede, Balazs Zsenits, Dawn Riedy, Jose Alcantara, Deborah Stamps, and Melissa Bronstein. "Amidst the CAUTI Metrics Hurley Burly, a Sustained SURly Success Adaptable for Reducing Other Nosocomial Infections." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s115. http://dx.doi.org/10.1017/ice.2020.621.
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Background: Surveillance metrics for catheter-associated urinary tract infections (CAUTIs) are subject to ongoing debate and refinement to best capture infectious catheter-related harm (ICRH) and noninfectious catheter-related harm (NCRH). Indwelling urinary catheters cause 5 times more NCRH than ICRH. The commonly used standardized infection ratio (SIR) does not fully capture NCRH nor the impact of prevention efforts in all settings. Alternatively, device utilization rates and ratios (DUR) do not reflect differences in other factors that may describe levels of device use. DUR lose comparability over time and across settings and can mask truly effective interventions by selecting for a higher risk group of catheterized patients. Experts now advocate use of the standardized utilization ratio (SUR). We sought to implement a multidimensional intervention to reduce exposure risk, CAUTI, and NCRH across a 5-hospital healthcare system, totaling 1,692 acute-care beds. Methods: The intervention comprised the following elements: (1) an interactive educational campaign comprising one-on-one engagements between infection preventionists and frontline providers, encouraging the use of female external urinary collection devices and male custom-fitted condom catheters, rewarding overall participation, device utilization, hand hygiene, and CAUTI rates; (2) educational emails to all staff from top executives; (3) increasing the urinalysis reflex to culture threshold from >5 to ≥10 WBCs; and (4) clinical decision support (CDS) for ordering urine cultures for patients with indwelling catheters and for encouraging Foley catheter alternatives and catheter removal. Monthly, quality department representatives discuss unit level DURs with managers, who then discuss patient-level device use at daily huddles with physicians and advanced practice providers. Significance was determined using the 2-tailed t test. The results are listed in Table 1. Discussion: One year after the intervention, use of device alternatives increased 5-fold, CDS-driven ordering predominated, and the SIR and SUR remained significantly decreased. These successes are especially notable because , a ventricular-assist device program was launched in the postintervention period. By the end of the study, the program became the second-busiest of its type in the United States, resulting in a group of patients at high risk of device use and infection in the postintervention period, but absent in the preintervention period. numerous reports of effective interventions for reducing CAUTI have been published, we found no large studies using the SUR as the main metric. The limitations of this study include the lack of a population SIR and data pertaining to catheter-related bacteriuria and antibiotic usage. However, this approach is easily customizable to any infection, device, and diagnostic test.Disclosures: NoneFunding: None
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Esposito, S., S. Noviello, S. Leone, A. Marvaso, L. Drago, and F. Marchetti. "A Pilot Study on Prevention of Catheter-Related Urinary Tract Infections with Fluoroquinolones." Journal of Chemotherapy 18, no. 5 (October 2006): 494–501. http://dx.doi.org/10.1179/joc.2006.18.5.494.
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P., Leelakrishna, and Karthik Rao B. "A study of risk factors for catheter associated urinary tract infection." International Journal of Advances in Medicine 5, no. 2 (March 21, 2018): 334. http://dx.doi.org/10.18203/2349-3933.ijam20180525.
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Background: Catheter associated urinary tract infections (CAUTIs) are the most common causes of UTIs in postoperative cases. Many risk factors are associated with its incidence. The present study was conducted with the aim to determine the related risk factors and to identify the causative agents contributing to the urinary tract infection.Methods: This prospective study was conducted on 210 patients meeting the requirements of inclusion criteria during September 2012 to February 2014. Detailed history of the patients was recorded. Urine culture was done at different time intervals to identify the causative agent suggestive to CAUTI. Univariate analyses of the association of each variable with CAUTI and multivariable logistic regression were done to predict CAUTI outcome.Results: The mean age of study participants was 51.61 years. Among them 141 were males and 69 were female patients. On univariate analysis purpose for urine catheterization, place of catheterization, breach in the closed system of drainage, duration of catheterization, hemoglobin value less than 10, raised renal parameters with serum creatinine more than 1.5 were all significantly associated with development of CAUTI (p value 0.000). Sex of the patient (p value 0.279) and catheter size (p value 0.279) was not found to have a significant correlation with increased risk of CAUTI. On multivariate analysis, age, catheter size, diabetes, duration of catheterization, a breach in the closed system of catheter drainage and sex were found to be the significant risk factors associated with CAUTI (p<0.05).Conclusion: An understanding of the risk factors in development of CAUTI, significantly helps in reducing the additional burden on the health care system. Measures such as shortening the duration of catheterization, strict control of diabetes and sterile precautions in insertion and maintenance of indwelling catheters can help in prevention CAUTI.
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Greene, M. Todd, David Ratz, Jennifer Meddings, Mohamad G. Fakih, and Sanjay Saint. "Potential Misclassification of Urinary Tract–Related Bacteremia Upon Applying the 2015 Catheter-Associated Urinary Tract Infection Surveillance Definition From the National Healthcare Safety Network." Infection Control & Hospital Epidemiology 37, no. 4 (January 18, 2016): 469–71. http://dx.doi.org/10.1017/ice.2015.339.
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The Centers for Disease Control and Prevention recently updated the surveillance definition of catheter-associated urinary tract infection to include only urine culture bacteria of at least 1×105 colony-forming units/mL. Our findings suggest that the new surveillance definition may fail to capture clinically meaningful catheter-associated urinary tract infections.Infect. Control Hosp. Epidemiol. 2016;37(4):469–471
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Henry, Michelle. "Evaluation of evidence-based practice of catheter associated urinary tract infections prevention in a critical care setting: An integrative review." Journal of Nursing Education and Practice 8, no. 7 (January 28, 2018): 22. http://dx.doi.org/10.5430/jnep.v8n7p22.
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Background and objective: An estimated 449,300 catheter-associated tract urinary infection (CAUTI) incidents affecting Americans and 13,000 CAUTI-related deaths in the United States every year. The purpose of the review was the appraisal and integration of the best evidence practice for preventing CAUTI interventions and strategies to guide safety and quality initiatives in order to improve patient care.Methods: A total of 20 articles complied with the exclusion and inclusion criteria. The articles were studied, and the chosen articles were categorized in two areas of study: CAUTI prevention, and nurse education and knowledge improvement.Results: The articles selected were reviewed to encompass a review on the articles offering the most applicable corresponding information involving catheter-associated urinary tract infections and competency-based education.Conclusions: Analysis of the data from the literature search indicates the potential lack of compliance of CAUTI infection control practices is an issue for CAUTI problem. So implementing the best evidence to enforce CAUTI bundles compliance for CAUTI prevention is a key to reduce CAUTI rates.
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Sultan, Safaa M. "Fungal Urinary Tract Infections in Pediatric Age Groups." NTU Journal of Pure Sciences 1, no. 3 (September 18, 2022): 40–47. http://dx.doi.org/10.56286/ntujps.v1i3.351.
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One of the most prevalent and recurring bacterial diseases in kids is urinary tract infections (UTI). At least 8% of girls and 2% of boys are thought to suffer UTIs as children. The fungi are often linked to UTIs, and their antibiotic susceptibility patterns change over time and across various environments. To choose the best empirical antimicrobial therapy, it is crucial to understand the trends of uropathogenic antibiotic resistance in certain geographic areas. Therefore, this research assesses the causal organisms in urine samples and their antibiotic susceptibility profile among patients who visit Mosul's general outpatient department clinic. Due to space restrictions, our research primarily focused on fungus-related UTIs in children (2–12) years old. . Adult infections, reflux nephropathy, catheter-associated and nosocomial infections, medication assessment for particular antimicrobials, and viral and rickettsial infections are only a few examples of the subjects covered. The study intends to close a gap in the literature about how candiduria manifests in pediatric inpatients and outpatients. The current study's objective was to ascertain the prevalence of candiduria among kids visiting External laboratories in Mosul, Iraq. Additionally, isolates' sensitivity to several antifungal medications was taken into consideration.
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Nicolle, Lindsay E. "Catheter-Related Urinary Tract Infection: Practical Management in the Elderly." Drugs & Aging 31, no. 1 (November 28, 2013): 1–10. http://dx.doi.org/10.1007/s40266-013-0089-5.
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Fakih, Mohamad G., Carolyn V. Gould, Barbara W. Trautner, Jennifer Meddings, Russell N. Olmsted, Sarah L. Krein, and Sanjay Saint. "Beyond Infection: Device Utilization Ratio as a Performance Measure for Urinary Catheter Harm." Infection Control & Hospital Epidemiology 37, no. 3 (November 27, 2015): 327–33. http://dx.doi.org/10.1017/ice.2015.287.
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Catheter-associated urinary tract infection (CAUTI) is considered a reasonably preventable event in the hospital setting, and it has been included in the US Department of Health and Human Services National Action Plan to Prevent Healthcare-Associated Infections. While multiple definitions for measuring CAUTI exist, each has important limitations, and understanding these limitations is important to both clinical practice and policy decisions. The National Healthcare Safety Network (NHSN) surveillance definition, the most frequently used outcome measure for CAUTI prevention efforts, has limited clinical correlation and does not necessarily reflect noninfectious harms related to the catheter. We advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is patient-centered and objective and is currently captured as part of NHSN reporting. Furthermore, these data are readily obtainable from electronic medical records. The DUR also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.Infect. Control Hosp. Epidemiol. 2016;37(3):327–333