scholarly journals A Large Multicenter Prospective Study of Community-Onset Healthcare Associated Bacteremic Urinary Tract Infections in the Era of Multidrug Resistance: Even Worse than Hospital Acquired Infections?

2021 ◽  
Author(s):  
Silvia Gómez-Zorrilla ◽  
Federico Becerra-Aparicio ◽  
Inmaculada López Montesinos ◽  
Enrique Ruiz de Gopegui ◽  
Inmaculada Grau ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Urinary Tract ◽  
Prospective Study ◽  
Urinary Tract Infections ◽  
Hospital Acquired Infections ◽  
Multicenter Prospective Study ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
Community Onset

scholarly journals Urinary tract infections in children

2018 ◽  
Vol 60 (1) ◽  
pp. 35-40
Author(s):  
Elzbieta Osuch ◽  
Andre Marais
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Recurrent Utis ◽  
Hospital Acquired Infections ◽  
Diagnostic Studies ◽  
Tract Infections ◽  
Hospital Acquired

Urinary tract infections (UTIs) are common in childhood and represent approximately 10% of hospital-acquired infections. It is clinically challenging to distinguish cystitis (lower UTI) from pyelonephritis (upper UTI) in those younger than two years. Most UTI patients can however be safely managed as outpatients if diligent follow-up procedures are in place. Recurrent UTIs in children may indicate malfunction or an anatomical defect of the urinary tract, and require specialised diagnostic studies. The proper approach for a child with UTI remains controversial, and treatment often differs according to regional or institutional empirical guidelines.

scholarly journals A Multifaceted Approach to Reduction of Catheter-Associated Urinary Tract Infections in the Intensive Care Unit With an Emphasis on “Stewardship of Culturing”

2016 ◽  
Vol 38 (2) ◽  
pp. 186-188 ◽  
Author(s):  
Katherine M. Mullin ◽  
Christopher S. Kovacs ◽  
Cynthia Fatica ◽  
Colette Einloth ◽  
Elizabeth A. Neuner ◽  
...  
Keyword(s):  
Critical Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Critically Ill Patient ◽  
Multifaceted Approach ◽  
Hospital Acquired Infections ◽  
Control And Prevention ◽  
Tract Infections ◽  
Hospital Acquired ◽  
Successful Reduction

BACKGROUNDCatheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications.OBJECTIVETo implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture.METHODSA project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs. Interventions implemented between year 1 and year 2 included protocols recommended by the Centers for Disease Control and Prevention for placement, maintenance, and removal of catheters. Leaders from all critical care disciplines agreed to align routine culturing practice with American College of Critical Care Medicine (ACCCM) and Infectious Disease Society of America (IDSA) guidelines for evaluating a fever in a critically ill patient. Surveillance data for CAUTI and hospital-acquired bloodstream infection (HABSI) were recorded prospectively according to National Healthcare Safety Network (NHSN) protocols. Device utilization ratios (DURs), rates of CAUTI, HABSI, and urine cultures were calculated and compared.RESULTSThe CAUTI rate decreased from 3.0 per 1,000 catheter days in 2013 to 1.9 in 2014. The DUR was 0.7 in 2013 and 0.68 in 2014. The HABSI rates per 1,000 patient days decreased from 2.8 in 2013 to 2.4 in 2014.CONCLUSIONSEffectively reducing ICU CAUTI rates requires a multifaceted and collaborative approach; stewardship of culturing was a key and safe component of our successful reduction efforts.Infect Control Hosp Epidemiol 2017;38:186–188

scholarly journals Inhibiting Host Protein Deposition on Urinary Catheters Reduces Urinary Tract Infections

2021 ◽  
Author(s):  
Marissa Jeme Andersen ◽  
ChunKi Fong ◽  
Alyssa Ann La Bella ◽  
Alex Molesan ◽  
Matthew M. Champion ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Serum Proteins ◽  
Host Protein ◽  
Urinary Catheters ◽  
Hospital Acquired Infections ◽  
Protein Deposition ◽  
Tract Infections ◽  
Hospital Acquired

SummaryMicrobial adhesion to medical devices is common for hospital-acquired infections, particularly for urinary catheters. If not properly treated these infections cause complications and exacerbate antimicrobial resistance. Catheter use elicits bladder inflammation, releasing host serum-proteins, including fibrinogen, into the bladder, which deposit on the urinary catheter. Enterococcus faecalis uses fibrinogen as a scaffold to bind and persist in the bladder despite antibiotic treatments. Inhibition of fibrinogen-pathogen interaction significantly reduces infection. Here, we show deposited fibrinogen is advantageous for uropathogens, suggesting that targeting catheter protein deposition may reduce colonization creating an effective intervention. Hostprotein deposition was reduced, using liquid-infused catheters, resulting in decreased colonization on catheters, in bladders, and dissemination in vivo. Furthermore, proteomics revealed a significant decrease in deposition of host-secreted proteins on liquid-infused catheter surfaces. Our findings suggest targeting microbial binding scaffolds may be an effective antibiotic-sparing intervention for use against catheter-associated urinary tract infections and other medical device infections.

Community-onset healthcare-related urinary tract infections: Comparison with community and hospital-acquired urinary tract infections

2012 ◽  
Vol 64 (5) ◽  
pp. 478-483 ◽  
Author(s):  
Silvia Aguilar-Duran ◽  
Juan P. Horcajada ◽  
Luisa Sorlí ◽  
Milagro Montero ◽  
Margarita Salvadó ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tract Infections ◽  
Hospital Acquired ◽  
Community Onset

scholarly journals 406. Incidence of Community and Hospital Acquired Infections in Critically Ill COVID-19 Patients in the Dominican Republic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S304-S305
Author(s):  
Rita Alexandra Rojas-Fermin ◽  
Anel E Guzman ◽  
Ann Sanchez ◽  
Edwin Germosen ◽  
Cesar Matos ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Dominican Republic ◽  
Critically Ill ◽  
Urinary Tract Infections ◽  
Bloodstream Infections ◽  
Central Venous ◽  
Health Crisis ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Abstract Background The disease caused by SARS-CoV-2, COVID-19, has caused a global public health crisis. COVID-19 causes lower respiratory tract infection (LRTI) and hypoxia. There is a paucity of data on bacterial and fungal coinfection rates in patients with COVID-19 at low and middle income countries (LMICs). Our objective is to describe the clinical characteristics of critically ill patients with COVID-19 in the Dominican Republic (DR) Methods We performed a retrospective review of patients admitted to the ICU with COVID-19 from March 14th to December 31st 2020, at a 296-bed tertiary care level and teaching Hospital in the Dominican Republic. Demographic and clinical information was collected and tabulated. Laboratory confirmed bacterial and fungal infections were defined as community acquired infections (CAI) if diagnosed within 48 hours of admission and hospital acquired infections (HAI) when beyond 48 hours. Microbiologic data was tabulated by source and attribution. Results Our cohort had 382 COVID-19 patients. Median age was 64 and most were male (64.3%) and 119 (31.1%) were mechanically ventilated and 200 (52%) had central venous catheters. A total of 28 (7%) laboratory confirmed community acquired infections and 55 (14%) HAIs occurred. Community acquired infections included 13 (46%) bloodstream infections (BSIs), 11 (39%) urinary tract infections (UTI) and 6 (21%) LRTIs. HAIs included 39 (70%) BSIs, 11 (20%) UTIs and 6 (11%) ventilator associated pneumonias (VAP). Causal organisms of community and hospital acquired BSI and UTI are in Figure 1 and Figure 2 respecively. All-cause mortality was 35.3% (135/382) in our cohort, and 100% mortality (76) in those with coinfections. Figure 1. Community acquired and hospital acquired bloodstream infections in COVID-19 patients admitted to the ICU Figure 2. Community acquired and hospital acquired urinary tract infections in COVID-19 patients admitted to the ICU Conclusion Community and hospital acquired infections were common and in the ICU and likely contributed to patient outcomes. More than two thirds of HAIs in the ICU were BSIs. Central venous catheter device utlization and maintenance may play a role in BSIs, along with immunosuppression from COVID-19 therapeutics and translocation from mucosal barrier injury. Mortality in patients with coinfections was higher than those without. Infection prevention strategies to reduce device utilization during COIVD-19 in LMICs may have an impact on HAIs. Disclosures All Authors: No reported disclosures

Bacteremia due to healthcare-associated urinary tract infections in children

2021 ◽  
Vol 28 (2) ◽  
pp. 147-149
Author(s):  
F. Devrim ◽  
İ. Çağlar ◽  
N. Demiray ◽  
Y. Oruç ◽  
Y. Ayhan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tract Infections ◽  
Healthcare Associated
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