Healthcare-associated Urinary Tract Infection (HA-UTI): A Risk Factor for Clostridioides Difficile Infection (CDI)? Results of a Real-world Data (RWD) Analysis

2020 ◽  
Vol 48 (8) ◽  
pp. S33
Author(s):  
Timothy Kelly ◽  
ChinEn Ai ◽  
John Murray ◽  
Yan Xiong ◽  
Hanna Jokinen-Gordon
Keyword(s):  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Real World ◽  
Real World Data ◽  
World Data ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Healthcare Associated

scholarly journals 794. Healthcare-Associated Urinary Tract Infection (HA-UTI): A Risk Factor for Clostridioides difficile Infection (CDI)? Results of a Real-World Data Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S440-S441
Author(s):  
Timothy Kelly ◽  
Timothy Kelly ◽  
ChinEn Ai ◽  
ChinEn Ai ◽  
John Murray ◽  
...  
Keyword(s):  
Risk Factor ◽  
Data Analysis ◽  
Urinary Tract ◽  
Real World ◽  
Healthcare Associated Infection ◽  
Real World Data ◽  
World Data ◽  
Increased Risk ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Background It is estimated that 223,900 cases of CDI occur annually in hospitalized patients resulting in 12,800 deaths and $1 billion in attributable costs. Antimicrobial use is a risk factor for CDI and the antimicrobials ordered to treat urinary tract infections have been identified as a factor in both recurrent CDI and community-acquired CDI. This real-world data analysis seeks to explore the relationship between HA-UTI and hospital-onset CDI (HO-CDI). Methods An electronic infection surveillance system was the source of de-identified real-world data from 290 hospitals. Algorithmically-derived measures of healthcare-associated infections (ADM-HAIs), and records of all-cause antimicrobial orders, for all inpatient admissions for the period 10/1/18–9/30/19 were analyzed. All patients who presented with a urine ADM-HAI – suggestive of HA-UTI – and no other healthcare-associated infection (Urine+ patients), were observed for subsequent HO-CDI. Urine+ patients were compared to patients with no HAI of any type, other than CDI (HAI-free patients), and relative risk (RR) was estimated. The analysis was repeated for the subgroup of patients who received an antimicrobial order for any reason during their stay. Results 3,050,525 inpatient admissions were analyzed. 26,634 were identified as Urine+ patients. 188 of those patients subsequently presented with HO-CDI. 2,978,507 were identified as HAI-free patients. 6,238 of those patients presented with HO-CDI. The incidence of HO-CDI was significantly higher in Urine+ patients compared to HAI-free patients (RR=3.37, 95% CL[2.92, 3.89], p< 0.0001). When the analysis was repeated to examine only patients who received antimicrobial orders, Urine+ patients continued to be at higher risk of subsequent HO-CDI compared to HAI-free patients (RR=3.28, 95% CL[2.74,3.92], p< 0.0001). Conclusion The presence of a urine ADM-HAI, suggestive of HA-UTI, was associated with an increased risk of subsequent HO-CDI. This held when only patients with antimicrobial orders were considered. These observations mirror findings from other published studies, however, other factors may have contributed to increased risk for both HA-UTI and HO-CDI. Disclosures Timothy Kelly, MS, MBA, BD (Employee) ChinEn Ai, MPH, BD (Employee) John Murray, MPH, BD (Employee) Yan Xiong, n/a, BD (Becton Dickinson) (Employee) Hanna Jokinen-Gordon, PhD, BD (Employee)

scholarly journals 157 Clinical Burden of Recurrent Clostridioides difficile Infection: A Real-World Data Analysis

2019 ◽  
Vol 114 (1) ◽  
pp. S94-S96
Author(s):  
Laura Stong ◽  
Winnie W. Nelson ◽  
Paul Feuerstadt ◽  
Mena Boules ◽  
Naomi Sacks ◽  
...  
Keyword(s):  
Data Analysis ◽  
Real World ◽  
Real World Data ◽  
World Data ◽  
Clostridioides Difficile ◽  
Clinical Burden ◽  
Clostridioides Difficile Infection

The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults

2021 ◽  
Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Positive Culture ◽  
Clostridioides Difficile

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.

IS URINARY TRACT INFECTION A RISK FACTOR FOR HYPERTENSION IN ELDERLY?: PP.30.214

2010 ◽  
Vol 28 ◽  
pp. e512 ◽  
Author(s):  
A Pacurari ◽  
C Serban ◽  
A Narita ◽  
I Romosan
Keyword(s):  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection

Tu2008 Urinary Tract Infection in Infancy Is a Risk Factor for Chronic Abdominal Pain in Childhood

2014 ◽  
Vol 146 (5) ◽  
pp. S-897
Author(s):  
John M. Rosen ◽  
Alyssa Kriegermeier ◽  
Papa Adams ◽  
Miguel Saps
Keyword(s):  
Urinary Tract Infection ◽  
Risk Factor ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Tract Infection ◽  
Chronic Abdominal Pain

Types of Interventions

2021 ◽  
pp. 24-39
Author(s):  
Jennifer Meddings ◽  
Vineet Chopra ◽  
Sanjay Saint
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Infection Prevention ◽  
Indwelling Catheters ◽  
Inappropriate Use ◽  
Day Hospitals ◽  
Healthcare Associated

Infection prevention programs were slow to develop—they were a rarity as recently as the 1950s—but they have become a staple of modern-day hospitals. Great strides have been made in identifying clinician activities that can control or prevent various healthcare-associated infections. This chapter describes the contents of an infection prevention bundle for catheter-associated urinary tract infection (CAUTI). In the case of CAUTI, the so-called bladder bundle sets forth appropriate and inappropriate use of indwelling catheters. A nursing checklist, on paper or as a template in the electronic medical record, is used to track patients’ daily urinary catheter status. Doctors and nurses are asked to rethink when a Foley is called for, what alternatives should be considered, what catheter equipment should be used, and how long the Foley should remain in place.

Taking on Clostridioides difficile

2021 ◽  
pp. 141-157
Author(s):  
Jennifer Meddings ◽  
Vineet Chopra ◽  
Sanjay Saint
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Clostridium Difficile ◽  
Tract Infection ◽  
Infectious Diseases ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Infection Prevention ◽  
Hospital Staff ◽  
Clostridioides Difficile

The adaptive approach used in the previous chapters to prevent catheter-associated urinary tract infection (CAUTI) is applied to an initiative to prevent Clostridioides difficile (formerly Clostridium difficile) infection. These two initiatives differ regarding their scope, the members of their teams, and the elements of their bundles. For preventing C. difficile, for example, the most important bundle item is antimicrobial stewardship since the use of broad-spectrum antibiotics vastly increases a person’s risk of becoming infected. Infectious diseases physicians or clinical pharmacists are to examine the circumstances of antimicrobial prescriptions they have filled to see whether they meet infection prevention standards; if not, the prescribing physician will receive prompt feedback. Differences aside, the basic elements of the CAUTI framework apply, from the C-suite’s decision to go ahead with the initiative to the tactics used to sell the C. difficile bundle to the hospital staff.

Fever

2018 ◽  
pp. 217-220
Author(s):  
Glenn Patriquin
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Common Causes ◽  
Criteria For Diagnosis ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Specific Symptoms ◽  
Growth Of Bacteria

This case illustrates one of the most common healthcare-associated infections (HAI) in a patient who is admitted to hospital. Catheter-associated urinary tract infections (CAUTI) can be prevented by eliminating unnecessary urinary catheter use. Furthermore, non-specific symptoms are frequently erroneously attributed to a presumed urinary tract infection (UTI) upon isolating bacteria from a urine sample. Except for a few specific circumstances, asymptomatic bacteriuria should not be treated with antibiotics. Without symptoms consistent with UTI, growth of bacteria from urine does not constitute an infection. Culturing urine without UTI symptoms can lead to misuse of antibiotics, which can increase adverse events and drive antimicrobial resistance. This case reviews common causes of UTIs and criteria for diagnosis.

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