Virtual Breakthrough Series, Part 1: Preventing Catheter-Associated Urinary Tract Infection and Hospital-Acquired Pressure Ulcers in the Veterans Health Administration

2016 ◽  
Vol 42 (11) ◽  
pp. 485-AP2 ◽  
Author(s):  
Lisa Zubkoff ◽  
Julia Neily ◽  
Beth J. King ◽  
Mary Ellen Dellefield ◽  
Sarah Krein ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pressure Ulcers ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Hospital Acquired ◽  
Breakthrough Series

Assessing a National Collaborative Program To Prevent Catheter-Associated Urinary Tract Infection in a Veterans Health Administration Nursing Home Cohort

2018 ◽  
Vol 39 (07) ◽  
pp. 820-825 ◽  
Author(s):  
Sarah L. Krein ◽  
M. Todd Greene ◽  
Beth King ◽  
Deborah Welsh ◽  
Karen E. Fowler ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
Incidence Rate ◽  
Urine Culture ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based

OBJECTIVECollaborative programs have helped reduce catheter-associated urinary tract infection (CAUTI) rates in community-based nursing homes. We assessed whether collaborative participation produced similar benefits among Veterans Health Administration (VHA) nursing homes, which are part of an integrated system.SETTINGThis study included 63 VHA nursing homes enrolled in the “AHRQ Safety Program for Long-Term Care,” which focused on practices to reduce CAUTI.METHODSChanges in CAUTI rates, catheter utilization, and urine culture orders were assessed from June 2015 through May 2016. Multilevel mixed-effects negative binomial regression was used to derive incidence rate ratios (IRRs) representing changes over the 12-month program period.RESULTSThere was no significant change in CAUTI among VHA sites, with a CAUTI rate of 2.26 per 1,000 catheter days at month 1 and a rate of 3.19 at month 12 (incidence rate ratio [IRR], 0.99; 95% confidence interval [CI], 0.67–1.44). Results were similar for catheter utilization rates, which were 11.02% at month 1 and 11.30% at month 12 (IRR, 1.02; 95% CI, 0.95–1.09). The numbers of urine cultures per 1,000 residents were 5.27 in month 1 and 5.31 in month 12 (IRR, 0.93; 95% CI, 0.82–1.05).CONCLUSIONSNo changes in CAUTI rates, catheter use, or urine culture orders were found during the program period. One potential reason was the relatively low baseline CAUTI rate, as compared with a cohort of community-based nursing homes. This low baseline rate is likely related to the VHA’s prior CAUTI prevention efforts. While broad-scale collaborative approaches may be effective in some settings, targeting higher-prevalence safety issues may be warranted at sites already engaged in extensive infection prevention efforts.Infect Control Hosp Epidemiol 2018;820–825

scholarly journals Bacterial profile, antimicrobial susceptibility pattern and associated factors of community and hospital acquired urinary tract infection at Dessie referral hospital, Dessie, Northeast Ethiopia

2021 ◽  
Author(s):  
Berhanu Adugna ◽  
Bekele Sharew ◽  
Mohabaw Jemal
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Associated Factors ◽  
Referral Hospital ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Hospital Acquired ◽  
Dessie Referral Hospital

Abstract Back ground: Urinary tract infection are one of the most common bacterial infections in the community and in the hospital. Nowadays, little is known about the status of community and hospital acquired urinary tract infection, antimicrobial susceptibility pattern and associated factors among urinary tract infection patients in Ethiopia, particularly in our study area. Methods A hospital based cross sectional study was carried out in Dessie referral hospital. A total of 422 urine samples were enrolled using systematic random sampling technique. All isolates were identified by standard microbiological techniques and their antibiotic susceptibility was done by Kirby Bauer disc diffusion method. Data was entered using Epi data version 3.1 and analyzed by SPSS software version 20. P- Value < 0.05 at 95% CI was considered as statistically significant. Result Of 422 urine samples processed 100 (23.7%) yielded bacterial isolates. About50(30.7%) and 50(19.3%) samples from hospitalized and community showed significant bacteriuria respectively. E. coli 44/103(42.7%), predominated across the two groups followed by S. aureus 25/103(24.3%), CONs,14/103(13.5%), Klebsiella spps 7/103(6.78), proteus spps 3/103(2.91), and Entrococcus spps 3/103 (2.91%). Pseudomonas spps 3/103 (2.91), Citrobacter spps 2/103(1.94%) and Acinetobacter Spp 1/103(0.999), which were isolated from only the hospitalized samples. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3–100% and 76.9–100% in hospitalized and community acquired respectively. Among risk factors previous use of antibiotics, female gender, Age, Diabetics, catheterization were associated with the infection. Conclusion The present study revealed that slightly high prevalence of urinary tract infection. High antimicrobial resistance was observed to most antimicrobial drugs tested. Meropenem and Nitrofurantoin were the most active drugs for urinary tract infection. Empirical selection of antimicrobial agents should be based on antibiotic sensitivity pattern of uropathogens that prevalent in that area. Female sex, age, previous use of antibiotics, catheterization and diabetics were at risk of urinary tract infection.

Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract Infection

2019 ◽  
Vol 171 (7_Supplement) ◽  
pp. S38 ◽  
Author(s):  
Jennifer Meddings ◽  
Milisa Manojlovich ◽  
Jessica M. Ameling ◽  
Russell N. Olmsted ◽  
Andrew J. Rolle ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Quantitative Results ◽  
Hospital Acquired

scholarly journals Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study

2008 ◽  
Vol 46 (2) ◽  
pp. 243-250 ◽  
Author(s):  
S. Saint ◽  
C. P. Kowalski ◽  
S. R. Kaufman ◽  
T. P. Hofer ◽  
C. A. Kauffman ◽  
...  
Keyword(s):  
United States ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
The United States ◽  
National Study ◽  
Hospital Acquired

The pathogenesis of catheter-associated urinary tract infection

2009 ◽  
Vol 10 (2) ◽  
pp. 50-56 ◽  
Author(s):  
JMT Barford ◽  
ARM Coates
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Additional Benefit ◽  
Bladder Epithelium ◽  
Physical Damage ◽  
Hospital Acquired Infections ◽  
Residual Urine ◽  
Catheter Surface ◽  
Hospital Acquired

Catheter-associated urinary tract infection (CAUTI) remains one of the most common types of hospital-acquired infections. Further progress in the prevention of CAUTI requires a better understanding of its pathogenesis. Bacteria may enter the bladder through contamination of the tip during insertion with the flora of the distal urethra or from bacteria ascending the outside or the inside of the catheter. Residual urine in the bladder of catheterised patients increases the risk of bacteriuria. During the process of infection, bacteria need first to adhere to the epithelial cells of the urinary tract and/or the surface of the catheter. They will then develop into biofilms on the catheter surface and are resistant to the immune system and antibiotics. Catheters by themselves may cause immediate physical damage to the bladder epithelium; they may be toxic and also cause inflammation. Bacteria can also damage the epithelium and cause inflammation and the combination of both may be synergistic in producing symptoms in the patient. Most episodes of catheter-associated bacteriuria are asymptomatic but it is not known why some patients are symptomatic and others are not. Further research into the pathogenesis of CAUTI needs to be carried out. A suggestion for the prevention of CAUTI is the use of catheters with an additional eye-hole beneath the balloon to prevent residual urine in the bladder or to remove the tip and balloon altogether, with the additional benefit of having no tip to cause damage or inflammation to the bladder epithelium.

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