Impact of an Antimicrobial Stewardship Care Bundle to Improve the Management of Patients with Suspected or Confirmed Urinary Tract Infection

2016 ◽  
Vol 37 (12) ◽  
pp. 1499-1501 ◽  
Author(s):  
Curtis D. Collins ◽  
Jared J. Kabara ◽  
Sarah M. Michienzi ◽  
Anurag N. Malani
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Asymptomatic Bacteriuria ◽  
Care Bundle ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program ◽  
Bundle Compliance ◽  
Tract Infections

Implementation of an antimicrobial stewardship program bundle for urinary tract infections among 92 patients led to a higher rate of discontinuation of therapy for asymptomatic bacteriuria (52.4% vs 12.5%; P =.004), more appropriate durations of therapy (88.7% vs 63.6%; P =.001), and significantly higher overall bundle compliance (75% vs 38.2%; P < .001).Infect Control Hosp Epidemiol 2016;1499–1501

scholarly journals Pharmacist recommendations for carbapenem de-escalation in urinary tract infection within an antimicrobial stewardship program

2020 ◽  
Vol 13 (4) ◽  
pp. 558-563 ◽  
Author(s):  
Svetlana Sadyrbaeva-Dolgova ◽  
Pilar Aznarte-Padial ◽  
Alberto Jimenez-Morales ◽  
Manuela Expósito-Ruiz ◽  
Miguel Ángel Calleja-Hernández ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program

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.

Preventing Catheter-Associated Urinary Tract Infections in the Pediatric Intensive Care Unit

2020 ◽  
Vol 40 (1) ◽  
pp. e12-e17
Author(s):  
Megan D. Snyder ◽  
Margaret A. Priestley ◽  
Michelle Weiss ◽  
Cindy L. Hoegg ◽  
Natalie Plachter ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Pediatric Intensive Care ◽  
Urinary Catheters ◽  
Bundle Compliance ◽  
Tract Infections

Background Catheter-associated urinary tract infections are common health care–associated infections and have been associated with increased mortality, morbidity, length of stay, and cost. Prevention strategies are grouped into bundles focused on reducing unnecessary catheter use and promptly removing urinary catheters. Before intervention in the study institution, no urinary catheters were unnecessarily used and compliance with the catheter-associated urinary tract infection bundle was 84%. Objective To increase bundle compliance by using targeted rounds specifically focused on eliminating dependent loops in drainage tubing and ensuring appropriate catheter use to reduce the incidence of catheter-associated urinary tract infections. Methods A multidisciplinary team was formed to identify misperceptions, highlight best practices, and eliminate barriers to success over 1 year in a single pediatric intensive care unit. The team completed a quality improvement project of daily targeted rounding for patients with an indwelling urinary catheter. The goals were to assess appropriateness of catheterization, increase bundle compliance, and decrease catheter-associated urinary tract infection risk. Targeted rounds were conducted in addition to the medical team rounds. Results Bundle compliance supported by targeted rounding increased from 84% to 93% and helped reduce the overall catheter-associated urinary tract infection rate from 2.7 infections per 1000 catheter-days at baseline to 0. This change was sustained for 1 year. Conclusion Targeted rounding for pediatric patients with an indwelling urinary catheter is an effective and sustainable strategy to reduce catheter-associated urinary tract infections. The ease of implementation for this intervention lends itself to generalizability to other patient populations.

scholarly journals Microbiological profile of symptomatic and asymptomatic bacteriuria recovered from female patients with urinary tract infection

2015 ◽  
Vol 3 (1) ◽  
pp. 34-37
Author(s):  
Una Jessica Sarker ◽  
Md Sakil Munna ◽  
Saurab Kishore Munshi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nalidixic Acid ◽  
Asymptomatic Bacteriuria ◽  
Female Patients ◽  
Medical College ◽  
Tract Infections ◽  
Dominant Bacteria ◽  
Klebsiella Spp

With the previous knowledge on the production of ?-lactamase by the bacterial pathogens causing urinary tract infection, present study further investigated the presence of symptomatic and asymptomatic bacteriuria in female patients admitted into the Delta Medical College with suspected urinary tract infections (UTIs). The manifestation of uropathogens and their responses against locally available antibiotics (amoxicillin, 10 ?g; cephradin, 30 ?g; ciprofloxacin, 5 ?g; cotrimoxazole, 23.8 ?g; gentamicin, 10 ?g; nalidixic acid, 30 ?g) were inquired by means of conventional cultural techniques and double-disc diffusion methods, respectively. Among 110 urine samples collected from the patients with suspected UTI, 34 were found to be culture positive. Symptomatic (64.7%) and asymptomatic (36.3%) bacteriuria were noticed inside the puss cell of the UTI positive cases. Escherichia coli (73.5%) was the dominant bacteria while Klebsiella spp. (26.5%) was also exultant. Around 96% uropathogens were found to be sensitive against imipenem, and 75% against amikacin. E. coli was found to be sensitive against all of the antibiotics used, whereas Klebsiella spp. was found to be 100% resistant against nalidixic acid and cotrimoxazole. DOI: http://dx.doi.org/10.3329/sjm.v3i1.22751 Stamford Journal of Microbiology, Vol.3(1) 2013: 34-37

Male veterans with complicated urinary tract infections: Influence of a patient-centered antimicrobial stewardship program

2016 ◽  
Vol 44 (12) ◽  
pp. 1549-1553 ◽  
Author(s):  
James F. Carbo ◽  
Christine A. Ruh ◽  
Kari E. Kurtzhalts ◽  
Michael C. Ott ◽  
John A. Sellick ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Stewardship Program ◽  
Patient Centered ◽  
Stewardship Program ◽  
Male Veterans ◽  
Tract Infections

Urinary Tract Infections

2012 ◽  
pp. 267-273
Author(s):  
Walter C Hellinger
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Renal Involvement ◽  
Asymptomatic Bacteriuria ◽  
Flank Pain ◽  
Recent Onset ◽  
Significant Bacteriuria ◽  
Tract Infections ◽  
Abnormal Urinary Tract

There are several terms important to a discussion of urinary tract infection (UTI). Bacteriuria is bacteria in the urine. Significant bacteriuria is at least 105 bacteria/mL of voided urine. Asymptomatic bacteriuria is bacteria in the urine without symptoms associated with urinary tract infection. Urinary tract infection is bacteriuria (or funguria) and symptoms associated with upper UTI or lower UTI (or both). UTI s are sometimes characterized as asymptomatic or symptomatic, in which case asymptomatic UTI is synonymous with asymptomatic significant bacteriuria. Uncomplicated UTI is infection of a physiologically and anatomically normal urinary tract. Complicated UTI is infection of a physiologically or anatomically abnormal urinary tract. Cystitis is lower UTI typically associated with urinary frequency, dysuria, or urgency. Acute pyelonephritis is upper UTI of recent onset with renal involvement, often associated with fever, chills, flank pain, or nausea. Diagnosis and treatment of specific infections are also reviewed.

Urinary Tract Infections

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 746-746
Author(s):  
ELLEN F. CRAIN ◽  
JEFFREY C. GERSHEL
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Incidental Finding ◽  
Asymptomatic Bacteriuria ◽  
Positive Urine ◽  
Tract Infections

In Reply.— Dr Roscelli calls attention to the 16 infants in our sample with positive urine cultures but negative urinalyses and admission diagnoses other than urinary tract infection (UTI). These patients, Dr Roscelli suggests, could have had asymptomatic bacteriuria with a different source for their fever. Although we doubt that these infants had asymptomatic bacteriuria, in theory it is possible that the bacteriuria was not the cause of the fever. However, as Dr Roscelli states, "at this time there no way to determine if the bacteriuria is causing the patient's fever or is simply an incidental finding."

scholarly journals ASYMPTOMATIC BACTERIURIA IN PREGNANCY AND COMPLICATIONS ASSOCIATED WITH ASYMPTOMATIC BACTERIURIA

2021 ◽  
pp. 1-2
Author(s):  
Spriha Smriti ◽  
R.K Srivastava ◽  
N.P Sahu
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Common Species ◽  
Microbial Colonization ◽  
Urine Specimen ◽  
Age Group ◽  
Significant Bacteriuria ◽  
Tract Infections

Introduction- Urinary tract infections refers to both microbial colonization of urine and tissue invasion of any structure of urinary tract. ASYMPTOMATIC BACTERIURIA (ASB) is a condition in which urine culture reveals significant growth of pathogens that is greater than 1,00,000 bacteria/ml of urine but not showing symptoms of urinary tract infection. Asymptomatic bacteriuria may be of significance or to doubtful significance or of no significance depending on number of bacteria present in urine. ASB is more common in women. Material and Method- The present study was conducted on 200 pregnant women without any symptoms of urinary tract infection attending Obs & Gynae department of RIMS, Ranchi, Jharkhand. It was conducted between August 2013 to December 2014. Urine specimen should be cultured for isolation of the common agents of UTI. The urine should be mixed thoroughly before plating. The plates are inoculated using a calibrated loop designed to deliver a known volume either 0.01 or 0.001 ml. Choice of media to inoculate depends on patient served and microbiologist preference, usually MacConkey Agar and 5% Blood Agar were used. In recent years a selective media CLED (Cysteine lactose electrolyte deficient) agar is used. This media is selective for urinary pathogens cultured plates are incubated at 37⁰C for 24 hrs. Colony count is done>100000/ml of CFU was taken as significant bacteriuria. Kirby Baeur disc diffusion is used for sensitivity test. Result – Asymtomatic bacteriuria is seen in 7.5% cases. It is more common in age group 20- 30 yrs age group and in second trimester of pregnancy. Most common species isolated was E.coli followed by Klebsiella species.Discussion- The percentage of ASB in the present study (7.5%) correlates with the studies of Lavanya SV et al 2002 (8.4%) CA Turpin et al 2007 (7.3%) & R. Sujata et al 2012 (7.3%).In this study, culture positivity with significant bacteriuria was highest in age group 20-30 yrs (73.34%). In 2011 study done by Dr. Rajshekhar maximum incidence was seen in 20-30 yrs age (57.57%).

scholarly journals Clinical and Therapeutic Treatment Approach Between Diabetes Mellitus and Urinary Tract Infection

2021 ◽  
Vol 9 (9) ◽  
pp. 288-298
Author(s):  
Larissa Amoroso da Silva ◽  
Bianca Pereira Carnevali ◽  
Rogério Rodrigo Ramos
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Tract Infection ◽  
Urinary Incontinence ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Organic Systems ◽  
Multiple Origins ◽  
Patients With Diabetes ◽  
Tract Infections

Diabetes Mellitus is a metabolic syndrome of multiple origins, caused by the insulin absence in the bloodstream and/or by the inability of insulin to adequately exert its effects, causing hyperglycemia and subsequent complications in the body's organic systems. Urinary tract infection (UTI) is one of the most frequent due to the glucose increase in blood circulation and the impairment of cellular immunity, creating a favorable environment for the bacteria proliferation at the inflammation spots. This review describes the clinical and therapeutic aspects of diabetes mellitus and urinary tract infection, with guidelines on glucose management in these events. A non-systematic review was carried out in the Virtual Health Library, PubMed, Scielo, and Google Academic databases with the descriptors Diabetes mellitus, Urinary Tract Infection, Hyperglycemia, Bacteriuria, and Urinary Incontinence. The most relevant articles were selected. Pertinent clinical and therapeutic issues were discussed, covering the diabetes factors that contribute to the onset of UTI; urinary tract infection complications in patients with diabetes mellitus; asymptomatic bacteriuria, recurrent urinary tract infections, and urinary incontinence in people with diabetes; treatments for diabetes and urinary tract infection; and the relationship between glucose-lowering medications and UTI. Given the greater susceptibility of people with diabetes to acquire UTI, the combined insight into these diseases is crucial, both for better UTI prevention in diabetics and for the treatment of both.

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