scholarly journals Inappropriate Testing for Urinary Tract Infection in Hospitalized Patients: An Opportunity for Improvement

2013 ◽  
Vol 34 (11) ◽  
pp. 1204-1207 ◽  
Author(s):  
Sarah Hartley ◽  
Staci Valley ◽  
Latoya Kuhn ◽  
Laraine L. Washer ◽  
Tejal Gandhi ◽  
...  

Urine cultures are frequently obtained for hospitalized patients. We reviewed documented indications for culture and compared these with professional society guidelines. Lack of documentation and important clinical scenarios (before orthopedic procedures and when the patient has altered mental status without a urinary catheter) are highlighted as areas of use outside of current guidelines.

2015 ◽  
Vol 36 (11) ◽  
pp. 1355-1357 ◽  
Author(s):  
Molly L. Paras ◽  
Erica S. Shenoy ◽  
Heather E. Hsu ◽  
Rochelle P. Walensky ◽  
David C. Hooper

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


2019 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Hadiati Setyorini ◽  
Nunuk Mardiana ◽  
Artaria Tjempakasari

Introduction: Urinary tract infection (UTI) is the most common infection that can be fatal and has higher rate mortality especially in some patient. This study is aim to analyze risk factors for urinary tract infection in hospitalized patients for prevention and more aggressive approach can be taken.Methods: Consecutively, medical records of 285 patients with urinary analysis was recorded for risk factors and urine culture results if suspected UTI. Risk factors for sex, age, urinary catheter, urolithiasis, DM, and immobilization was analyzed with bivariate analysis and multivariate analysis.Results: From 285 patients, 92 patients had UTI with average age was 52.45 years old, 48 (56.49%) were female. Most common pathogen were E. coli (41.3%), Enterobacter sp. (8.8%) and Enterococcus faecalis (7.6 %). From bivariate analysis, geriatric age (>60 years) has RR 1.421 (95% CI 1.015-1.989, p=0.046) and immobilization has RR 1.861 (95% CI 1.266-2.738, p=0.007), whereas sex (RR 1.190 95% CI 0.851 – 1.664, p=0.310), diabetes (RR 1.171 95% CI 0.833 – 1.645, p=0.367), insulin usage (RR 0.900 95% CI 0.519 – 1.561, p= 0.703), glycosuria (RR 1.152 95% CI 0.741 – 1.791, p=0.522), and CKD (RR 1.475 95% CI 0.896 – 2.430, p= 0.126) give insignificant result. From multivariate analysis, urinary catheter has OR 4.506 (95% CI 2.312-8.872, p=0.000), urolithiasis with OR 4.970 (95% CI 1.931-12.787, p=0.001), and hyperglycemia has OR 2.871 (95% CI 1.485-5.551, p=0.002).Conclusion: Geriatric age and immobilization are risk factors for urinary tract infection, and urinary catheter, urolithiasis, and hyperglycemia are independent risk factors for urinary tract infection.


2006 ◽  
Vol 64 ◽  
pp. S108
Author(s):  
A. Brandenburg ◽  
M. Lingsma ◽  
S. Terpstra ◽  
H. Vd Mijle ◽  
A. Ott

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Uri Alon ◽  
Menucha Pery ◽  
Giora Davidai ◽  
Moshe Berant

A prospective blind study comparing the findings of ultrasonography, intravenous pyelography, and voiding cystourethrography was conducted on 81 patients to examine the place of ultrasonography in the initial radiologic evaluation of children with urinary tract infection. The patients' mean age was 4.8 years; 15 were male. Forty-eight were inpatients (mean age, 3.2 years) and 33 were outpatients (mean age, 7.2 years). In 29 patients (35.8%) abnormality of the urinary system was detected by one or more of the three imaging procedures; 21 were inpatients and eight were outpatients. The most frequent finding was vesicoureteral reflux, occurring in 62.1% of the pathologic cases. The findings at ultrasonography correlated well with those of intravenous pyelography in 73 of the 81 studies (90.1%), but they failed to demonstrate double collecting systems and several of the minor changes. However, ultrasonography in combination with cystourethrography identified all patients who had abnormal urinary systems, except for two children with negligible findings. Moreover, ultrasonography and cystourethrography together identified all 11 patients, nine of them inpatients, in whom surgical treatment was indicated. It is concluded that ultrasonography can successfully replace intravenous pyelography as a screening imaging procedure for the urinary system, but because of the superiority of intravenous pyelography in the detection of some types of lesions, intravenous pyelography will be required whenever ultrasonography or cystourethrography results are abnormal. Accordingly, and in view of the differences in the frequency and severity of pathologic findings between outpatients and hospitalized patients, the following protocol is suggested for the radiologic evaluation of children with urinary tract infection: For outpatients, cystourethrography can be performed 4 to 6 weeks after cessation of antibiotic therapy. If the study is normal, ultrasonography can be done; if this is also normal, no further radiologic workup is needed. Only when cystourethrography or ultrasonography findings are abnormal is intravenous pyelography also indicated. For hospitalized patients, especially young children, ultrasonography can be used as the early screening procedure, within two to four days after the diagnosis of urinary tract infection. If the results are normal, cystourethrography can follow after 4 to 6 weeks; if abnormal, cystourethrography can be performed after ten to 14 days. Here, too, intravenous pyelography is needed only when ultrasonography and/or cystourethrography results are abnormal.


2020 ◽  
Vol 40 (1) ◽  
pp. e12-e17
Author(s):  
Megan D. Snyder ◽  
Margaret A. Priestley ◽  
Michelle Weiss ◽  
Cindy L. Hoegg ◽  
Natalie Plachter ◽  
...  

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.


Author(s):  
Écila Campos Mota ◽  
Adriana Cristina Oliveira

ABSTRACT Objective: To identify factors related to the occurrence of urinary tract infection associated with urinary catheter use. Method: A longitudinal, retrospective cohort study carried out by analyzing the electronic medical records of patients admitted to an intensive care unit of a high-complexity hospital from July 2016 to June 2017. Demographic and clinical data were analyzed by descriptive and analytical analysis. Results: The incidence density of urinary tract infection related to urinary catheter use was 4.8 per 1000 catheters/day, the majority (80.6%) with no indication for catheter use, and there was no prescription for insertion and/or maintenance in 86.7%. The mean time between catheter insertion and infection diagnosis was 11.3 ± 6.3 days (6 to 28 days). Statistically significant factors (p < 0.001) related to urinary infection linked to catheter use were hospitalization time in the unit (16.7 ± 9 days), catheter permanence time (12.7 ± 6.9 days), and the use of antimicrobials in the intensive care unit (8.6 ± 6.3 days). Conclusion: The association of indication absence and the record of the need for maintenance possibly potentiated the occurrence of urinary tract infection associated to catheter use.


2020 ◽  
Vol 41 (3) ◽  
pp. 365-368
Author(s):  
Hong Chen ◽  
Joyce Wai Yan Lee ◽  
Kelvin Chung Ho Yu ◽  
Christina Ka Wai Chan ◽  
Andrew Tin Yau Wong ◽  
...  

AbstractWe conducted a survey of 16,914 patients to determine the point prevalence of healthcare-associated catheter-associated urinary tract infection (HA-CAUTI) and urinary catheter care in public hospitals in Hong Kong. Overall HA-CAUTI prevalence was 0.27%. Compliance was generally good, except for documenting the date of planned removal and securing the catheter properly.


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