scholarly journals Regional Variation in Urinary Catheter Use and Catheter-Associated Urinary Tract Infection: Results from a National Collaborative

2014 ◽  
Vol 35 (S3) ◽  
pp. S99-S106 ◽  
Author(s):  
M. Todd Greene ◽  
Mohamad G. Fakih ◽  
Karen E. Fowler ◽  
Jennifer Meddings ◽  
David Ratz ◽  
...  

Objective.To examine regional variation in the use and appropriateness of indwelling urinary catheters and catheter-associated urinary tract infection (CAUTI).Design and Setting.Cross-sectional study.Participants.US acute care hospitals.Methods.Hospitals were divided into 4 regions according to the US Census Bureau. Baseline data on urinary catheter use, catheter appropriateness, and CAUTI were collected from participating units. The catheter utilization ratio was calculated by dividing the number of catheter-days by the number of patient-days. We used the National Healthcare Safety Network (NHSN) definition (number of CAUTIs per 1,000 catheter-days) and a population-based definition (number of CAUTIs per 10,000 patient-days) to calculate CAUTI rates. Logistic and Poisson regression models were used to assess regional differences.Results.Data on 434,207 catheter-days over 1,400,770 patient-days were collected from 1,101 units within 726 hospitals across 34 states. Overall catheter utilization was 31%. Catheter utilization was significantly higher in non-intensive care units (ICUs) in the West compared with non-ICUs in all other regions. Approximately 30%–40% of catheters in non-ICUs were placed without an appropriate indication. Catheter appropriateness was the lowest in the West. A total of 1,099 CAUTIs were observed (NHSN rate of 2.5 per 1,000 catheter-days and a population-based rate of 7.8 per 10,000 patient-days). The population-based CAUTI rate was highest in the West (8.9 CAUTIs per 10,000 patient-days) and was significantly higher compared with the Midwest, even after adjusting for hospital characteristics (P = .02).Conclusions.Regional differences in catheter use, appropriateness, and CAUTI rates were detected across US hospitals.

2017 ◽  
Vol 5 (2) ◽  
pp. 150-158
Author(s):  
Ghuzala Anwar ◽  
Ghalib Nawaz ◽  
Muhammad Afzal ◽  
Iram Majeed ◽  
Ali Waqas

Nursing is an art science and an essential health care profession in which the skilled knowledgeable persons are committed to provide care to  sick peoples and strive for the, protection and promotion of health and prevention against diseases and helps to minimize the risk and risk related injuries. Urinary tract infections are very common infection in the hospital settings almost responsible for 40% nosocomial infections. All the urinray tract infection is expected that approximately more than 70% infection reported because of indewelling cathters.Objectives: To assess the perceptions of nurses regarding indwelling urinary catheter and its care. To assess the practices of nurses to prevent the indwelling catheter related urinary tract infection. Methodology: Descriptive cross sectional design and data was collected through a five point Likert scale questioner. Study population was the nursing staff from the Jinnah hospital Lahore.  Sample size was 184 nurses from all indoor departments of the Jinnah Hospital Lahore. Results: The findings show that the practice and perceptions scores of the registered nurses’ in the study group are insignificant with age, qualification and experience (i.e., p-value > 0.05) with the evidence-based guidelines for prevention of catheter associated urinary tract infection. Results of study indicated insignificant relationship between registered nurses’ practice and perceptions regarding the indwelling urinary catheter associated infection.Int. J. Appl. Sci. Biotechnol. Vol 5(2): 150-158


Author(s):  
Chia-Hung Huang ◽  
Ying-Hsiang Chou ◽  
Han-Wei Yeh ◽  
Jing-Yang Huang ◽  
Shun-Fa Yang ◽  
...  

To investigate the association among lower urinary tract infection (UTI), the type and timing of antibiotic usage, and the subsequent risk of developing cancers, especially genitourinary cancers (GUC), in Taiwan. This retrospective population-based cohort study was conducted using 2009–2013 data from the Longitudinal Health Insurance Database. This study enrolled patients who were diagnosed with a UTI between 2010 and 2012. A 1:2 propensity score-matched control population without UTI served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyze the data. A total of 38,084 patients with UTI were included in the study group, and 76,168 participants without UTI were included in the control group. The result showed a higher hazard ratio of any cancer in both sexes with UTI (for males, adjusted hazard ratio (aHR) = 1.32; 95% confidence interval (CI) = 1.12–1.54; for females, aHR = 1.21; 95% CI = 1.08–1.35). Patients with UTI had a higher probability of developing new GUC than those without UTI. Moreover, the genital organs, kidney, and urinary bladder of men were significantly more affected than those of women with prior UTI. Furthermore, antibiotic treatment for more than 7 days associated the incidence of bladder cancer in men (7–13 days, aHR = 1.23, 95% CI = 0.50–3.02; >14 days, aHR = 2.73, CI = 1.32–5.64). In conclusion, UTI is significantly related to GUC and may serve as an early sign of GUC, especially in the male genital organs, prostate, kidney, and urinary bladder. During UTI treatment, physicians should cautiously prescribe antibiotics to patients.


2021 ◽  
Author(s):  
◽  
Gerald Turyatunga

Background: A urinary tract infection (UTIs) is a common type of infection caused by bacteria that travel up the urethra to the bladder. Globally, it is reported that 150 million people are diagnosed with a UTI annually, costing the world economy over 6 million US dollars in treatment and work loss. Studies conducted in the in-patients pediatric ward of Muhimbili Hospital in Tanzania and Mulago National Referral Hospital in Uganda between five to ten years reported the prevalence of UTI to be 16.8% and 14.6% respectively. On average at Kam Medical Consult Clinic, patients who turn up in the laboratory are about 20%, and 50% of patients present with recurring UTIs clinically. Therefore,  there is a need to establish and investigate the prevalence of bacterial pathogens associated with UTI and multiple pathogens that are not known. Methodology: The cross-sectional study was carried out at Kam medical consult clinic (KMCC) located in Kafeero zone Mulago II Kawempe division. The study population was adults and children presenting with symptoms of urinary tract infection. 120 Midstream urine Samples were collected from patients presenting clinical signs of UTI. The diagnosis was done through macroscopy dry chemistry, microscopy, and culture. Results Among the sampled population, 33% of males had urinary tract infections while 67% of females had urinary tract infections.  88.5% were outpatients while 11.5 % were in-patients The overall prevalence of UTI among patients was 63.3% with children aged (1-10) having a prevalence of 5.8 %. Conclusion and recommendation: E.coli is an etiological agent causing UTIs in male and female patients presenting UTI at Kam Medical Consult Clinic. Other etiological agents included Klebsiella, Coliform, Enterococcus species, staphylococcus aureus, pseudomonas species, and candida species. There is a need to monitor the profile of etiological bacteria of UTI through culture and sensitivity regularly. 


2019 ◽  
Author(s):  
Joel Paschal Manyahi ◽  
Upendo Kibwana ◽  
Victor Sensa ◽  
Sydney C Yongolo ◽  
Eligius Lyamuya

Abstract Background Surgical site infection (SSI) is one of the major hospital acquired infections highly associated with prolonged hospitalization, morbidity and mortality. In open urological surgeries, little is known on magnitude and factors associated with development of SSI. Methods and Materials This was a cross-sectional prospective observational study performed between August 2015 and March 2016 at Muhimbili National hospital (MNH), Dar es Salaam, Tanzania. All patients who underwent open urological surgery and met inclusion criteria were consecutively enrolled, and followed up for 30 days. Patients´ and operative characteristics were recorded using standard structured questionnaires. Wound/ pus swabs were collected from patients with clinical evidence of SSI for bacteriological processing. Data analysis was performed using SPSS version 20. Results Of 182 patients who underwent open urological surgery, 22% developed SSI. Pre-operative urinary tract infection (aOR 9.73, 95%CI 3.93-24.09, p<0.001) and contaminated wound class (aOR 24.997, 95%CI 2.58-242.42, p = 0.005) were independent predictors for development of SSI. Shaving within 30 hrs before surgical procedure was found to be protective for developing SSI (aOR 0.26, 95%CI 0.09-0.79, p = 0.02). Escherichia coli (20/40) was the most predominant pathogen in SSI followed by Klebsiella pneumoniae (7/40) and S. aureus (6/40). Gram-negative bacteria were highly resistant to ceftriaxone, gentamicin, amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole. Conclusion SSI was high in open urological interventions. Pre-operative urinary tract infection and contaminated wound class predicted SSI. Bacteria causing SSI were highly resistant to commonly used antibiotics.


2021 ◽  
Vol 8 (10) ◽  
pp. 522-526
Author(s):  
Bhavani Shankar Rokkam ◽  
Chowdary Babu Menni ◽  
Ramu Pedada ◽  
Deepak Kumar Alikana

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture


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