Reducing Catheter-associated Urinary Tract Infections via Cost-saving Diagnostic Stewardship

2020 ◽  
Author(s):  
Allison Luu ◽  
Fernando Dominguez ◽  
Brandon Yeshoua ◽  
Christopher Vo ◽  
Swathi Nallapa ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Tertiary Care ◽  
Audit And Feedback ◽  
Academic Hospital ◽  
Improvement Project ◽  
Stewardship Program ◽  
Tract Infections ◽  
Hospital Acquired

Abstract We conducted a quality improvement project at our large, public, tertiary-care, academic hospital to reduce the standardized infection ratio (SIR) of hospital-acquired catheter-associated urinary tract infections (CAUTIs). Our diagnostic stewardship program, based on education and audit and feedback, significantly reduced inpatient urine culture orders and CAUTI SIR.

scholarly journals Infection surveillance analysis of catheter associated urinary tract infections in obstetrics and gynecology department of a tertiary care hospital of Central India

2017 ◽  
Vol 7 (1) ◽  
pp. 215
Author(s):  
Mudita Jain ◽  
Rituja Kaushal ◽  
Malini Bharadwaj
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Central India ◽  
Integrated Approach ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Stewardship Program ◽  
Tract Infections ◽  
A Prospective Study

Background: The prevalence of catheter associated urinary tract infections (CAUTIs) in the catheterized patients in acute care settings (catheter used for <7 days) is 3%-7%, in patients who require a urinary catheter for >7 days, it is up to 25% and it approaches 100% after 30 days. As device related hospital acquired infections are imposing major threats in surgical realm of medical sciences, this study was undertaken with the objective to asses catheter related urinary tract infections magnitude.Methods: This study was undertaken in a tertiary care setting of Obstetrics and Gynecology Department of a Central Indian city. It is a prospective study conducted over a full year span from April 2016 to March 2017.Results: CAUTI was calculated as 8.95 per thousand catheter days for the whole study period. Out of the total number of 18 urinary isolates, E. Coli and Enterococcus species were more commonly implicated.Conclusions: In order to restraint the enigma, a multidisciplinary integrated approach including periodic training sessions for all health care workers based on bundled care interventions supervisory checklists etc. is needed. Aseptic techniques along with IDSA (Infectious disease society of America) guidelines/other similar protocols are recommended to bring down overall prevalence. Prudent use of antibiotics is to be accorded as per antibiotic stewardship program to combat drug resistance.

scholarly journals Bacteriological Profile and Antibiotic Sensitivity Pattern in Patients with Urinary Tract Infection in Janakpurdham, Nepal

2021 ◽  
Vol 8 (10) ◽  
pp. 5692-5697
Author(s):  
Dr. Digbijay Kumar Thakur ◽  
Dr. Rameshwar Mahaseth ◽  
Dr. Shambhu Kumar Sah
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional ◽  
Bacteriological Culture ◽  
Sensitivity Pattern ◽  
Culture And Sensitivity ◽  
Tract Infections

Background: Urinary tract infections are most common bacterial infection in routine clinical practice. It is also most common nosocomial infection in many hospitals. Antibiotics are usually given empirically before urine culture reports available and treatment failure rate used to be significantly high. Study of causative agents and their antimicrobial sensitivity pattern are important factors helping formulating antibiotic policy. Generally, most common uropathogene is Escherichia Coli. Tertiary care hospitals, catering of already partially treated or mal treated patients as major chunk, may have varying etiologies and different sensitivity patterns. Objective: To study the culture and sensitivity patterns of urinary tract infections in patients presenting with urinary symptoms in local hospitals. Study design: A cross sectional study Materials and methods: Study was conducted at Madanta Research Clinic Private Limited from 12th march 021 to 12th September 021. Urine from cases suspected to have symptoms suggestive of UTI were send for bacteriological culture and sensitivity. Demographic profiles of each participant along with pathogen isolated, culture sensitivity pattern was documented. Data analysis was done in IBM spss 25. Results: A total 200 samples were selected for bacteriological culture and sensitivity out of which 32% were male and 68% were female. Around 50% of participants were in age group 20-40. There was no growth in 64% sample. Among positive samples (36%), E. coli (most common) was detected in 91.66%, Klebsiella was detected in 6.94%. Gentamicin, Amikacin and Nitrofurantoin were most common antibiotics sensitive to organisms in culture and Cephalosporins group of antibiotics are commonly resistant. Conclusions: coli is the most common organism isolated in urine culture in our region Janakpur. Cephalosporins are resistant in majority of cases where as Aminoglycosides like Amikacin, Gentamicin and Nitrofurantoin are found to be highly sensitive in most of positive cases.

scholarly journals A study of risk factors for bacteremia caused by urinary tract infections

2018 ◽  
Vol 9 (5) ◽  
pp. 25-30
Author(s):  
Muralidhar Varma ◽  
Sravan Kumar Peravali ◽  
Vandana KE ◽  
Asha Kamath ◽  
Rahul Singh
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Medical Sciences ◽  
E Coli ◽  
Tract Infections ◽  
Control Study

Background: Urinary tract infections are not only one of the most common infections, but also one of the most common sources of bacteremia in both the general population and hospitalized patients.Aims and Objectives: The objective of this study was to identify risk factors for bacteremia caused by urinary tract infections.Materials and Methods: This was a prospective case control study conducted from October 2012 to July 2014in a tertiary care teaching hospital in southern India. Urinary tract infections were diagnosed based on the CDC criteria.Patients witha set of blood cultures and urine culture isolating same organism were grouped as cases while patients with urine culture alone isolating organism with sterile blood cultures were identified as controls.Results: Out of the 198 patientsin the study, 66 were cases while 132 were controls. E coli was the most organism isolated (81% of cases and 66% of controls). Risk factors for bacteremia based on univariate and multivariate analysis were diabetes mellitus with uncontrolled sugars (univariate: p=0.001; OR=5.250 [2.044-13.582]; and multivariate: p=0.01; OR= 6.023 [1.52-23.51]) and pyelonephritis (univariate: p=0.001; OR=6.56 [2.87-1.48]; and multivariate: p=0.047; OR=4.95 [1.02-24.12]).Conclusion: Upper UTI and complicated UTI patients should be evaluated for bacteremia since prompt and targeted treatment may be required.Asian Journal of Medical Sciences Vol.9(5) 2018 25-30

Effect of a urine culture stewardship initiative on urine culture utilization and catheter-associated urinary tract infections in intensive care units

2021 ◽  
pp. 1-4
Author(s):  
Layla A. Al-Bizri ◽  
Amit T. Vahia ◽  
Khulood Rizvi ◽  
Ana C. Bardossy ◽  
Paula K. Robinson ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Series Data ◽  
Study Cohort ◽  
Stewardship Program ◽  
Tract Infections

Abstract Objective: Urine cultures have poor specificity for catheter-associated urinary tract infections (CAUTIs). We evaluated the effect of a urine-culture stewardship program on urine culture utilization and CAUTI in adult intensive care units (ICUs). Design: A quasi-interventional study was performed from 2015 to 2017. Setting and patients: The study cohort comprised 21,367 patients admitted to the ICU at a teaching hospital. Intervention: The urine culture stewardship program included monthly 1-hour discussions with ICU house staff emphasizing avoidance of “pan-culture” for sepsis workup and obtaining urine culture only if a urinary source of sepsis is suspected. The urine culture utilization rate metric (UCUR; ie, no. urine cultueres/catheter days ×100) was utilized to measure the effect. Monthly UCUR, catheter utilization ratio (CUR), and CAUTI rate were reported on an interactive quality dashboard. To ensure safety, catheterized ICU patients (2015–2016) were evaluated for 30-day readmission for UTI. Time-series data and relationships were analyzed using Spearman correlation coefficients and regression analysis. Results: Urine culture utilization decreased from 3,081 in 2015 to 2,158 in 2016 to 1,218 in 2017. CAUTIs decreased from 78 in 2015 to 60 in 2016 and 28 in 2017. Regression analysis over time showed significant decreases in UCUR (r, 0.917; P < .0001) and CAUTI rate (r, 0.657; P < .0001). The co-correlation between UCUR and CAUTI rate was (r, 0.625; P < .0001) compared to CUR and CAUTI rate (r, 0.523; P = .004). None of these patients was readmitted with a CAUTI. Conclusions: Urine culture stewardship program was effective and safe in reducing UC overutilization and was correlated with a decrease in CAUTIs. Addition of urine-culture stewardship to standard best practices could reduce CAUTI in ICUs.

scholarly journals Antibiotic drug resistance pattern of uropathogens seen in the first episode of community-acquired pediatric urinary tract infections at a tertiary care hospital

2021 ◽  
Author(s):  
Eyup Sari ◽  
Fatma Yazilitas ◽  
Fatma Zehra Oztek Celebi ◽  
Meltem Akcaboy ◽  
Ozlem Akisoglu ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Tertiary Care Hospital ◽  
Urine Culture ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistance Pattern ◽  
Amoxicillin Clavulanate ◽  
Tract Infections

Abstract BackgroundIncreased antibiotic resistance is a significant problem associated with higher morbidity, mortality, and costs in managing urinary tract infections (UTI). This study aims to analyze the antimicrobial resistance profile of uropathogens isolated from children with the first attack of community-acquired UTI.Materials and MethodsThis retrospective cohort study was conducted between January 2010-December 2016, with the patients aged one month to 18 years diagnosed with the first attack of community-acquired UTI at the pediatric outpatient clinic of a tertiary care hospital. Patients' age, sex, UTI history, clinical findings at admission, urine analysis, urine culture, and antibiogram results were recorded.ResultsA total of 1086 patients and 1086 cultures were included in the study. The male/female ratio was 1/5.3. The mean age of the children was 73.7±47.1 (0.4-215.9) months. 16.0% were aged 1-24 months. E. coli was the most common causative agent found to be 85.1% in frequency. The overall antimicrobial resistance was found to be highest for ampicillin, followed by piperacillin and trimethoprim-sulfamethoxazole (63.5, 41.6 and 38.1%, respectively). Imipenem, amikacin, and tobramycin had the least resistance (0.5, 0.5, and 7.6%, respectively). The overall antimicrobial resistance against amoxicillin-clavulanate, ampicillin-sulbactam, cefuroxime, ceftriaxone was 19.4, 24, 25.9 and 21.1%; respectively.Extended-spectrum beta-lactamase positivity was detected in 5.6% (n=61) of samples.ConclusionOur study showed significant increase in antimicrobial resistance to the most common antibiotics which are prescribed before urine culture results and antibiotic sensitivities are available. The resistance rates for amoxicillin-clavulanate, ampicillin-sulbactam, cefuroxime, ceftriaxone were almost 20% or above in children with the first UTI attack in an outpatient setting.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

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