Fever

2018 ◽  
pp. 217-220
Author(s):  
Glenn Patriquin

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.

2016 ◽  
Vol 37 (12) ◽  
pp. 1499-1501 ◽  
Author(s):  
Curtis D. Collins ◽  
Jared J. Kabara ◽  
Sarah M. Michienzi ◽  
Anurag N. Malani

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


2015 ◽  
Vol 3 (1) ◽  
pp. 34-37
Author(s):  
Una Jessica Sarker ◽  
Md Sakil Munna ◽  
Saurab Kishore Munshi

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


2016 ◽  
Vol 38 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Barbara W. Trautner ◽  
M. Todd Greene ◽  
Sarah L. Krein ◽  
Heidi L. Wald ◽  
Sanjay Saint ◽  
...  

OBJECTIVETo assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative.DESIGNBaseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections.SETTINGNursing homes across 14 states participating in the national “Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection.”PARTICIPANTSLicensed (RNs, LPNs, APRNs, MDs) and unlicensed (clinical nursing assistants) healthcare personnel.METHODSEach facility aimed to obtain responses from at least 10 employees (5 licensed and 5 unlicensed). We assessed the percentage of correct responses.RESULTSA total of 184 (78%) of 236 participating facilities provided 1 response or more. Of the 1,626 respondents, 822 (50.6%) were licensed; 117 facilities (63.6%) were for-profit. While 99.1% of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1% knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria. Among unlicensed personnel, 99.6% knew to notify a nurse if a resident developed fever or confusion, but only 27.7% knew that cloudy, smelly urine should not routinely be cultured. Although 100% of respondents reported receiving training in hand hygiene, less than 30% knew how long to rub hands (28.5% licensed, 25.2% unlicensed) or the most effective agent to use (11.7% licensed, 10.6% unlicensed).CONCLUSIONSThis national assessment demonstrates an important need to enhance infection prevention knowledge among healthcare personnel working in nursing homes to improve resident safety and quality of care.Infect. Control Hosp. Epidemiol. 2016;1–6


Author(s):  
Walter C Hellinger

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.


PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 746-746
Author(s):  
ELLEN F. CRAIN ◽  
JEFFREY C. GERSHEL

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."


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
EIY Madela ◽  
Alain Assounga

Abstract Background and Aims Urinary tract infection is among the most common causes of sepsis presenting in hospitals. The aim was to collect data to enable empirical treatment of urinary tract infections in HIV negative and positive nephrology patients while waiting for urine culture results in order to reduce hospital stay. Our aim is also to assess incidence and antimicrobial susceptibility of urinary tract infections in HIV negative and positive patients. Method A retrospective chart review of nephrology patients admitted from January to December 2014 in Nephrology ward and the first consecutive 200 outpatients seen in Nephrology clinic in 2014 at Inkosi Albert Luthuli Central Hospital was conducted. Information was gathered with the use of a data collection sheet and urinary tract infection was based on urine culture results. All data was analysed using Statistical Package for Social Sciences version 23. Percentages of basic characteristics were calculated between groups. Logistic regression analysis was used to identify factors associated with positive urine culture. Results There were 654 patients in the study, 514 (79%) were HIV negative and 139 (21%) were HIV positive. The incidence of UTI in nephrology patients was 9%, 10.1% in inpatients and 6.5% in outpatients. 22% were HIV positive (p value 0.883, 95% CI 0.550-2.003). 19% had Diabetes mellitus, 15% had Systemic Lupus Erythematosus and 5% were post renal transplant patients. Escherichia coli and Klebsiella pneumonia were the common causes of urinary tract infection at 40.7% and 15.3% respectively with 22% cases on extended beta lactam resistance. Conclusion There was no statistically significant difference on the incidence and anti-microbial isolates between HIV infected and HIV negative nephrology patients with urinary tract infection. Hence, empirical treatment for UTI should remain the same in the 2 groups. Escherichia coli and Klebsiella pneumoniae were the most commonly cultured organisms in both groups. There is microbial resistance to commonly used antibiotics. Constant assessment of anti-microbial sensitivity of urinary tract infections is of paramount importance.


2008 ◽  
Vol 29 (S1) ◽  
pp. S41-S50 ◽  
Author(s):  
Evelyn Lo ◽  
Lindsay Nicolle ◽  
David Classen ◽  
Kathleen M. Arias ◽  
Kelly Podgorny ◽  
...  

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Burden of CAUTIsa. Urinary tract infection is the most common hospital-acquired infection; 80% of these infections are attributable to an indwelling urethral catheter.b. Twelve to sixteen percent of hospital inpatients will have a urinary catheter at some time during their hospital stay.c. The daily risk of acquisition of urinary infection varies from 3% to 7% when an indwelling urethral catheter remains in situ.2. Outcomes associated with CAUTIa. Urinary tract infection is the most important adverse outcome of urinary catheter use. Bacteremia and sepsis may occur in a small proportion of infected patients.b. Morbidity attributable to any single episode of catheterization is limited, but the high frequency of catheter use in hospitalized patients means that the cumulative burden of CAUTI is substantial.c. Catheter use is also associated with negative outcomes other than infection, including nonbacterial urethral inflammation, urethral strictures, and mechanical trauma.


2021 ◽  
pp. 1-2
Author(s):  
Spriha Smriti ◽  
R.K Srivastava ◽  
N.P Sahu

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%).


Author(s):  
Larissa Amoroso da Silva ◽  
Bianca Pereira Carnevali ◽  
Rogério Rodrigo Ramos

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.


Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1055
Author(s):  
Dominique E. Werter ◽  
Brenda M. Kazemier ◽  
Caroline Schneeberger ◽  
Ben W. J. Mol ◽  
Christianne J. M. de Groot ◽  
...  

Symptomatic urinary tract infections are associated with preterm birth. However, data on risk indicators for urinary tract infections are limited and outdated. The research is a secondary analysis. The study was a prospective multicenter cohort study of low-risk pregnant women. Logistic regression was used to identify risk indicators for urinary tract infections. The incidence of urinary tract infections was 9.4%. Multivariate logistic regression showed that a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria in the present pregnancy were associated with urinary tract infections (resp. OR 3.14, 95%CI 1.40–7.02 and OR 1.96 95%CI 1.27–3.03). Women with a urinary tract infection were at increased risk of preterm birth compared to women without a urinary tract infection (12 vs. 5.1%; adjusted HR 2.5 95%CI 1.8–3.5). This increased risk was not found in women with the identified risk indicators (resp. 5.3% vs. 5.1%, adjusted HR 0.35 95%CI 0.00–420 and adjusted HR 1.5 95CI% 0.59–3.9). In conclusion, in low-risk pregnant women, risk indicators for urinary tract infections are: a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria. The risk of preterm birth is increased in women with a urinary tract infection in this pregnancy. However, women with recurrent urinary tract infections and asymptomatic bacteriuria this pregnancy appear not to be at increased risk of preterm birth.


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