scholarly journals Studies on Biofilm Formation by Psuedomonas Aeruginosa in Different Urinary Catheters

2021 ◽  
Author(s):  
Emmanuel Asante
Keyword(s):  
Growth Rate ◽  
Biofilm Formation ◽  
Quality Evaluation ◽  
Urinary Catheter ◽  
Urinary Catheters ◽  
Silicone Catheter ◽  
Different Types ◽  
Necessary Evil ◽  
Tract Infections ◽  
Healthcare Associated

ABSTRACTUrinary Catheters are the leading cause of healthcare –associated Urinary Tract Infections (UTIs) making their use a necessary evil. Various models and approaches had been developed to help reduce the complications associated with the use of these catheters. This study aimed at investigating how two different types of urinary catheters (Silicone Catheter and Latex Coated Catheter) support biofilm formation of Pseudomonas aeruginosa isolates. The growth rate of the bacteria and the rate of formation of biofilm on each urinary catheter was determined by preparing biofilm assays, ranking them using crystal violet satins and measuring their absorbance using UV-VIS spectrophotometer. A difference in the level of biofilm in the catheters were observed. The differences in the level of biofilm observed in the catheters imply that different catheters may have different susceptibility for the formation of biofilms. The study recommends the assessment of biofilm formation in the quality evaluation of catheters. Also further studies should be done to investigate how different catheter material support biofilm formation and the mechanisms involved.

scholarly journals Implementation of a Female External Urinary Catheter Reduces Indwelling Urinary Catheter Use and Catheter-Associated Urinary Tract Infections

2020 ◽  
Vol 41 (S1) ◽  
pp. s482-s483
Author(s):  
Paul Gentile ◽  
Jesse Jacob ◽  
Shanza Ashraf
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Improve Patient Safety ◽  
Academic Medical Center ◽  
Secondary Outcome ◽  
Successful Implementation ◽  
Urinary Catheters ◽  
Tract Infections ◽  
The Impact

Background: Using alternatives to indwelling urinary catheters plays a vital role in reducing catheter-associated urinary tract infections (CAUTIs). We assessed the impact of introducing female external catheters on urinary catheter utilization and CAUTIs. Methods: In a 500-bed academic medical center, female external catheters were implemented on October 1, 2017, with use encouraged for eligible females with urinary incontinence but not meeting other standard indications for urinary catheters. Nurses were educated and trained on female external catheter application and maintenance, and infection prevention staff performed surveillance case reviews with nursing and medical staff. We determined the number of catheter days for both devices based on nursing documentation of device insertion or application, maintenance, and removal. We used the CAUTI and DUR (device utilization ratio) definitions from the CDC NHSN. Our primary outcomes were changes in DUR for both devices 21 months before and 24 months after the intervention in both intensive care units (ICUs) and non-ICU wards. We used a generalized least-squares model to account for temporal autocorrelation and compare the trends before and after the intervention. Our secondary outcome was a reduction in CAUTIs, comparing females to males. Results: In total, there were 346,213 patient days in 35 months. The mean rate of patient days per month increased from 7,436.4 to 7,601.9 after the implementation of female external catheters, with higher catheter days for both urinary catheters (18,040 vs 19,625) and female external catheters (22 vs 12,675). After the intervention, the DUR for female external catheters increased (0 vs 0.07; P < .001) and for urinary catheters the DUR decreased (0.12 vs 0.10; P < .001) (Fig. 1). A reduction in urinary catheter DUR was observed in ICUs (0.29 vs 0.27; P < .001) but not wards (0.08 vs 0.08; P = NS) (Fig. 2). Of the 39 CAUTIs, there was no significant overall change in the rate per 1,000 catheter days (1.22 vs 0.87; P = .27). In females (n = 20 CAUTI), there was a 61% reduction in the CAUTI rate per 1,000 catheter days (0.78 vs 0.31; P = .02), but no significant change in the rate in males (0.44 vs 0.56; P = .64). The CAUTI rate per 1,000 catheter days among females decreased in the ICUs (1.14 vs 0.31; P = .04) but not in wards (0.6 vs 0.33; P = .96). Conclusions: In a setting with a baseline low UC DUR, successful implementation of female external catheters further modestly reduced UC DUR and was associated with a 61% decrease in CAUTI among females in the ICU but not in wards. Further interventions to better identify appropriate patients for female external catheters may improve patient safety and prevent patient harm.Funding: NoneDisclosures: None

592 Prevention of CAUTIs in a Burn ICU

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S138-S138
Author(s):  
Vina Vargas ◽  
Emiko Rivera ◽  
Teresa Sidhu ◽  
Lea Lyn Zaballero ◽  
Yvonne L Karanas
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Infection Prevention ◽  
Urinary Catheter ◽  
Antimicrobial Use ◽  
Research To Practice ◽  
Urinary Catheters ◽  
Open Forum ◽  
Excellent Care ◽  
Tract Infections

Abstract Introduction Catheter-associated urinary tract infections (CAUTIs) are the most common hospital-associated infection (HAI). Urinary catheter use is associated with urinary tract infections (UTIs) that can lead to complications such as cystitis, pyelonephritis, bacteremia, septic shock, and death. CAUTIs are associated with an excess length of stay of 2–4 days, increase costs of $0.4–0.5 billion per year nationally, and lead to unnecessary antimicrobial use. Through numerous implementations, a Burn ICU was able to drastically decrease their incidence of CAUTIs. Methods A Burn ICU implemented several interventions to reduce CAUTI rates. These interventions included: Results When this project was initiated in September of 2017, there were 9 CAUTIs identified in a Burn ICU, per the hospital’s Infection Prevention Department. By the end of 2017, there were 11, which equated to a rate of 14.67 per 1000 urinary catheter days. In 2018, the Burn ICU had 1 CAUTI, with a rate of 1.92 per 1000 urinary catheter days. In 2019 (through quarter 2), the Burn ICU has not had a CAUTI per the Infection Prevention Department. We believe the interventions made have drastically decreased the incidence of CAUTIs. Conclusions A Burn ICU implemented many new practices in 2017 when the CAUTI rate and SIR were above the hospital’s overall SIR. The Burn ICU staff now practice proper care and maintenance of urinary catheters and continue to provide excellent care. Although we have decreased our incidence of CAUTIs for 2018 and 2019, it is equally important we sustain this improvement. Therefore, we will continue to provide an open forum for discussion with staff so we can all do our part in keeping patients safe. Applicability of Research to Practice A Burn ICU decreased the incidence of CAUTIs by educating staff on proper care and maintenance of urinary catheters, removing catheters as soon as possible, and testing for UTIs upon admission to determine the patient’s baseline. By doing so, CAUTI rates went from 14.67 to 0 per 1000 urinary catheter days.

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 Catheter-Associated Urinary Tract Infections in Adults: Diagnosis, Treatment, and Prevention

2019 ◽  
Vol 15 (9) ◽  
pp. 552-556 ◽  
Author(s):  
Karen Clarke ◽  
Casey L Hall ◽  
Zanthia Wiley ◽  
Sheri Chernetsky Tejedor ◽  
James S Kim ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Patient Outcomes ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Financial Impact ◽  
Healthcare Associated Infections ◽  
Incentive Program ◽  
Treatment And Prevention ◽  
Tract Infections ◽  
Healthcare Associated

Urinary tract infections (UTIs) are among the most common healthcare-associated infections, and 70%-80% are catheter-associated urinary tract infections (CAUTIs). About 25% of hospitalized patients have an indwelling urinary catheter placed during their hospital stay, and therefore, are at risk for CAUTIs which have been associated with worse patient outcomes. Additionally, hospitals face a significant financial impact since the Centers for Medicare and Medicaid Services incentive program penalizes hospitals with higher than expected CAUTIs. Hospitalists care for many patients with indwelling urinary catheters and should be aware of and engage in processes that reduce the rate of CAUTIs. This article will discuss the diagnosis, treatment, and prevention of CAUTIs in adults.

scholarly journals Surveillance of Healthcare-Associated Bloodstream and Urinary Tract Infections in a National Level Network of Indian Hospitals

2020 ◽  
Vol 41 (S1) ◽  
pp. s398-s399
Author(s):  
Purva Mathur ◽  
Paul Malpiedi ◽  
Kamini Walia ◽  
Rajesh Malhotra ◽  
Padmini Srikantiah ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Data Quality ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
National Level ◽  
Central Line ◽  
Infection Prevention And Control ◽  
Utilization Ratio ◽  
Tract Infections ◽  
Healthcare Associated

Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.Funding: NoneDisclosures: None

Understanding Inpatient Perceptions of Indwelling Urinary Catheters Using the Health Belief Model

2016 ◽  
Vol 37 (9) ◽  
pp. 1098-1100 ◽  
Author(s):  
Joshua Quast ◽  
Mary Jo Knobloch ◽  
Erin Patterson ◽  
Suzanne Purvis ◽  
Daniel Shirley ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Urinary Catheter ◽  
Health Belief ◽  
Patient Perceptions ◽  
Urinary Catheters ◽  
Model Framework ◽  
Patient Interviews ◽  
Belief Model ◽  
Tract Infections ◽  
The Health Belief Model

Patient interviews using the Health Belief Model framework identified thematic patient perceptions of indwelling urinary catheters and catheter-associated urinary tract infections. Generally, patients perceived catheters as convenient and were unaware of catheter alternatives and risks for infection. Better patient education is needed to reduce urinary catheter use and infections.Infect Control Hosp Epidemiol 2016;37:1098–1100

scholarly journals Impact of Female External Urinary Catheter on Indwelling Catheter Use and Catheter-Associated Urinary Tract Infection Rates

2021 ◽  
Vol 1 (S1) ◽  
pp. s5-s5
Author(s):  
Lea Monday ◽  
Geehan Suleyman ◽  
George Alangaden ◽  
Stephanie Schuldt ◽  
Catherine Jackman ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Catheter ◽  
Indwelling Catheter ◽  
Significant Difference ◽  
Pressure Injury ◽  
Utilization Ratio ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
The Impact

Background: Catheter-associated urinary tract infections (CED: TIs) are one of the most prevalent healthcare-associated infections. They can lead to bacteremia and increased length of stay, healthcare costs, and mortality. Indwelling urinary catheter (IUC) prevention bundles, nurse-driven removal protocols, and the use of external catheters can help reduce CED: TIs. However, female external urinary catheters (FEUCs) have only recently become widely available. FEUCs were introduced at our institution in July 2017. The purpose of this study was to evaluate the impact of FEUC on IUC utilization ratio and overall CED: TI rate in an 844-bed teaching hospital in southeastern Michigan. Methods: We retrospectively evaluated the utilization ratio of FEUCs (female FEUC days per patient days ×1,000) and female IUCs (IUC days per patient days ×1,000), and labia hospital-acquired pressure injury (HAPI) rate due to FEUC from July 2017 through June 2019. We compared the overall (male and female) CED: TI rate per 1,000 IUC days in the preintervention period (January 2016 to June 2017) to the postintervention period (July 2017 to June 2019). Results: In total, 4,013 FEUCs were placed during the intervention period. The utilization ratio of FEUC increased by 59% and the utilization ratio of female IUC decreased by 13% over the course of the 2 years. Only 1 HAPI was reported during the observation period at a rate of 0.025% (1 of 4,013). The overall CED: TI rate decreased from 1.60 to 1.40 (P = .372). Conclusion: Introduction of a FEUC was associated with a decrease in the IUC utilization ratio in female patients with minimal adverse events; however, there was no significant difference in the overall CED: TI rate.Funding: NoDisclosures: None

scholarly journals Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results

2009 ◽  
Vol 53 (12) ◽  
pp. 5145-5149 ◽  
Author(s):  
Ray Hachem ◽  
Ruth Reitzel ◽  
Agatha Borne ◽  
Ying Jiang ◽  
Peggy Tinkey ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Urinary Tract ◽  
Urinary Catheter ◽  
Rabbit Model ◽  
Urinary Catheters ◽  
Tract Infections ◽  
Scanning Electron

ABSTRACT Urinary catheters are widely used for hospitalized patients and are often associated with high rates of urinary tract infection. We evaluated in vitro the antiadherence activity of a novel antiseptic Gendine-coated urinary catheter against several multidrug-resistant bacteria. Gendine-coated urinary catheters were compared to silver hydrogel-coated Foley catheters and uncoated catheters. Bacterial biofilm formation was assessed by quantitative culture and scanning electron microscopy. These data were further correlated to an in vivo rabbit model. We challenged 31 rabbits daily for 4 days by inoculating the urethral meatus with 1.0 × 109 CFU streptomycin-resistant Escherichia coli per day. In vitro, Gendine-coated urinary catheters reduced the CFU of all organisms tested for biofilm adherence compared with uncoated and silver hydrogel-coated catheters (P < 0.004). Scanning electron microscopy analysis showed that a thick biofilm overlaid the control catheter and the silver hydrogel-coated catheters but not the Gendine-coated urinary catheter. Similar results were found with the rabbit model. Bacteriuria was present in 60% of rabbits with uncoated catheters and 71% of those with silver hydrogel-coated catheters (P < 0.01) but not in those with Gendine-coated urinary catheters. No rabbits with Gendine-coated urinary catheters had invasive bladder infections. Histopathologic assessment revealed no differences in toxicity or staining. Gendine-coated urinary catheters were more efficacious in preventing catheter-associated colonization and urinary tract infections than were silver hydrogel-coated Foley catheters and uncoated catheters.

scholarly journals MODIFICATION OF URINARY CATHETERS USING ANTIMICROBIALS FROM STREPTOMYCES SP. ABK 07 FOR URINARY TRACT INFECTION RESISTANCE

2018 ◽  
Vol 11 (7) ◽  
pp. 158
Author(s):  
Angima Bichanga Kingsley, ◽  
Usha R
Keyword(s):  
Mechanical Properties ◽  
Spectral Analysis ◽  
Biofilm Formation ◽  
Urinary Catheter ◽  
Antimicrobial Properties ◽  
Antimicrobial Compound ◽  
Urinary Catheters ◽  
Streptomyces Sp ◽  
Infection Resistance

Objective: The main aim of this study is to prevent biofilm formation by impregnating an antimicrobial on urinary catheter.Methods: Catheter segments were immersed in the antimicrobial compound for impregnation. After 2 h, the segments were removed, sterilized and dried after which mechanical and antimicrobial properties of the catheter segments were determined. The shelf life of the impregnated segments was also ascertained as well as anti-biofilm assay. Spectral analysis (UV & FTIR) was also performed.Results: Impregnation was achieved by immersing catheter segments in antimicrobial compound ensuring it does not affect the catheter texture. The impregnated antimicrobial catheters were able to prevent colonization by common uropathogens Escherichia coli, Proteus, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella, and Candida albicans for up to 12 weeks. Antibiotic impregnation of the catheters did not affect the mechanical properties and did not render it as unfit for insertion. The antimicrobial-impregnated catheter offers a means of reducing biofilm formation and subsequently reducing the infection in long-term urinary catheter users. Spectral analysis was done by UV-Vis and FTIR.Conclusion: Antibiotic impregnation of the catheters did not affect the mechanical properties and did not render it as unfit for insertion. The antimicrobial impregnated catheter offers a means of reducing biofilm formation and subsequently reducing the infection in long-term urinary catheter users.

scholarly journals In Situ Deposition of Green Silver Nanoparticles on Urinary Catheters under Photo-Irradiation for Antibacterial Properties

Processes ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. 1630
Author(s):  
Fueangfahkan Chutrakulwong ◽  
Kheamrutai Thamaphat ◽  
Sukon Tantipaibulvut ◽  
Pichet Limsuwan
Keyword(s):  
Silver Nanoparticles ◽  
Antibacterial Activity ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Silver Content ◽  
High Price ◽  
Urinary Catheters ◽  
Tract Infections ◽  
Durian Rind

Urinary tract infections, especially catheter-associated urinary tract infections (CAUTIs), are the most common type of nosocomial infections. Patients with chronic indwelling urinary catheters have a higher risk of infection due to biofilm formation on the urinary catheter surface. Therefore, in this work, a novel, cost-effective antimicrobial urinary catheter was developed using green technology. Silver nanoparticles (AgNPs) synthesized from Mon Thong durian rind waste were used as an antimicrobial agent for the prevention of infection. Flavonoids, phenolic compounds, and glucose extracted from durian rind were used as a reducing agent to reduce the Ag+ dissolved in AgNO3 solution to form non-aggregated AgNPs under light irradiation. The AgNPs were simultaneously synthesized and coated on the inner and outer surfaces of silicone indwelling urinary catheters using the dip coating method. The results showed that the antimicrobial urinary catheter fabricated using a 0.3 mM AgNO3 concentration and 48 h coating time gave the highest antibacterial activity. The as-prepared spherical AgNPs with an average diameter of 9.1 ± 0.4 nm formed on catheter surfaces in a monolayer approximately 1.3 µm thick corresponding to a 0.712 mg/cm2 silver content. The AgNP layer was found to damage and almost completely inhibit the growth of Escherichia coli cells with antibacterial activity by 91%, equivalent to the commercial, high-price antimicrobial urinary catheter. The cumulative amount of silver released from the coated catheter through artificial urine over 10 days was about 0.040 µg/mL, which is less than the silver content that causes tissue and organ toxicity at 44 µg/mL. Thus, we concluded that the developed antimicrobial urinary catheter was useful in reducing the risk of infectious complications in patients with indwelling catheters.

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