Virtual Reality Module Depicting Catheter-Associated Urinary Tract Infection as Educational Tool to Reduce Antibiotic Resistant Hospital-Acquired Bacterial Infections

Background: Urinary tract infection (UTI) is one of the most common bacterial infections seen in children. A wide range of organisms with varying antibiotic sensitivity patterns have been known to cause UTI. The objective of the study was to analyse the clinical presentation of UTI in children between 1-month to15 years of age and to analyse the causative microorganism and their drug susceptibility in UTI in children between 1 month to 15 years of age.Methods: A retrospective study was conducted in a teaching hospital in Kerala, between July 2018 and June 2020 among children 1 month to 15 years of age who presented with symptoms of UTI. Patients who had culture positive UTI were included in the study. Clinical data was obtained from inpatient and outpatient records. Antimicrobial susceptibility was done for positive urine culture by Kirby-Bauer disk diffusion method. Statistical analysis was done using Statistical package for social sciences (SPSS) software version 16.Results: Of the 1057 urine samples analysed, 18.44% had significant bacteuria. 43.07% were children less than one year of age with male predominance. Fever and dysuria were the most common clinical presentation. E. coli was the most prevalent pathogen isolated followed by Klebsiella pneumoniae. Enterococcus faecalis was the only gram-positive bacilli isolated. Highest resistance was shown to ampicillin, third generation cephalosporins and co-trimoxazole. Least resistance was shown to nitrofurantoin, fluoroquinolones, aminoglycosides, piperacillin- tazobactam and carbapenems.Conclusions: Regular surveillance programme is necessary for implementation of guidelines for empiric treatment of UTI.

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Virtual Reality Module Depicting Catheter-Associated Urinary Tract Infection as Educational Tool to Reduce Antibiotic Resistant Hospital-Acquired Bacterial Infections

University of the Future: Re-Imagining Research and Higher Education ◽

10.29117/quarfe.2020.0250 ◽

2020 ◽

Author(s):

Yosra M Mekki ◽

Mohamed M Mekki ◽

Mohamed Hamammi ◽

Susu Zughaier

Keyword(s):

Medical Education ◽

Virtual Reality ◽

Antibiotic Resistance ◽

Learning Outcomes ◽

Health Care Providers ◽

Resistant Bacteria ◽

Educational Tool ◽

Care Providers ◽

Antibiotic Resistant ◽

Hospital Acquired

Introduction: Virtual reality (VR) and augmented reality (AR) are used as simulation models in student-patient interactive medical education and shown to enhance learning outcomes. The rise in global burden of infectious diseases and antibiotic resistance world-wide prompt immediate action to combat this emerging threat. Catheter associated urinary infections (CAUTI) are the leading cause of hospital-acquired infections. The aim of this research is to develop a virtual reality (VR) based educational tool depicting the process of CAUTI caused by antibiotic resistant bacteria. The VR-CAUTI module is designed to provide insights to health care providers and community which help in reducing the burden of antibiotic resistant infections. Material and methods: The VRCAUTI module is designed using tools including Blender, Cinema4D and Unity to create a scientifically accurate first-person interactive movie. The users are launched inside a human bladder that needs to be drained. They can witness the insertion of a medical catheter into the bladder to drain the urine. Bacteria adhere to the catheter to establish colonization and infection. An interaction between antibiotic molecules and bacteria in the biofilm is observed later. After designing the 3D models, a highlight of the interaction between models, taken from the storyboard, is used to determine the necessary animation. Moreover, dialogue that facilitates the understanding of infections and antibiotic resistance is recorded. This is followed by the assembly of the module on Unity, and enrichments such as lights and orientation. Results and conclusion: This VRCAUTI module is the proof-of-concept for designing detailed VR based scientifically very accurate medical simulation that could be used in medical education to maximize learning outcomes. VR based modules that have the potential to transform and revolutionize learning experience and render medical education compatible with the IoT in the current 4th industrial revolution.

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Bacterial profile, antimicrobial susceptibility pattern and associated factors of community and hospital acquired urinary tract infection at Dessie referral hospital, Dessie, Northeast Ethiopia

10.21203/rs.3.rs-157817/v1 ◽

2021 ◽

Author(s):

Berhanu Adugna ◽

Bekele Sharew ◽

Mohabaw Jemal

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Referral Hospital ◽

Susceptibility Pattern ◽

Antimicrobial Susceptibility Pattern ◽

Hospital Acquired ◽

Dessie Referral Hospital

Abstract Back ground: Urinary tract infection are one of the most common bacterial infections in the community and in the hospital. Nowadays, little is known about the status of community and hospital acquired urinary tract infection, antimicrobial susceptibility pattern and associated factors among urinary tract infection patients in Ethiopia, particularly in our study area. Methods A hospital based cross sectional study was carried out in Dessie referral hospital. A total of 422 urine samples were enrolled using systematic random sampling technique. All isolates were identified by standard microbiological techniques and their antibiotic susceptibility was done by Kirby Bauer disc diffusion method. Data was entered using Epi data version 3.1 and analyzed by SPSS software version 20. P- Value < 0.05 at 95% CI was considered as statistically significant. Result Of 422 urine samples processed 100 (23.7%) yielded bacterial isolates. About50(30.7%) and 50(19.3%) samples from hospitalized and community showed significant bacteriuria respectively. E. coli 44/103(42.7%), predominated across the two groups followed by S. aureus 25/103(24.3%), CONs,14/103(13.5%), Klebsiella spps 7/103(6.78), proteus spps 3/103(2.91), and Entrococcus spps 3/103 (2.91%). Pseudomonas spps 3/103 (2.91), Citrobacter spps 2/103(1.94%) and Acinetobacter Spp 1/103(0.999), which were isolated from only the hospitalized samples. Meropenem susceptibly was 100% in both study groups and Ampicillin resistance was documented as 83.3–100% and 76.9–100% in hospitalized and community acquired respectively. Among risk factors previous use of antibiotics, female gender, Age, Diabetics, catheterization were associated with the infection. Conclusion The present study revealed that slightly high prevalence of urinary tract infection. High antimicrobial resistance was observed to most antimicrobial drugs tested. Meropenem and Nitrofurantoin were the most active drugs for urinary tract infection. Empirical selection of antimicrobial agents should be based on antibiotic sensitivity pattern of uropathogens that prevalent in that area. Female sex, age, previous use of antibiotics, catheterization and diabetics were at risk of urinary tract infection.

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Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case–control study

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkm141 ◽

2007 ◽

Vol 60 (1) ◽

pp. 92-99 ◽

Cited By ~ 91

Author(s):

Sharon Hillier ◽

Zoe Roberts ◽

Frank Dunstan ◽

Chris Butler ◽

Anthony Howard ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Case Control Study ◽

Case Control ◽

Antibiotic Resistant ◽

Control Study

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Quantitative Results of a National Intervention to Prevent Hospital-Acquired Catheter-Associated Urinary Tract Infection

Annals of Internal Medicine ◽

10.7326/m18-3534 ◽

2019 ◽

Vol 171 (7_Supplement) ◽

pp. S38 ◽

Cited By ~ 4

Author(s):

Jennifer Meddings ◽

Milisa Manojlovich ◽

Jessica M. Ameling ◽

Russell N. Olmsted ◽

Andrew J. Rolle ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Quantitative Results ◽

Hospital Acquired

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Preventing Hospital-Acquired Urinary Tract Infection in the United States: A National Study

Clinical Infectious Diseases ◽

10.1086/524662 ◽

2008 ◽

Vol 46 (2) ◽

pp. 243-250 ◽

Cited By ~ 135

Author(s):

S. Saint ◽

C. P. Kowalski ◽

S. R. Kaufman ◽

T. P. Hofer ◽

C. A. Kauffman ◽

...

Keyword(s):

United States ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

The United States ◽

National Study ◽

Hospital Acquired

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The pathogenesis of catheter-associated urinary tract infection

Journal of Infection Prevention ◽

10.1177/1757177408098265 ◽

2009 ◽

Vol 10 (2) ◽

pp. 50-56 ◽

Cited By ~ 5

Author(s):

JMT Barford ◽

ARM Coates

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Additional Benefit ◽

Bladder Epithelium ◽

Physical Damage ◽

Hospital Acquired Infections ◽

Residual Urine ◽

Catheter Surface ◽

Hospital Acquired

Catheter-associated urinary tract infection (CAUTI) remains one of the most common types of hospital-acquired infections. Further progress in the prevention of CAUTI requires a better understanding of its pathogenesis. Bacteria may enter the bladder through contamination of the tip during insertion with the flora of the distal urethra or from bacteria ascending the outside or the inside of the catheter. Residual urine in the bladder of catheterised patients increases the risk of bacteriuria. During the process of infection, bacteria need first to adhere to the epithelial cells of the urinary tract and/or the surface of the catheter. They will then develop into biofilms on the catheter surface and are resistant to the immune system and antibiotics. Catheters by themselves may cause immediate physical damage to the bladder epithelium; they may be toxic and also cause inflammation. Bacteria can also damage the epithelium and cause inflammation and the combination of both may be synergistic in producing symptoms in the patient. Most episodes of catheter-associated bacteriuria are asymptomatic but it is not known why some patients are symptomatic and others are not. Further research into the pathogenesis of CAUTI needs to be carried out. A suggestion for the prevention of CAUTI is the use of catheters with an additional eye-hole beneath the balloon to prevent residual urine in the bladder or to remove the tip and balloon altogether, with the additional benefit of having no tip to cause damage or inflammation to the bladder epithelium.

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