Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals

MotivationCatheter-associated urinary tract infections (CAUTI) are a common and serious healthcare-associated infection. Despite many efforts to reduce the occurrence of CAUTI, there remains a gap in the literature about CAUTI risk factors, especially pertaining to the effect of catheter dwell-time on CAUTI development and patient comorbidities.ObjectiveTo examine how the risk for CAUTI changes over time. Additionally, to assess whether time from catheter insertion to CAUTI event varied according to risk factors such as age, sex, patient type (surgical vs medical) and comorbidities.DesignRetrospective cohort study of all patients who were catheterised from 2012 to 2016, including those who did and did not develop CAUTIs. Both paediatric and adult patients were included. Indwelling urinary catheterisation is the exposure variable. The variable is interval, as all participants were exposed but for different lengths of time.SettingUrban academic health system of over 2500 beds. The system encompasses two large academic medical centres, two community hospitals and a paediatric hospital.ResultsThe study population was 47 926 patients who had 61 047 catheterisations, of which 861 (1.41%) resulted in a CAUTI. CAUTI rates were found to increase non-linearly for each additional day of catheterisation; CAUTI-free survival was 97.3% (CI: 97.1 to 97.6) at 10 days, 88.2% (CI: 86.9 to 89.5) at 30 days and 71.8% (CI: 66.3 to 77.8) at 60 days. This translated to an instantaneous HR of. 49%–1.65% in the 10–60 day time range. Paraplegia, cerebrovascular disease and female sex were found to statistically increase the chances of a CAUTI.ConclusionsUsing a very large data set, we demonstrated the incremental risk of CAUTI associated with each additional day of catheterisation, as well as the risk factors that increase the hazard for CAUTI. Special attention should be given to patients carrying these risk factors, for example, females or those with mobility issues.

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Predictors of Urinary Tract Infections in Children and Antibiotic Susceptibility Pattern in the Buea Health District, South West Region, Cameroon

BioMed Research International ◽

10.1155/2020/2176569 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Che Pantalius Nji ◽

Jules Clément Nguedia Assob ◽

Jane-Francis Tatah Kihla Akoachere

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Antibiotic Susceptibility ◽

Trichomonas Vaginalis ◽

Pediatric Population ◽

Health Facilities ◽

Bivariate Analysis ◽

Cross Sectional ◽

Tract Infections

Urinary tract infections (UTI) are among the most common pediatric infections and if not promptly diagnosed and treated, it could cause long term complications. Worldwide and in Cameroon, little attention has been paid to this growing problem in the pediatric population. Identification of risk factors will contribute significantly to prevention. A cross-sectional case-control study was carried out in children ≤ 15 years to identify the risk factors of UTI, etiologic agents, and their antibiotic susceptibility. Samples (urine) were collected from in and outpatients with symptoms of UTI attending two health facilities in Buea. Controls were age- and sex-matched children in the community and those visiting these health facilities for unrelated reasons. Samples were analyzed by microscopy, culture, and antibiotic susceptibility of bacteria isolates tested by the disc diffusion technique. Questionnaires were administered to collect sociodemographic, clinical characteristics and data on risk factors. Odds ratios and bivariate and multivariate analyses were used to assess the relationship between predictors (symptoms and risk factors) and UTI. P < 0.05 was considered significant. A total of 405 participants (200 cases and 205 controls) were investigated. UTI prevalence was 12% in cases. From the UTI cases, bacteria was the major cause of infection, with E. coli (39.4%) predominating. Parasitic organisms, Trichomonas vaginalis (0.5%) and Schistosoma spp (0.5%), and yeast (6%) were also detected. Urinary urgency ( F = 4.98 , P = 0.027 ) and back pain ( F = 12.37 , P = 0.001 ) were associated to UTI following bivariate analysis. These parameters could be used to predict UTI in the pediatric population in the study area. Third generation cephalosporins: ceftriaxone (90.1%) and cefadroxil (85.4%) were the most effective and thus recommended for treatment.

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Risk factors for resistance in urinary tract infections in women in general practice: A cross-sectional survey

Journal of Infection ◽

10.1016/j.jinf.2015.05.012 ◽

2015 ◽

Vol 71 (3) ◽

pp. 302-311 ◽

Cited By ~ 9

Author(s):

Louise Rossignol ◽

Sylvie Maugat ◽

Alexandre Blake ◽

Sophie Vaux ◽

Beate Heym ◽

...

Keyword(s):

Risk Factors ◽

General Practice ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tract Infections

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Extended-spectrum β-lactamase producing E. coli in urinary tract infections: A two-center, cross-sectional study of prevalence, genotypes and risk factors in Amman, Jordan

Journal of Infection and Public Health ◽

10.1016/j.jiph.2018.07.011 ◽

2019 ◽

Vol 12 (1) ◽

pp. 21-25 ◽

Cited By ~ 4

Author(s):

Sayida A. Al-Jamei ◽

Abla Y. Albsoul ◽

Faris G. Bakri ◽

Amal G. Al-Bakri

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

E Coli ◽

Extended Spectrum ◽

Tract Infections

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A clinical prediction tool for extended-spectrum β-lactamase-producing Enterobacteriaceae urinary tract infection

BMC Infectious Diseases ◽

10.1186/s12879-022-07040-y ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Hui Liu ◽

Suishan Qiu ◽

Minghao Chen ◽

Jun Lyu ◽

Guangchao Yu ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Clinical Decision Making ◽

Susceptibility Testing ◽

Empirical Treatment ◽

Data Set ◽

Extended Spectrum ◽

Tract Infections

Abstract Background Prevalence of extended-spectrum beta-lactamase-producing-Enterobacteriaceae (ESBL-E) has risen in patients with urinary tract infections. The objective of this study was to determine explore the risk factors of ESBL-E infection in hospitalized patients and establish a predictive model. Methods This retrospective study included all patients with an Enterobacteriaceae-positive urine sample at the first affiliated hospital of Jinan university from January 2018 to December 2019. Antimicrobial susceptibility patterns of ESBL-E were analyzed, and multivariate analysis of related factors was performed. From these, a nomogram was established to predict the possibility of ESBL-E infection. Simultaneously, susceptibility testing of a broad array of carbapenem antibiotics was performed on ESBL-E cultures to explore possible alternative treatment options. Results Of the total 874 patients with urinary tract infections (UTIs), 272 (31.1%) were ESBL-E positive. In the predictive analysis, five variables were identified as independent risk factors for ESBL-E infection: male gender (OR = 1.607, 95% CI 1.066–2.416), older age (OR = 4.100, 95% CI 1.678–12.343), a hospital stay in preceding 3 months (OR = 1.872, 95% CI 1.141–3.067), invasive urological procedure (OR = 1.810, 95% CI 1.197–2.729), and antibiotic use within the previous 3 months (OR = 1.833, 95% CI 1.055–3.188). In multivariate analysis, the data set was divided into a training set of 611 patients and a validation set of 263 patients The model developed to predict ESBL-E infection was effective, with the AuROC of 0.650 (95% CI 0.577–0.725). Among the antibiotics tested, several showed very high effectiveness against ESBL-E: amikacin (85.7%), carbapenems (83.8%), tigecycline (97.1%) and polymyxin (98.2%). Conclusions The nomogram is useful for estimating a UTI patient’s likelihood of infection with ESBL-E. It could improve clinical decision making and enable more efficient empirical treatment. Empirical treatment may be informed by the results of the antibiotic susceptibility testing.

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The Clinical Significance of High Antimicrobial Resistance in Community-Acquired Urinary Tract Infections

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2020/2967260 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Maria G. Zavala-Cerna ◽

Midrori Segura-Cobos ◽

Ricardo Gonzalez ◽

Isidro G. Zavala-Trujillo ◽

Silvia F. Navarro-Perez ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Clinical Variable ◽

Microbiological Analysis ◽

Cross Sectional ◽

E Coli ◽

Tract Infections ◽

Esbl Producers

Background. Urinary tract infections (UTIs) affect up to 150 million individuals annually worldwide, mainly due to Escherichia coli (E. coli) and Klebsiella. The emergence and spread of multidrug-resistant (MDR) bacteria are increasing, representing one of the biggest threats for human health. The objective of our study was to describe antimicrobial patterns of resistance and identify risk factors associated with MDR uropathogens. Methods. We conducted a cross-sectional study in 296 patients with community-acquired UTI who underwent clinical and microbiologic analysis, and clinical associations to MDR uropathogens were investigated. Findings. Microbiological analysis included E. coli (55%), ESBL-E. coli (26%), Enterococcus (6%), Klebsiella (5%), and others (8%). Higher frequencies of MDR bacteria were found among ESBL-E. coli, with resistance to ampicillin (100%), ceftriaxone (96%), gentamicin (57%), ciprofloxacin (89%), and TMP/SMX (53%). However, they were sensitive to fosfomycin (6.6%), nitrofurantoin (1.3%), and carbapenems (0%). Fosfomycin MIC90 for ESBL-E. coli was 5.78 μg/mL. The only clinical variable with significant association to ESBL producers was the presence of comorbidities: hypertension and type 2 diabetes mellitus with an OR (95%CI) of 2.51.3−4.9p<0.01 and 2.81.2−6.7p<0.05, respectively. Conclusions. In the majority of cases, resistance rates to commonly prescribed antimicrobials in UTIs were high, except for fosfomycin, nitrofurantoin, and carbapenems. To provide appropriate treatment, both the identification of risk factors and the uropathogen would be important. An active surveillance in UTIs in the community is required since the proportion of ESBL producers is increasing.

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A Risk Assessment of Clostridium Difficile Infection after Antibiotherapy for Urinary Tract Infections in the Urology Department for Hospitalized Patients

Revista de Chimie ◽

10.37358/rc.17.7.5694 ◽

2017 ◽

Vol 68 (7) ◽

pp. 1453-1456

Author(s):

Nicolae Grigore ◽

Maria Totan ◽

Valentin Pirvut ◽

Sebastian Ioan Cernusca Mitariu ◽

Radu Chicea ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Clostridium Difficile ◽

Urinary Tract Infections ◽

Preventive Measures ◽

Healthcare Associated Infection ◽

Duration Of Treatment ◽

Antibiotic Associated Diarrhea ◽

Tract Infections ◽

Healthcare Associated

Antibiotherapy is the treatment of choice for the urinary tract infections in hospitalized urological patients. Antibiotic associated diarrhea (ADD) caused by the Clostridium difficile cytotoxin producer represents one of the most severe side effects of the antibiotic treatment. It is important to evaluate the risk factors for a hospitalized patient to develop a C. difficile healthcare associated infection during hospitalization in order to put in practice effective preventive measures. The aim of the study is to analyzed the risk factors associated with the demographic status: age, sex, and also risk factors related to healthcare conditions: use of antibiotics (number, type, duration of treatment), other significant medication taken prior to the onset of diarrhea (histamine-2-receptor antagonists and proton-pump inhibitors, comorbidities, possible contamination from other in-patients who developed ADD in the same period and data about in-hospital mortality.

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Assessing known/common risk factors for urinary tract infections to which pupils are exposed to at Ndola primary school:cross section study (Preprint)

10.2196/preprints.16900 ◽

2019 ◽

Author(s):

Jotham Chibwaya

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Urinary Tract ◽

Primary School ◽

Urinary Tract Infections ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Common Risk Factors ◽

Tract Infections

BACKGROUND : Urinary tract infection is an infection of any part of the urinary system starting from the kidneys up to the urethra. It is a common infection with a prevalence of about 33%. If left unattended to urinary tract infections can lead to serious complications. The objective of the study was to assess which of the known risk factors for urinary tract infections are more common among pupils at Ndola Primary School and also assess which age group and sex have more risks. OBJECTIVE Assessing known/common risk factors for urinary tract infections METHODS : The study was a cross-sectional study and targeted primary school pupils aged between 7 and 12 years of age. Simple semi-structured questionnaires and a data collection form were used to collect data. The study also reviewed what other studies regarding urinary tract infections have found in other regions of Africa and a few from outside Africa then compared them to our findings RESULTS : Findings revealed that Lack of deworming was the commonest risk factor amongst pupils with a prevalence of 84%. The least common risk factor is lack of circumcision among boys 37.1%. Ignoring the urge to void had a prevalence of 72.1% while inadequate water intake, constipation and wiping from back to front had 71.2%, 66.9% and 63.9, respectively. The study also revealed that there was no association between age/sex and the risk factors for urinary tract infections except voiding which had a P value of 0.045. Furthermore, water and sanitation conditions existing at the school are very poor and below standard. Pupil toilet ratio is 1:166 and 1:191 for boys and girls, respectively CONCLUSIONS The study showed that most pupils are exposed to the risks factors for urinary tract infections with the commonest risk being lack of deworming and the least being lack of circumcision. There is great need to enhance efforts to improve sensitization by coming up with strategies to reach as many pupils as possible and organize workshops and training programs to assist teachers involved in health education in schools. The number of toilets should be increased to improve hygiene conditions existing at the school.

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