scholarly journals Clinical outcomes of hospitalised patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: the COMBACTE-MAGNET RESCUING study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Aina Gomila ◽  
◽  
Jordi Carratalà ◽  
Noa Eliakim-Raz ◽  
Evelyn Shaw ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Term Care ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
The Impact

Abstract Background Although catheter-associated urinary tract infection (CA-UTI) is a major healthcare-related problem worldwide, there is a scarcity of current data from countries with high antimicrobial resistance rates. We aimed to determine the clinical outcomes of patients with CA-UTI compared to those of patients with other sources of complicated urinary tract infection (cUTI), and to assess the impact of antimicrobial resistance. We also aimed to identify the factors influencing 30-day mortality among patients with CA-UTI. Methods This was a multicentre, multinational retrospective cohort study including hospitalised adults with cUTI between January 2013 and December 2014 in twenty hospitals from eight countries from southern Europe, Turkey and Israel. The primary endpoint was 30-day mortality. The secondary endpoints were length of hospital stay, symptom improvement after 7 days’ treatment, symptom recurrence at 30 days and readmission 60 days after hospital discharge. Results Of the 807 cUTI episodes, 341 (42.2%) were CA-UTIs. The time from catheter insertion to cUTI diagnosis was less than 2 weeks in 44.6% of cases. Overall, 74.5% of cases had hospital or healthcare-acquired CA-UTI. Compared to patients with other cUTI aetiologies, those with CA-UTI had the following characteristics: they were more frequently males, older, admitted for a reason other than cUTI and admitted from a long-term care facility; had higher Charlson’s comorbidity index; and more frequently had polymicrobial infections and multidrug-resistant Gram-negative bacteria (MDR-GNB). Patients with CA-UTI also had significantly higher 30-day mortality rates (15.2% vs 6%) and longer hospital stay (median 14 [interquartile range -IQR- 7-27] days vs 8 [IQR 5–14] days) than patients with cUTI of other sources. After adjusting for confounders, CA-UTI was not independently associated with an increased risk of mortality (odds ratio, 1.40; 95% confidence interval, 0.77–2.54), and neither was the presence of MDR-GNB. Conclusions CA-UTI was the most frequent source of cUTI, affecting mainly frail patients. The mortality of patients with CA-UTI was high, though this was not directly related to the infection.

scholarly journals Emerging Role of Microbiome in the Prevention of Urinary Tract Infections in Children

2022 ◽  
Vol 23 (2) ◽  
pp. 870
Author(s):  
Anna Kawalec ◽  
Danuta Zwolińska
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Pediatric Population ◽  
Urologic Diseases ◽  
Increased Risk ◽  
Tract Infections ◽  
The Impact

The microbiome of the urinary tract plays a significant role in maintaining health through the impact on bladder homeostasis. Urobiome is of great importance in maintaining the urothelial integrity and preventing urinary tract infection (UTI), as well as promoting local immune function. Dysbiosis in this area has been linked to an increased risk of UTIs, nephrolithiasis, and dysfunction of the lower urinary tract. However, the number of studies in the pediatric population is limited, thus the characteristic of the urobiome in children, its role in a child’s health, and pediatric urologic diseases are not completely understood. This review aims to characterize the healthy urobiome in children, the role of dysbiosis in urinary tract infection, and to summarize the strategies to modification and reshape disease-prone microbiomes in pediatric patients with recurrent urinary tract infections.

scholarly journals Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non–Veterans Affairs Nursing Homes

2016 ◽  
Vol 38 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Lona Mody ◽  
M. Todd Greene ◽  
Sanjay Saint ◽  
Jennifer Meddings ◽  
Barbara W. Trautner ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
System Integration ◽  
Infection Prevention ◽  
Prevention Programs ◽  
Veterans Affairs ◽  
Term Care ◽  
The Impact

OBJECTIVEThe impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non–VA nursing homes.SETTINGVA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative.METHODSNursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire.RESULTSA total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004).CONCLUSIONSAmong nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems.Infect Control Hosp Epidemiol 2017;38:287–293

scholarly journals Incidence, Clinical Profile, and Risk Factors for Serious Bacterial Infections in Children Hospitalized With Fever in Ujjain, India

2020 ◽  
Author(s):  
Ashish Pathak ◽  
Radika Upadhayay ◽  
Aditya Mathur ◽  
Sunil Rathi ◽  
Cecilia Stålsby Lundborg
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Signs ◽  
Increased Risk ◽  
History Of

Abstract Background Fever is a cause for concern for both parents and the treating pediatrician and a common reason for antibiotic overuse. However, the proportion of children hospitalized for fever with serious bacterial infection (SBI) is uncertain. We aimed to evaluate the epidemiological, clinical, hematological, and biochemical risks for SBI among the children admitted with fever. Method This prospective study was conducted in a rural teaching hospital in India on consecutive children, aged 3 months–12 years, presenting with fever 100°F (37.7°C) or higher. The presence of SBI was confirmed with one of the following criteria: (a) a positive blood culture; (b) roentgenographically confirmed pneumonia with high titres of C-reactive protein; (c) a culture-confirmed urinary tract infection; (d) enteric fever diagnosed clinically in addition to either a positive blood culture or high Widal titers; and (e) meningitis diagnosed clinically in addition to either a positive blood culture or cerebrospinal fluid culture. A predefined questionnaire was filled. Results A total of 302 children were included in the study, out of which 47% (95% CI 41.4%-52.7%) presented with SBI. The factors associated with confirmed SBI in bivariate analysis were history of previous hospitalization, history of chronic illness, history of medication in the previous one week, a partially immunized child, history of common cold, moderate-grade fever, toxic look, significant lymphadenopathy, absence of BCG scar, delayed development, irritability, breathlessness, respiratory distress, poor feeding, significant weight loss, suspected urinary tract infection, hyponatremia, hypokalemia, and abnormal leucocyte count. The final generalized logistic regression model revealed partially immunized child (RR 4.26), breathlessness (RR 1.80), weight loss (RR 2.28), and suspected urinary tract infection (RR 1.95) as risk factors for the increased risk of SBI. Conclusion The study identified multiple risk factors for SBI. Pediatricians can be made aware of these risk factors. Further studies are warranted to identify age-specific risk factors for SBI because most clinicians depend on clinical signs and symptoms to identify SBI.

Reducing Catheter-Associated Urinary Tract Infection: The Impact of Routine Screening in the Geriatric Hip Fracture Population

2021 ◽  
Vol 28 (5) ◽  
pp. 290-297
Author(s):  
Shridevi Singh ◽  
L. D. George Angus ◽  
Swapna Munnangi ◽  
Dooniya Shaikh ◽  
Jody C. Digiacomo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Hip Fracture ◽  
Tract Infection ◽  
Routine Screening ◽  
Geriatric Hip Fracture ◽  
Fracture Population ◽  
The Impact
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