scholarly journals Development of a Tailored, Complex Intervention for Clinical Reflection and Communication about Suspected Urinary Tract Infections in Nursing Home Residents

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 360
Author(s):  
Sif H. Arnold ◽  
Julie A. Olesen ◽  
Jette N. Jensen ◽  
Lars Bjerrum ◽  
Anne Holm ◽  
...  
Keyword(s):  
General Practice ◽  
Nursing Home ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Communication Skills ◽  
Urinary Tract Infections ◽  
Complex Intervention ◽  
Resistant Bacteria ◽  
Nursing Home Staff ◽  
Tract Infections

Background: Inappropriate antibiotic treatments for urinary tract infections (UTIs) in nursing homes cause the development of resistant bacteria. Nonspecific symptoms and asymptomatic bacteriuria are drivers of overtreatment. Nursing home staff provide general practice with information about ailing residents; therefore, their knowledge and communication skills influence prescribing. This paper describes the development of a tailored, complex intervention for a cluster-randomised trial that targets the knowledge of UTI and communication skills in nursing home staff to reduce antibiotic prescriptions. Methods: A dialogue tool was drafted, drawing on participatory observations in nursing homes, interviews with stakeholders, and a survey in general practice. The tool was tailored through a five-phase process that included stakeholders. Finally, the tool and a case-based educational session were tested in a pilot study. Results: The main barriers were that complex patients were evaluated by healthcare staff with limited knowledge about disease and clinical reasoning; findings reported to general practice were insignificant and included vague descriptions; there was evidence of previous opinion bias; nonspecific symptoms were interpreted as UTI; intuitive reasoning led to the inappropriate suspicion of UTI. Conclusion: Sustainable change in antibiotic-prescribing behaviour in nursing homes requires a change in nursing home staff’s beliefs about and management of UTIs.

scholarly journals Do Volunteers Make a Difference on Nursing Home Quality Measures?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 382-382
Author(s):  
Paul Falkowski ◽  
Christopher Kelly ◽  
Nancy Kelley
Keyword(s):  
Nursing Home ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Urinary Tract Infections ◽  
Quality Measures ◽  
Bivariate Analysis ◽  
Volunteer Program ◽  
Hypnotic Drugs ◽  
Feeding Assistance ◽  
Tract Infections

Abstract The purpose of this study was to explore the relationship between nursing home volunteer programming and quality measures and increase the knowledge base of nursing home volunteer programming in various settings. Fifty-two nursing homes were surveyed using electronic surveys and personal interviews. Questions focused on the organization of the nursing home, characteristics of the volunteer program and volunteer activities. Of the 52 facilities surveyed, 19 were not part of a chain, 37 were in urban settings, and 24 were for-profit entities. Volunteers were used in 46 nursing homes with a mean number of volunteers of 51.7 onsite an average of 4.9 days per week. Bivariate analysis revealed statistically significant correlations (p<.05) between organizational and volunteer programming characteristics and six quality measures (pressure sores, urinary tract infections, depression, use of restraints, falls, use of antipsychotic and hypnotic drugs). Statistically significant (p<.05) inverse relationships were found between volunteers providing individualized activities (e.g., feeding assistance, combing hair, doing nails, and letter writing) and the incidence of urinary tract infections and the use of psychotropic drugs. Multiple regression analysis revealed a statistically significant (p<.05) inverse relationship between personal volunteer services such as combing hair and doing nails and the use of hypnotic drugs and antipsychotic drugs. This study indicates a significant correlation between volunteer programming and quality measure scores. A larger study of these relationships is indicated.

Urinary Tract Infections with Antibiotic Resistant Organisms in Catheterized Nursing Home Patients

1984 ◽  
Vol 5 (4) ◽  
pp. 173-176 ◽  
Author(s):  
David T. Bjork ◽  
Lawrence L. Pelletier ◽  
Robert R. Tight
Keyword(s):  
Nursing Home ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Urinary Catheters ◽  
Antibiotic Resistant ◽  
Inappropriate Use ◽  
Nursing Home Patients ◽  
Tract Infections ◽  
Antibiotic Courses

AbstractLong-term use of indwelling urinary catheters in nursing home (NH) patients is a potential cause of significant morbidity. We retrospectively studied 10 NH patients with chronic indwelling urinary catheters. Sixty-four percent of all 84 antibiotic courses prescribed were for bacteriuria alone without clinical infection. Seventy percent of 63 antibiotic courses were followed by bacteriuria with organisms resistant to the antibiotic administered. Bacteria isolated from NH patients often displayed greater resistance to specific antibiotics than those isolated from hospitalized patients. Four of the 20 urinary tract infections were associated with bacteremia. Three episodes of bacteremia were with highly-resistant organisms and one was fatal. Use of urinary catheters and inappropriate use of antibiotics in NH patients results in urinary tract colonization and infection with resistant bacteria and is an important cause of morbidity and mortality.

scholarly journals The Antibacterial Activity of Human Amniotic Membrane against Multidrug-Resistant Bacteria Associated with Urinary Tract Infections: New Insights from Normal and Cancerous Urothelial Models

Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 218
Author(s):  
Taja Železnik Ramuta ◽  
Larisa Tratnjek ◽  
Aleksandar Janev ◽  
Katja Seme ◽  
Marjanca Starčič Erjavec ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Amniotic Membrane ◽  
Multidrug Resistant ◽  
Basic Knowledge ◽  
Resistant Bacteria ◽  
Human Amniotic Membrane ◽  
Multidrug Resistant Bacteria ◽  
Tract Infections

Urinary tract infections (UTIs) represent a serious global health issue, especially due to emerging multidrug-resistant UTI-causing bacteria. Recently, we showed that the human amniotic membrane (hAM) could be a candidate for treatments and prevention of UPEC and Staphylococcus aureus infections. However, its role against multidrug-resistant bacteria, namely methicillin-resistant S. aureus (MRSA), extended-spectrum beta-lactamases (ESBL) producing Escherichia coli and Klebsiella pneumoniae, vancomycin-resistant Enterococci (VRE), carbapenem-resistant Acinetobacter baumannii, and Pseudomonas aeruginosa has not yet been thoroughly explored. Here, we demonstrate for the first time that the hAM homogenate had antibacterial activity against 7 out of 11 tested multidrug-resistant strains, the greatest effect was on MRSA. Using novel approaches, its activity against MRSA was further evaluated in a complex microenvironment of normal and cancerous urinary bladder urothelia. Even short-term incubation in hAM homogenate significantly decreased the number of bacteria in MRSA-infected urothelial models, while it did not affect the viability, number, and ultrastructure of urothelial cells. The hAM patches had no antibacterial activity against any of the tested strains, which further exposes the importance of the hAM preparation. Our study substantially contributes to basic knowledge on the antibacterial activity of hAM and reveals its potential to be used as an antibacterial agent against multidrug-resistant bacteria.

scholarly journals Measuring Antibiotic Appropriateness for Urinary Tract Infections in Nursing Home Residents

2017 ◽  
Vol 38 (8) ◽  
pp. 998-1001 ◽  
Author(s):  
Taniece Eure ◽  
Lisa L. LaPlace ◽  
Richard Melchreit ◽  
Meghan Maloney ◽  
Ruth Lynfield ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Nursing Home ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Nursing Home Residents ◽  
Infect Control Hosp ◽  
Antibiotic Prescribing ◽  
Appropriate Use ◽  
Tract Infections

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001

Nghiên cứu sự kháng kháng sinh của các chủng vi khuẩn gây nhiễm khuẩn đường tiết niệu phân lập được tại Bệnh viện Hữu nghị Đa khoa Nghệ An

2021 ◽  
Author(s):  
Trâm Quế Anh
Keyword(s):  
Urinary Tract ◽  
General Hospital ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Antibiotics Resistance ◽  
Bacterial Strains ◽  
E Coli ◽  
Linezolid Resistance ◽  
Drug Resistant Bacteria ◽  
Tract Infections

TÓM TẮT Đặt vấn đề: Xác định đúng căn nguyên gây NKĐTN và mức độ kháng kháng sinh của các vi khuẩn sẽ giúp cho việc điều trị có hiệu quả, giảm được chi phí điều trị, hạn chế sự gia tăng vi khuẩn đề kháng kháng sinh. Đối tượng và phương pháp nghiên cứu: Các chủng VK gây nhiễm khuẩn đương tiết niệu phân lập được tại bệnh viện Hữu nghị Đa khoa Nghệ An từ 1/2020 đến 12/2020. Thiết kế nghiên cứu: Cắt ngang mô tả. Kết quả: Phân lập được 473 chủng vi khuẩn gây NKĐTN, trong đó, E. coli 38,48%; P. aeruginosa 14,15; Enterococcus sp 10,57; K. pneumoniae 13,32%. E. coli: kháng các kháng sinh Cephalosporine, Quinolones từ 56,7 - 63,8%, Carbapenem 4,5 - 6,2%, sinh ESBL 49,4%. P. aeruginosa: đã kháng các kháng sinh thử nghiệm từ 59,1 - 69,2%. Enterococcus sp: kháng với các kháng sinh nhóm Quinolone 73,5%, kháng Vancomycin 8,3%; Chưa ghi nhận đề kháng Linezolid. K. pneumoniae: kháng nhóm Cephalosporin, Quinolone từ 66,7 - 74,6%, đề kháng với Carbapenem từ 46,0 - 50,8%. Kết luận: Các vi khuẩn gây nhiễm khuẩn tiết niệu thường gặp là: E. coli, P. aeruginosa, Enterococcus sp. K. pneumoniae. Các vi khuẩn phân lập được đã đề kháng với nhiều kháng sinh thường dùng với các mức độ khác nhau. Xuất hiện các chủng vi khuẩn Gram âm kháng Carbapenem, Gram dương kháng Vancomycin. Từ khóa: Nhiễm khuẩn tiết niệu, E.coli, Klebsiella, P.aeruginosa, Enterococcus sp ABSTRACT RESEARCH OF ANTIBIOTICS RESISTANCE OF BACTERIA STRAINS CAUSING URINARY TRACT INFECTIONS ISOLATED AT NGHEAN FRIENDSHIP GENERAL HOSPITAL Background: The good identification of UTI microorganism and their antimicrobial susceptibility would promote the effective treatment, reduce the cost as well as the emergence of drug resistant bacteria. Methods: Bacterial strains causing urinary tract infections were isolated at Nghe An Friendship General Hospital from 1/2020 to 12/2020. Study design: Descriptive cross section. Results: 473 bacterial strains causing UTIs were isolated, in which, E. coli 38.48%; P. aeruginosa 14.15; Enterococcus sp 10.57; K. pneumoniae 13.32%. E. coli: resistant to Cephalosporin antibiotics, Quinolones from 56.7 - 63.8%, Carbapenem 4.5 - 6.2%, producing ESBL 49.4%. P. aeruginosa: was resistant to the tested antibiotics from 59.1 - 69.2%. Enterococcus sp: resistant to Quinolone antibiotics 73.5%, resistant to Vancomycin 8.3%; Linezolid resistance has not been recorded. K. pneumoniae: resistant to Cephalosporin, Quinolone from 66.7 - 74.6%, resistant to Carbapenem from 46.0 - 50.8%. Conclusion: Common bacteria causing urinary tract infections are: E. coli, P. aeruginosa, Enterococcus sp. K. pneumoniae. The isolates were resistant to many commonly used antibiotics to varying degrees. Occurrence of strains of Gram - negative bacteria resistant to Carbapenem, Gram - positive resistant to Vancomycin. Keywords: Urinary Tract infections, E. coli, Klebsiella, P. aeruginosa, Enterococcus sp.

scholarly journals Oral D mannose in the prevention and treatment of recurrent urinary tract infections: A review

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Daniele Porru ◽  
Annalisa De Silvestri ◽  
Edda Buffa ◽  
Catherine Klersy ◽  
Barbara Gardella ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antibiotic Prophylaxis ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Control Groups ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Tract Infections

The results of several studies reveal that antibiotics may promote treatment resistance by causing alterations in the intestinal flora. The development of a gut reservoir of resistant bacteria promotes the development of UTIs through autoinfection. This review aims to address clinical reliability, efficacy and safety of long-term treatment with oral D mannose for the prevention of Recurrent Urinary Tract Infections (RUTI) in females. A comprehensive MEDLINE, Embase, Scopus and Cochrane search was performed for English language reports published before December 2018 using the term “recurrent urinary tract infections and D mannose” was carried out. We searched Medline, Embase, Scopus and the Cochrane Register of Controlled Trials from January 2010 to December 2018. Eligible studies did not include non-oral therapy, local (vaginal) treatment in women with recurrent UTIs. We identified eligible original articles. A few limitations of the review are the heterogeneity of the available studies, their different rational and aim, the assumption of D mannose for prophylaxis or treatment of recurrent UTIs. Oral D mannose performs well in the prevention of UTIs recurrences, significant improvement of urinary symptoms was observed, the disease- free time was longer in the groups of patients under prophylaxis with D mannose in comparison with control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin (PAC) etc. The review has limitations, as the studies are heterogeneous, the meta-analysis requires classifications that can also be arbitrary. Furthermore, single-arm studies are not included. Some of the authors found this evidence inconclusive, which results as a limitation of the study. D mannose prolonged the recurrence-free interval of recurrent UTIs, thus reducing the prolonged or cyclical use of antibiotics, improving clinical symptoms, with a significant difference between treatment and control groups (no treatment, antibiotic prophylaxis, prophylaxis with Proanthocyanidin). However, most clinical trials used an association of different substances commingled with D mannose, dosages and regimens of D mannose were different. For this reason, the evidence of the efficacy of D mannose remains low.

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