scholarly journals Increased fluid intake to prevent urinary tract infections: systematic review and meta-analysis

2020 ◽  
Vol 70 (692) ◽  
pp. e200-e207 ◽  
Author(s):  
Anna Mae Scott ◽  
Justin Clark ◽  
Chris Del Mar ◽  
Paul Glasziou
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Primary Outcome ◽  
Fluid Intake ◽  
Risk Of Bias ◽  
Antimicrobial Use ◽  
Recurrent Utis ◽  
Tract Infections

BackgroundApproximately 15% of community-prescribed antibiotics are used in treating urinary tract infections (UTIs). Increase in antibiotic resistance necessitates considering alternatives.AimTo assess the impact of increased fluid intake in individuals at risk for UTIs, for impact on UTI recurrence (primary outcome), antimicrobial use, and UTI symptoms (secondary outcomes).Design and settingA systematic review.MethodThe authors searched PubMed, Cochrane CENTRAL, EMBASE, two trial registries, and conducted forward and backward citation searches of included studies in January 2019. Randomised controlled trials of individuals at risk for UTIs were included; comparisons with antimicrobials were excluded. Different time-points (≤6 months and 12 months) were compared for the primary outcome. Risk of bias was assessed using Cochrane Risk of Bias tool. Meta-analyses were undertaken where ≥3 studies reported the same outcome.ResultsEight studies were included; seven were meta-analysed. There was a statistically non-significant reduction in the number of patients with any UTI recurrence in the increased fluid intake group compared with control after 12 months (odds ratio [OR] 0.39, 95% confidence interval [CI] = 0.15 to 1.03, P = 0.06); reduction was significant at ≤6 months (OR 0.13, 95% CI = 0.07 to 0.25, P<0.001). Excluding studies with low volume of fluid (<200 ml) significantly favoured increased fluid intake (OR 0.25, 95% CI = 0.11 to 0.59, P = 0.001). Increased fluid intake reduced the overall rate of all recurrent UTIs (rate ratio [RR] 0.46, 95% CI = 0.40 to 0.54, P<0.001); there was no difference in antimicrobial use (OR 0.52, 95% CI = 0.25 to 1.07, P = 0.08). Paucity of data precluded meta-analysing symptoms.ConclusionGiven the minimal potential for harm, patients with recurrent UTIs could be advised to drink more fluids to reduce recurrent UTIs. Further research is warranted to establish the optimal volume and type of increased fluid.

scholarly journals Genetic Risk for Recurrent Urinary Tract Infections in Humans: A Systematic Review

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
M. Zaffanello ◽  
G. Malerba ◽  
L. Cataldi ◽  
F. Antoniazzi ◽  
M. Franchini ◽  
...  
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Urinary Tract ◽  
Candidate Genes ◽  
Recurrence Rate ◽  
Urinary Tract Infections ◽  
Genetic Risk ◽  
Host Response ◽  
Recurrent Uti ◽  
Tract Infections

Urinary tract infections (UTIs) are a frequent cause of morbidity in children and adults and affect up to 10% of children; its recurrence rate is estimated at 30–40%. UTI may occur in up to 50% of all women in their lifetimes and frequently require medication. Recent advances have suggested that a deregulation of candidate genes in humans may predispose patients to recurrent UTI. The identification of a genetic component of UTI recurrences will make it possible to diagnose at-risk adults and to predict genetic recurrences in their offspring. Six out of 14 genes investigated in humans may be associated with susceptibility to recurrent UTI in humans. In particular, the HSPA1B, CXCR1 & 2, TLR2, TLR4, TGF-1 genes seem to be associated with an alteration of the host response to UTIs at various levels.

90: A Systematic Review of Urinary Tract Infections Following Transposition of Bowel Segments into Urinary Tract

2004 ◽  
Vol 171 (4S) ◽  
pp. 24-24 ◽  
Author(s):  
Nabi Ghulam ◽  
Sze M. Yong ◽  
Eng Ong ◽  
Adrian Grant ◽  
Gladys C. McPherson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tract Infections ◽  
Bowel Segments

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.

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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