The analysis of hospital-acquired urinary tract infections. A 10 year longitudinal study in Małopolska (the Lesser Poland province)

2017 ◽  
Vol 2 (3) ◽  
pp. 141-154
Author(s):  
Marta Wałaszek ◽  
Małgorzata Kołpa ◽  
Zdzisław Wolak
Keyword(s):  
Internal Medicine ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Incidence Density ◽  
Hospital Acquired Infections ◽  
Control And Prevention ◽  
Hospital Acquired ◽  
Incidence Density Rate ◽  
Density Rate

Introduction: Hospital-acquired infections are one of the most serious health threats during a patient’s stay in hospital, including healthcare associated infections (HAI). The most typical form of hospital-acquired infections is urinary tract infection (UTI). Objective: To examine the frequency of appearing UTIs, the structure of UTIs in in-patients in the department of internal medicine and nephrology at Saint Lucas’s general hospital in Tarnów was analysed. Materials and methods: Data analysis of 13 965 in-patients staying in the department of internal medicine and nephrology from 2006 to 2015 was carried out. To investigate these data epidemiological methods and standard definitions of hospital- acquired infections issued by European Center for Disease Prevention as well as Control and Centers for Disease Control and Prevention were used. Results: 237 hospital-acquired UTIs were revealed, which is 33% of all UTIs revealed in the investigated ward. The UTI incidence rate was 1.7% including 1.5% for microbiologically confirmed symptomatic UTIs and 0.2% not microbiologically confirmed symptomatic UTIs. The incidence density rate per 1 000 person-days was 0.2 over 1 000. The number of revealed catheter-related cases was 168, and not catheter-related cases – 69. The incidence density rate of UTIs associated with urinary catheters was 3.3 per 1 000 person-days. The dominant etiological factors, which were taken to be detected from the infected patients’ specimens, were: Escherichia coli 63 (29%), Enterococcus spp. 37(16%), Klebsiella spp. 23 (11%). Conclusions: A 10 year observation of UTIs, which have appeared in the department of internal medicine and nephrology, allowed to conduct the accurate analysis of these infections. The comparison of urinary tract infection rates done in the investigated ward, and recorded in the Research Participation Programs at the Centers for Disease Control and Prevention (CDC), allows to draw the conclusion that the presented epidemiological situation does not differ significantly from other countries.

The pathogenesis of catheter-associated urinary tract infection

2009 ◽  
Vol 10 (2) ◽  
pp. 50-56 ◽  
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.

scholarly journals Myroides causing Catheter Associated Urinary Tract Infection in Diabetic Patients: An Emerging Multidrug Resistant “Superbug”

2020 ◽  
Author(s):  
Kalpana Chauhan ◽  
Priyanka Chaturvedi ◽  
Ravi Pratap Singh ◽  
Anita Pandey
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Inhibitory Concentration ◽  
Case Series ◽  
Multidrug Resistant ◽  
Diabetic Patients ◽  
Diabetic Mellitus ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Myroidesis a nonfermentative, gram-negative rod shaped bacterium which is an emerging multidrug resistant pathogen causing many serious hospital acquired infections like Catheter Associated Urinary Tract Infection (CAUTI). The authors report a case series (four cases) of CAUTI caused by Myroides species which was resistant to all tested antibiotics (ticarcillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefepime, aztreonam, cefoperazonesulbactam, imipenem, meropenem, amikacin, gentamycin ciprofloxacin, levofloxacin, colistin, tigecycline) and sensitive only to minocycline (minimum inhibitory concentration <1 μg/mL), in long-standing Diabetic Mellitus Type II patients. All the four patients were successfully treated with minocycline. Present cases highlight the importance of Myroides as a pathogen in Urinary Tract Infection (UTI) in diabetic patients, especially in nosocomial settings which clinicians should keep in mind.

scholarly journals Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department

2017 ◽  
Vol 30 (9) ◽  
pp. 608 ◽  
Author(s):  
Maria João Lobão ◽  
Paulo Sousa
Keyword(s):  
Internal Medicine ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Catheter Placement ◽  
Medicine Department ◽  
Bladder Catheter ◽  
Tract Infections ◽  
Hospital Acquired

Introduction: Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital.Material and Methods: Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department.Results: One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria.Discussion: These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments.Conclusion: The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.

scholarly journals Influence of the Alternative Sigma Factor RpoN on Global Gene Expression and Carbon Catabolism in Enterococcus faecalis V583

mBio ◽  
2021 ◽  
Vol 12 (3) ◽  
Author(s):  
Erica C. Keffeler ◽  
Vijayalakshmi S. Iyer ◽  
Srivatsan Parthasarathy ◽  
Matthew M. Ramsey ◽  
Matthew J. Gorman ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Enterococcus Faecalis ◽  
Carbon Metabolism ◽  
Sigma Factor ◽  
Alternative Sigma Factor ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

ABSTRACT The alternative sigma factor σ54 has been shown to regulate the expression of a wide array of virulence-associated genes, as well as central metabolism, in bacterial pathogens. In Gram-positive organisms, the σ54 is commonly associated with carbon metabolism. In this study, we show that the Enterococcus faecalis alternative sigma factor σ54 (RpoN) and its cognate enhancer binding protein MptR are essential for mannose utilization and are primary contributors to glucose uptake through the Mpt phosphotransferase system. To gain further insight into how RpoN contributes to global transcriptional changes, we performed microarray transcriptional analysis of strain V583 and an isogenic rpoN mutant grown in a chemically defined medium with glucose as the sole carbon source. Transcripts of 340 genes were differentially affected in the rpoN mutant; the predicted functions of these genes mainly related to nutrient acquisition. These differentially expressed genes included those with predicted catabolite-responsive element (cre) sites, consistent with loss of repression by the major carbon catabolite repressor CcpA. To determine if the inability to efficiently metabolize glucose/mannose affected infection outcome, we utilized two distinct infection models. We found that the rpoN mutant is significantly attenuated in both rabbit endocarditis and murine catheter-associated urinary tract infection (CAUTI). Here, we examined a ccpA mutant in the CAUTI model and showed that the absence of carbon catabolite control also significantly attenuates bacterial tissue burden in this model. Our data highlight the contribution of central carbon metabolism to growth of E. faecalis at various sites of infection. IMPORTANCE Hospital-acquired infections account for 2 billion dollars annually in increased health care expenses and cause more than 100,000 deaths in the United States alone. Enterococci are the second leading cause of hospital-acquired infections. They form biofilms at surgical sites and are often associated with infections of the urinary tract following catheterization. Nutrient uptake and growth are key factors that influence their ability to cause disease. Our research identified a large set of genes that illuminate nutrient uptake pathways in enterococci. Perturbation of the metabolic circuit reduces virulence in a rabbit endocarditis model, as well as in catheter-associated urinary tract infection in mice. Targeting metabolic pathways that are important in infection may lead to new treatments against multidrug-resistant enterococcal infections.

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

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.

scholarly journals Catheter-associated urinary tract infection: why do not we control this adverse event?

2019 ◽  
Vol 53 ◽  
Author(s):  
Écila Campos Mota ◽  
Adriana Cristina Oliveira
Keyword(s):  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Catheter ◽  
Incidence Density ◽  
The Mean ◽  
Mean Time ◽  
Significant Factors

ABSTRACT Objective: To identify factors related to the occurrence of urinary tract infection associated with urinary catheter use. Method: A longitudinal, retrospective cohort study carried out by analyzing the electronic medical records of patients admitted to an intensive care unit of a high-complexity hospital from July 2016 to June 2017. Demographic and clinical data were analyzed by descriptive and analytical analysis. Results: The incidence density of urinary tract infection related to urinary catheter use was 4.8 per 1000 catheters/day, the majority (80.6%) with no indication for catheter use, and there was no prescription for insertion and/or maintenance in 86.7%. The mean time between catheter insertion and infection diagnosis was 11.3 ± 6.3 days (6 to 28 days). Statistically significant factors (p < 0.001) related to urinary infection linked to catheter use were hospitalization time in the unit (16.7 ± 9 days), catheter permanence time (12.7 ± 6.9 days), and the use of antimicrobials in the intensive care unit (8.6 ± 6.3 days). Conclusion: The association of indication absence and the record of the need for maintenance possibly potentiated the occurrence of urinary tract infection associated to catheter use.

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

2019 ◽  
Vol 171 (7_Supplement) ◽  
pp. S38 ◽  
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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