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Urinary Tract Infection (UTI)

  • #AUA14 - Poster: Reduction in urinary incontinence and improvement in quality of life with onabotulinumtoxinA in overactive bladder patients is unaffected by the use of clean intermittent catheterization or the presence of urinary tract infection

    ORLANDO, FL USA (UroToday.com) - Presented by David Sussman,1 Jennifer Gruenenfelder,2 Heinrich Schulte-Baukloh,3 Steven Guard,4 Yan Zheng,5 and Karel Everaert6 at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA

    Published May 27, 2014
  • A 4-year retrospective study, in adult patients, of the prognostic value of semi-quantitative bacteruria counts in the diagnosis of group B streptococcus urinary tract infection, "Beyond the Abstract," by Kimberly B. Ulett, MD

    BERKELEY, CA (UroToday.com) - Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with up to 40% of healthy adult women experiencing at least one UTI episode in their lifetime.[1]

    Published July 1, 2013
  • A post-hoc analysis suggests that pravastatin can reduce the risk of recurrent urinary tract infections (UTIs), "Beyond the Abstract," by Koen Pouwels, MSc and Eelko Hak, PhD

    BERKELEY, CA (UroToday.com) - Recurrent urinary tract infections (UTIs) are a common problem affecting both women and men.[1,2] In light of the increasing prevalence of resistance of uropathogens against antimicrobial agents,[3,4] an alternative treatment against UTIs is warranted.

    Published July 15, 2013
  • A randomized crossover study of silver-coated urinary catheters in hospitalized patients - Abstract

    BACKGROUND: Urinary tract infections (UTIs) account for 30% to 40% of nosocomial infections resulting in morbidity, mortality, and increased length of hospital stay.

    OBJECTIVE: To assess the efficacy of a silver-alloy, hydrogel-coated latex urinary catheter for the prevention of nosocomial catheter-associated UTIs.

    METHODS: A 12-month randomized crossover trial compared rates of nosocomial catheter-associated UTI in patients with silver-coated and uncoated catheters. A cost analysis was conducted.

    RESULTS: There were 343 infections among 27,878 patients (1.23 infections per 100 patients) during 114,368 patient-days (3.00 infections per 1000 patient-days). The relative risk of infection per 1000 patient-days was 0.79 (95% confidence interval, 0.63-0.99; P =.04) for study wards randomized to silver-coated catheters compared with those randomized to uncoated catheters. Infections occurred in 291 of 11,032 catheters used on study units (2.64 infections per 100 catheters). The relative risk of infection per 100 silver-coated catheters used on study wards compared with uncoated catheters was 0.68 (95% confidence interval, 0.54-0.86; P =.001). Fourteen catheter-associated UTIs (4.1%) were complicated by secondary bloodstream infection. One death appeared related to the secondary infection. Estimated hospital cost savings with the use of the silver-coated catheters ranged from $14,456 to $573,293.

    CONCLUSIONS: The risk of infection declined by 21% among study wards randomized to silver-coated catheters and by 32% among patients in whom silver-coated catheters were used on the wards. Use of the more expensive silver-coated catheter appeared to offer cost savings by preventing excess hospital costs from nosocomial UTI associated with catheter use.

    Written by:
    Karchmer TB, Giannetta ET, Muto CA, Strain BA, Farr BM. Are you the author?
    PO Box 800473, University of Virginia Health System, Charlottesville, VA 22908, USA.

    Reference: Arch Intern Med. 2000 Nov 27;160(21):3294-8.

    http://archinte.jamanetwork.com/article.aspx?articleid=485555

     

    Published January 15, 2013
  • Adherence to urethral catheters by bacteria causing nosocomial infections - Abstract

    Previous clinical studies of catheters with hydrophilic coating have, in some instances, shown a delay in the onset of significant bacteriuria, while others reported no such effect. To attempt to determine reasons for these differences we decided to study bacterial adherence of bacteria obtained from nosocomial urinary tract infections associated with catheters. Almost all strains adhered to the silicone catheter and none of them adhered to the catheter with the hydrophilic surface whether incubated in urine or serum. When incubated in urine, all strains adhered to the red rubber catheters. Adherence was variable to the Teflon and elastomer surfaces.

    Written by:
    Roberts JA, Kaack MB, Fussell EN. Are you the author?
    Department of Urology, Tulane Regional Primate Research Center, Covington, Louisiana.

    Reference: Urology. 1993 Apr;41(4):338-42.

    http://www.goldjournal.net/article/0090-4295(93)90591-W/abstract

     

    Published January 15, 2013
  • AUGS 2012 - The urinary microbiome in participants with urgency incontinence randomized to anticholinergic versus botulinum toxin-A in the ABC trial - Session Highlights

    CHICAGO, IL USA (UroToday) - In this related ABC trial study, some women harbor urinary bacteria (microbiome) but the optimum levels of the bacterial status is not well understood. So the question was asked, “What is normal”?

    Published October 4, 2012
  • Complications of Foley catheters--is infection the greatest risk? - Abstract

    PURPOSE:Foley catheters cause a variety of harms, including infection, pain and trauma. Although symptomatic urinary tract infection and asymptomatic bacteriuria are frequently discussed, genitourinary trauma receives comparatively little attention.

    MATERIALS AND METHODS:A dedicated Foley catheter nurse prospectively reviewed the medical records of inpatients with a Foley catheter at the Minneapolis Veterans Affairs Medical Center from August 21, 2008 to December 31, 2009. Daily surveillance included Foley catheter related bacteriuria and trauma. Data were analyzed as the number of event days per 100 Foley catheter days.

    RESULTS:During 6,513 surveyed Foley catheter days, urinalysis/urine culture was done on 407 (6.3%) days. This testing identified 116 possible urinary tract infection episodes (1.8% of Foley catheter days), of which only 21 (18%) involved clinical manifestations. However, the remaining 95 asymptomatic bacteriuria episodes accounted for 39 (70%) of 56 antimicrobial treated possible urinary tract infection episodes (for proportion of treated episodes with vs without symptomatic urinary tract infection manifestations, p = 0.005). Concurrently 100 instances of catheter associated genitourinary trauma (1.5% of Foley catheter days) were recorded, of which 32 (32%) led to interventions such as prolonged catheterization or cystoscopy. Trauma prompting an intervention accounted for as great a proportion of Foley catheter days (0.5%) as did symptomatic urinary tract infection (0.3%) (p = 0.17).

    CONCLUSIONS: In this prospective surveillance project, intervention triggering Foley catheter related genitourinary trauma was as common as symptomatic urinary tract infection. Moreover, despite recent increased attention to the distinction between asymptomatic bacteriuria and symptomatic urinary tract infection in catheterized patients, asymptomatic bacteriuria accounted for significantly more antimicrobial treatment than did symptomatic urinary tract infection. Elimination of unnecessary Foley catheter use could prevent symptomatic urinary tract infection, unnecessary antimicrobial therapy for asymptomatic bacteriuria and Foley catheter related trauma.

    Written by:
    Leuck AM, Wright D, Ellingson L, Kraemer L, Kuskowski MA, Johnson JR. Are you the author?
    VA Medical Center, University of Minnesota, Minneapolis, Minnesota, USA.

    Reference: J Urol. 2012 May;187(5):1662-6. doi: 10.1016/j.juro.2011.12.113.

     http://jurology.com/article/S0022-5347(11)06062-9/abstract

     

    Published January 15, 2013
  • Evaluation of efficacy and tolerability of cefotaxime and sulbactam versus cefepime and tazobactam in patients of urinary tract infection-a prospective comparative study - Beyond the Abstract

    Treating urinary tract infection is still a major health challenge in developing countries. Cephalosporins are one of the mainstays of therapy and third generation among these are the first line agents for treatment of complicated UTIs including those of nosocomial origin.

    Published July 23, 2015
  • Evidence of Uncultivated Bacteria in the Adult Female Bladder

    ABSTRACT
    Clinical urine specimens are usually considered to be sterile when they do not yield uropathogens using standard clinical cultivation procedures. Our aim was to test if the adult female bladder might contain bacteria that are not identified by these routine procedures. An additional aim was to identify and recommend the appropriate urine collection method for the study of bacterial communities in the female bladder. Consenting participants who were free of known urinary tract infection provided urine samples by voided, transurethral, and/or suprapubic collection methods. The presence of bacteria in these samples was assessed by bacterial culture, light microscopy, and 16S rRNA gene sequencing. Bacteria that are not or cannot be routinely cultivated (hereinafter called uncultivated bacteria) were common in voided urine, urine collected by transurethral catheter (TUC), and urine collected by suprapubic aspirate (SPA), regardless of whether the subjects had urinary symptoms. Voided urine samples contained mixtures of urinary and genital tract bacteria. Communities identified in parallel urine samples collected by TUC and SPA were similar. Uncultivated bacteria are clearly present in the bladders of some women. It remains unclear if these bacteria are viable and/or if their presence is relevant to idiopathic urinary tract conditions.

    CDC joint statement

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    PubMed Central®
    2012

    Published February 11, 2013
  • ICS 2013 - Podcast: Jacques Corcos, MD, FRCSC discusses highlights of the neurourology sessions from the Annual Scientific Meeting of the International Continence Society

    BARCELONA, SPAIN (UroToday.com) - An interview conducted at the 43rd Annual Scientific Meeting of the International Continence Society (ICS) - August 26 - 30, 2013 - Barcelona, Spain, by Anna Forsberg, medical director for UroToday.com.

    Published September 9, 2013
  • IHI - How-to guide: prevent catheter-associated urinary tract infections

    The estimated number of hospital-acquired infections (HAIs) in US hospitals exceeds 1.7 million events annually, leading to an estimated 99,000 deaths. Urinary tract infections account for approximately 40% of all HAIs annually. Fully 80% of these hospital-acquired urinary tract infections are attributable to indwelling urethral catheters. If nursing homes are considered along with acute care hospitals, it is estimated that there are more than one million cases of catheter-associated urinary tract infections (CAUTI) annually.

    In the US, up to five million urinary catheters are placed annually. Between 12% and 25% of all hospitalized patients will receive a urinary catheter during their hospital stay, with as many as half not having an appropriate indication. In one study, almost 40% of attending physicians caring for patients with unnecessary urinary catheters were not aware that their patients had a urinary catheter in place.

    It is well established that the duration of catheterization is directly related to risk for developing a urinary tract infection. With a catheter in place, the daily risk of developing a urinary tract infection ranges from 3% to 7%. When a catheter remains in place for up to a week, bacteriuria risk increases to 25%; at one month, this risk is nearly 100%. Among those with bacteriuria, 10% will develop symptoms of UTI (fever, dysuria, urgency, frequency, suprapubic tenderness) and up to 3% will further develop bacteremia.

    IHIHowtoGuidePreventCAUTI

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    How-to Guide: Prevent Catheter-Associated Urinary Tract Infections. Cambridge, MA: Institute for Healthcare Improvement; 2011. (Available at www.ihi.org)

    Published January 16, 2013
  • Prevention of healthcare-associated infections (HAIs) in a surgical urology ward: observational study-analysis of the problem and strategies for implementation.

    Our purpose is to present the results of our working group, with a view to reduce the incidence and improve the management of healthcare-associated infections (HAIs) in a urology ward.

    The study consists on an observational database designed with the view to analyse the incidence and characteristics of HAIs in Urology.

    Published February 3, 2019
  • Prostatic artery embolization as an alternative to indwelling bladder catheterization to manage benign prostatic hyperplasia in poor surgical candidates: Beyond the Abstract

    While numerous methods exist for the medical and surgical management of benign prostatic hyperplasia (BPH), treatment options are extremely limited for patients that have failed medical management and are ineligible for surgical intervention. For many of these patients, compression of the prostatic urethra can result in urethral trauma during clean intermittent catheterization, and indwelling bladder catheterization (IBC) is their only option for bladder management. In addition to increasing the risk of urinary tract infection (UTI), IBC can have a significant impact upon quality of life.
    Published June 15, 2017
  • Recurrent urinary tract infections in patients with incomplete bladder emptying: is there a role for intravesical therapy?

    The goal of this review article is to discuss the etiology of recurrent urinary tract infections (UTIs) in individuals with impaired bladder emptying, evaluate existing studies regarding UTI prevention strategies in this population, and explore the published experiences with intravesical therapy for the prevention and treatment of recurrent UTIs in patients performing clean intermittent catheterization (CIC).

    Published August 21, 2017
  • Risk factors & associated complications for postoperative urinary retention after lumbar surgery for lumbar spinal stenosis.

    Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS).

    Published February 19, 2018
  • Safety issues associated with using medication to treat overactive bladder.

    The mainstay of overactive bladder treatment is the use of anticholinergic medication with its common side effects well known. This review focused on three less well-known safety issues when treating OAB.

    Published October 17, 2017
  • The association between bacteria and urinary stones.

    Urinary stone disease (USD) is an increasing clinical problem in both children and adults. One in ten individuals will experience a urinary stone, yet the mechanisms responsible for urinary stones remain largely unknown.

    Published March 6, 2017
  • The importance of gender-stratified antibiotic resistance surveillance of unselected uropathogens, "Beyond the Abstract," by Casper D.J. den Heijer, PhD, et al.

    BERKELEY, CA (UroToday.com) - With respect to antibiotic resistance surveillance systems, several issues need to be considered. For urinary tract infections (UTIs), most guidelines are based on studies that have been performed among women, but with the obvious genito-urinary differences, it is questionable whether these results can be extrapolated to men.

    Published January 8, 2014
  • Urinary tract infection in the neurogenic bladder.

    There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower urinary tract function. This results in significant morbidity and health care utilization. Multiple well-established risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation.

    Published March 1, 2016
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