ABSTRACT
Urinary tract infections (UTIs) are the most common health-care-associated infections (HCAIs) and one of the top-ranking microbial infections. In the community, about 80% of UTIs are caused by uropathogenic Escherichia coli (UPEC), but there is a high variability of etiological agents involved in hospital-acquired UTIs. With this context in mind, the current study aimed to evaluate the prevalence of the main etiological agents responsible for UTIs and their susceptibility profile at the Hospital das Clínicas de Ribeirão Preto, a high complexity reference hospital in the Southeast region of Brazil. This retrospective and descriptive study analyzed all positive inpatient cultures [100,000 colony-forming unit (CFU)/mL] from November 2016 to April 2017. The most prevalent microorganism was Kleb-siella pneumoniae (23 isolates), equivalent to 37.7% of positive urocultures. The second most prevalent agent was UPEC, with 19 isolates (31.1%). The risk factors evaluated in these inpatients showed that 17.5% underwent a uro-logical procedure on admission, 31.6% were using a urinary catheter; 26.2% were using immunosuppressive drugs during the period in which the clinical diagnosis was made. Our results demonstrate the prevalence of UTI causes in the hospital context and the main risk factors for them and will be pretty helpful in guiding empirical treatment in severe UTIs inside the hospital as well as reflect on the actual need and time duration of invasive procedures in the hospital environmen (AU)
As infecções do trato urinário (IU) são a terceira causa principal de infecções associadas ao ambiente hospitalar, logo após as infecções pulmonares e da corrente sanguínea. Na comunidade, cerca de 80% das IU são causadas por E. coli, mas há uma alta variabilidade de agentes etiológicos envolvidos nas IU hospitalares. Este estudo visa avaliar a prevalência dos principais agentes etiológicos e perfil de suscetibilidade envolvidos em IU em um am-biente hospitalar de referência de alta complexidade no sul do Brasil. Este é um estudo retrospectivo e descritivo que analisou todas as culturas positivas (100.000 ufc/ml) de pacientes nas enfermarias de um hospital terciário no período entre novembro de 2016 a abril de 2017. O microorganismo mais prevalente foi Klebsiella pneumoniae (23 isolados), o que equivale a 37,7% das uroculturas. O segundo agente mais prevalente foi Escherichia coli, com 19 isolados (31,1%). Os fatores de risco avaliados nestes pacientes mostraram que 17,5% foram submetidos a um procedimento urológico na admissão, 31,6% estavam usando um cateter urinário; 26,2% estavam usando drogas imunossupressoras no período em que o diagnóstico clínico foi feito. Nossos resultados demonstram uma mudança importante na prevalência das causas de IU no contexto hospitalar e os principais fatores de risco para elas e serão bastante úteis para orientar o tratamento empírico em IU grave dentro do hospital, bem como refletir sobre a real necessidade e a duração dos procedimentos invasivos no ambiente hospitalar (AU)
Subject(s)
Humans , Urinary Tract Infections , Escherichia coli , Urinary Catheters , Immunosuppressive Agents , Klebsiella pneumoniaeABSTRACT
Background: present study is done to study the antibiotic-sensitivity and resistance pattern of bacteria causing catheter associated urinary tract infection. Objectives of this study were to study the bacterial etiology of CAUTI, to study the prevalence of various bacteria causing catheter associated urinary tract infection, the antibiogram (sensitivity and resistance) pattern of isolated bacteria and the percentage of asymptomatic bacteriuria in the study population.Methods: In this prospective observational study, under aseptic precautions, urine sample was taken after 48 hours of catheterization and sent for culture and sensitivity pattern is studied.Results: In this study 500 urine samples were cultured and its antibiotic sensitivity pattern was observed. Out of the 53 culture positive samples most the subjects had asymptomatic bacteriuria. The study gave the incidence of catheter associated urinary tract infection (CAUTI) to be 10.6% and about 9% were polymicrobial. In this study about 7 causative bacteria were isolated. Escherichia coli were the most common organism that was isolated. On studying the antibiotic susceptibility pattern of each isolate, it has been observed that all of them are multidrug resistant and the sensitivity pattern is migrating towards higher antibiotics.Conclusions: Empirical use of antibiotics must be avoided and antibiotics must be used only after sensitivity testing. This will help in selection of the appropriate antibiotic for therapeutic use and prevent indiscriminate and irrational use of antibiotics. This will also improve the cost efficiency and decrease the duration of hospital stay.
ABSTRACT
Artificial conduits, including ureteral stents and catheters, are used widely as drainage tools in the urinary system. However, various bacteria in the urine and long duration of insertion can arouse the biofilm formation on the pipeline surface, which calls for effective antibacterial strategy. In this article, the mechanism of Catheter Associated Urinary Tract Infections (CAUTI) is explained from the perspective of etiology. Then, the biofilm formation conditions and the features of urine are analyzed, the antibacterial agents and approaches suitable for ureteral stents and catheters are introduced and their pros and cons are discussed respectively.
Subject(s)
Humans , Anti-Bacterial Agents , Catheters , Drainage , Stents , Urinary Catheterization , Urinary Tract InfectionsABSTRACT
Objective To detection the urine of bacteria hyphae and intracellular bacterial communities in patients with indwelling urinary catheter and discuss intracellular bacterial comnmunities in the pathogenesis of catheter-related urinary tract infection.Methods From May 2014 to February 2016,95 cases with D-J stent indwelling were enrolled in this study,including 38 male patients and 57 female patients.The mean age was (43 ±21)years old,ranging from 25 to 83 years old.We recorded those patient g clinical symptoms,middle urine culture results.If the middle urine culture was positive,further pathology test and scanning electron microscopy for bacteria hyphae and intracellular bacterial communities would be considered.Results The middle urine culture showed positive in 21 cases (22％,21/95);The classification of bacteria included E.coli in 11 cases,dung enterococcus in 2 cases,klebsiella pneumonia in 4 cases,pseudomonas aeruginosa in 3 cases,epidermis staphylococcus aureus in 1 case.Among those 21 patients,9 cases had the symptoms of fever and shiver.Urine pathology testing found hyphae in 6 cases (6％,6/95).all others were E.coli infection.For scanning electron microscope,6 cases were found rodshaped bacteria and hyphae.3 cases were found intracellular bacterial communities.Conclusions The presence of intracellular bacterial communities made urothelial itself the source of endogenous bacteria of urinary tract infection.Catheter-related urinary tract infections in patients with recurrence maybe basically homology bacteria.
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Purpose: Device-associated infections constitute the majority of health care-associated infections (HAIs) in ICUs. Trauma patients are predisposed to acquire such infections due to various trauma-related factors. The prevalence of HAIs is underreported from developing nations due to a lack of systematic surveillance. This study reports the impact of an intensive surveillance on the rates and outcome of device-associated infections in trauma patients from a developing country and compares the rates with a previous pilot observation. Materials and Methods: The study was conducted at a level-1 trauma centre of India. Surveillance for ventilator-associated pneumonia (VAP), central line-associated blood stream infections (CLA-BSIs) and catheter-associated urinary tract infections (CA-UTIs) was done based on centre for disease control-National Healthcare Safety Network (CDC-NHSN) defi nitions. The impact of an intensive surveillance, education and awareness drive on the rates of infections over the study period, and compliance to preventive bundles and hand hygiene was assessed. Results: A total of 15,462 ventilator days, 12,207 central line days and 17,740 urinary catheter days were recorded in the study population. The overall rates of VAP, CLA-BSI and CA-UTI were respectively 17, 7.2 and 15.5/1000 device days. There was a signifi cant correlation between device days and the propensity to develop infections. Infections were the cause of death in 36.6% of fatal trauma cases. A signifi cantly higher rate of VAP, CLA-BSI and CA-UTIs was noted in fatal cases. The compliance to ventilator bundle, central line bundle, bladder bundle and hand hygiene were 74.5%, 86%, 79.3% and 64.6%, respectively. A high rate of multi-drug-resistance was observed in all pathogens. A gross reduction in the rates of all infections was observed over time during the study due to implementation of a stringent surveillance system, feedbacks and education. The compliance to hand hygiene and preventive bundles also increased over time. Conclusion: The automated surveillance was easy and useful for data entry and analysis. Surveillance had a signifi cant impact on reduction of HAIs and mortality in trauma patients.
ABSTRACT
Objective To objectively evaluate the effectiveness of reminder system in reducing catheter-associated urinary tract infections.Methods Databases were electronically searched to collect the trials.According to the inclusion and exclusion criteria,the literatures were screened,the data were extracted and the methodological quality of the included studies was assessed.Then Meta-analysis was performed by using RevMan 5.0 software.Results A total of 10 literatures involving 5 662 participants were included.The results of Meta-analysis showed that the reminder system group was superior to the control group in decreasing the incidence rate of catheter-associated urinary tract infections,shortening the days of indwelling catheter,and there were statistical differences.Conclusions Reminder system can shorten the days of indwelling catheter,decrease catheter-associated urinary tract infections,
ABSTRACT
OBJECTIVE To explore the effect of smearing catheter surface with chloramphenicol for preventing catheter -associated urinary tract infections. METHODS Totally 100 cases of preoperative patients needed for indwelling urethral catheters were randomly grouped, 50 of 100 cases as test group, and the others 50 cases as the control group. Catheters after smearing surface with chloramphenicol were inserted using aseptic technique in the test group, urinary catheters without using chloramphenicol were inserted in the control group according to routine aseptic technique protocol, and then regularly taken out urinary specimen from two groups respectively for microbial culture. RESULTS The observation showed bacterial growth positive rate was 30%, and 66.7%, respectively in the control group, but positive rate was 6.7%, and 30%, respectively in the test group after the seventh day and the tenth day. There was a statistic significant difference (P