Management and Prevention of Nosocomial Urinary Tract Infections

Rudina Pirushi; Denisa Bego (Veseli); Zamira Imeraj

doi:10.3889/oamjms.2022.8436

Authors

Rudina Pirushi Department of Clinical and Nursing, University of Medicine, Faculty of Medical Technical Sciences, Tirana, Albania
Denisa Bego (Veseli) Department of Clinical and Nursing, University of Medicine, Faculty of Medical Technical Sciences, Tirana, Albania
Zamira Imeraj Department of Clinical and Nursing, University of Medicine, Faculty of Medical Technical Sciences, Tirana, Albania

DOI:

https://doi.org/10.3889/oamjms.2022.8436

Keywords:

Nosocomial infections, Urinary infe, Intensive therapy, Prevention, Managemen, etc

Abstract

BACKGROUND: Nosocomial infections are the leading cause of mortality, due to acquired nosocomial infections. Nosocomial urinary tract infections occur during or after hospitalization in patients who did not have an incubation phase of the infection at the time of admission to the hospital.

AIM: In this study, we aim to define and manage nosocomial urinary tract infections in intensive care at University Hospital Center “Mother Teresa” Tirana.

MATERIALS AND METHODS: 1350 patients were included in the study, of which 115 patients resulted in nosocomial nosocomial infections. The mean age of patients was 62 ± 16.6 years.

RESULTS: Out of 1350 patients hospitalized in the Intensive Care during the period October 2019 - December 2020, 4% of patients result in urinary tract infections or 45% of the total for 115 cases of nosocomial infections. We see that men have a higher percentage than women of being affected by urinary tract infections, it is significant (p < 0.001). The etiological cause of nosocomial urinary tract infections was Escherichia coli in 61.5% of cases. For nosocomial urinary tract infections, patients are monitored for fever, examination of urine complete, and uroculture. The mean hospital stay for patients without nosocomial infection of the urinary tract was 4 days, while that of those with urinary tract infection was 18.49 ± 27.68 (from 5 to 180 days). In comparison to the mean mentioned above, it is significant (p < 0.0001).

CONCLUSIONS: Nosocomial urinary tract infections are common in patients admitted to intensive care. Key recommendations should be given on diagnostic strategies, testing, selection of antibiotics as well as duration of treatment. We also need to collect data on how to prevent nosocomial infections in general and nosocomial urinary tract infections in particular.

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References

Johnson TM, Ouslander JG, Uman GC, Schnelle JF. Urinary incontinence treatment preferences in long-term care. J Am Geriatr Soc. 2001;49(6):710-8. https://doi.org/10.1046/j.1532-5415.2001.49146.x PMid:11454108 DOI: https://doi.org/10.1046/j.1532-5415.2001.49146.x

Saint S, Lipsky BA, Baker PD, McDonald LL, Ossenkop K. Urinary catheters: What type do men and their nurses prefer? J Am Geriatr Soc. 1999;47(12):1453-7. https://doi.org/10.1111/j.1532-5415.1999.tb01567.x PMid:10591242 DOI: https://doi.org/10.1111/j.1532-5415.1999.tb01567.x

Saint S, Lipsky BA, Goold SD. Indwelling urinary catheters: A one-point restraint? Ann Intern Med. 2002;137(2):125-7. Saint S. Clinical and economic consequences of nosocomial catheter-related bacteriuria. Am J Infect Control. 2000;28(1):68-75. https://doi.org/10.1016/s0196-6553(00)90015-4 PMid:10679141 DOI: https://doi.org/10.7326/0003-4819-137-2-200207160-00012

Johnson JR, Kuskowski MA, Wilt TJ. Systematic review: Antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients. Ann Intern Med. 2006;144(2):116-26. https://doi.org/10.7326/0003-4819-144-2-200601170-00009 PMid:16418411 DOI: https://doi.org/10.7326/0003-4819-144-2-200601170-00009

Kilonzo M, Vale L, Pickard R, Lam T, N’Dow J, Catheter Trial Group. Cost effectiveness of antimicrobial, catheters for adults requiring short-term catheterisation in hospital. Eur Urol. 2014;66(4):615-8. https://doi.org/10.1016/j.eururo.2014.05.035 PMid:24958624 DOI: https://doi.org/10.1016/j.eururo.2014.05.035

Fink R, Gilmartin H, Richard A, Capezuti E, Boltz M, Wald H, et al. Indwelling urinary catheter management and catheter-associated urinary tract infection prevention practices in nurses improving care for healthsystem elders hospitals. Am J Infect Control. 2012;40(8):715-20. https://doi.org/10.1016/j.ajic.2011.09.017 PMid:22297241 DOI: https://doi.org/10.1016/j.ajic.2011.09.017

Willson M, Wilde M, Webb ML, Thompson D, Parker D, Harwood J, et al. Nursing interventions to reduce the risk of catheter-associated urinary tract infection: Part 2: Staff education, monitoring, and care techniques. Wound Ostomy Continence Nurs. 2009;36(2):137-54. https://doi.org/10.1097/01.WON.0000347655.56851.04 PMid:19287262 DOI: https://doi.org/10.1097/01.WON.0000347655.56851.04

Welden LM. Electronic health record: Driving evidence-based catheter-associated urinary tract infections (CAUTI) care practices. Online J Issues Nurs. 2013;18(3):6. PMid:26812099 DOI: https://doi.org/10.3912/OJIN.Vol18No03PPT02

Kalsi J, Arya M, Wilson P, Mundy A. Hospital-acquired urinary tract infection. Int J Clin Pract. 2003;57(5):388-91. PMid:12846343

Kampf G, Löffler H, Gastmeier P. Hand hygiene for the prevention of nosocomial infections. Dtsch Arztebl Int. 2009;106(40):649-55. https://doi.org/10.3238/arztebl.2009.0649 PMid:19890431 DOI: https://doi.org/10.3238/arztebl.2009.0649

Gastmeier P, Kampf G, Wischnewski N, Hauer T, Schulgen G, Schumacher M, et al. Prevalence of nosocomial infections in representative German hospitals. J Hosp Infect. 1998;38(1):37-49. https://doi.org/10.1016/s0195-6701(98)90173-6 PMid:9513067 DOI: https://doi.org/10.1016/S0195-6701(98)90173-6

Saint S, Veenstra DL, Sullivan SD, Chenoweth C, Fendrick AM. The potential clinical and economic benefits of silver alloy urinary catheters in preventing urinary tract infection. Arch Intern Med. 2000;160(17):2670-5. https://doi.org/10.1001/archinte.160.17.2670 PMid:10999983 DOI: https://doi.org/10.1001/archinte.160.17.2670

Lam TB, Omar MI, Fisher E, Gillies K, MacLennan S. Lam TB, et al. Cochrane; Types of indwelling urethral catheters for short-term catheterisation in hospitalised adults. Database Syst Rev. 2014; https://doi.org/10.1002/14651858.CD004013 DOI: https://doi.org/10.1002/14651858.CD004013.pub4

Dave J, Reith S, Nash JQ, Marples RR, Dulake C. A double outbreak of exfoliative toxin-producing strains of Staphylococcus aureus in a maternity unit. Epidemiol Infect. 1994;112(1):103-14. https://doi.org/10.1017/s0950268800057460 PMid:8119349 DOI: https://doi.org/10.1017/S0950268800057460