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Gauhar V, Castellani D, Teoh JYC, Nedbal C, Chiacchio G, Gabrielson AT, Heldwein FL, Wroclawski ML, de la Rosette J, Donalisio da Silva R, Galosi AB, Somani BK. Catheter-Associated Urinary Infections and Consequences of Using Coated versus Non-Coated Urethral Catheters-Outcomes of a Systematic Review and Meta-Analysis of Randomized Trials. J Clin Med 2022; 11:jcm11154463. [PMID: 35956080 PMCID: PMC9369369 DOI: 10.3390/jcm11154463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Coated urethral catheters were introduced in clinical practice to reduce the risk of catheter-acquired urinary tract infection (CAUTI). We aimed to systematically review the incidence of CAUTI and adverse effects in randomized clinical trials of patients requiring indwelling bladder catheterization by comparing coated vs. non-coated catheters. This review was performed according to the 2020 PRISMA framework. The incidence of CAUTI and catheter-related adverse events was evaluated using the Cochran−Mantel−Haenszel method with a random-effects model and reported as the risk ratio (RR), 95% CI, and p-values. Significance was set at p < 0.05 and a 95% CI. Twelve studies including 36,783 patients were included for meta-analysis. There was no significant difference in the CAUTI rate between coated and non-coated catheters (RR 0.87 95% CI 0.75−1.00, p = 0.06). Subgroup analysis demonstrated that the risk of CAUTI was significantly lower in the coated group compared with the non-coated group among patients requiring long-term catheterization (>14 days) (RR 0.82 95% CI 0.68−0.99, p = 0.04). There was no difference between the two groups in the incidence of the need for catheter exchange or the incidence of lower urinary tract symptoms after catheter removal. The benefit of coated catheters in reducing CAUTI risk among patients requiring long-term catheterization should be balanced against the increased direct costs to health care systems when compared to non-coated catheters.
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Affiliation(s)
- Vineet Gauhar
- Department of Urology, Ng Teng Fong General Hospital (NUHS), Singapore 609606, Singapore;
| | - Daniele Castellani
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
- Correspondence: ; Tel.: +39-71-5963367
| | - Jeremy Yuen-Chun Teoh
- S.H.Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China;
| | - Carlotta Nedbal
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
| | - Giuseppe Chiacchio
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
| | - Andrew T. Gabrielson
- Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA;
| | - Flavio Lobo Heldwein
- Department of Urology, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil;
| | - Marcelo Langer Wroclawski
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil;
- Beneficência Portuguesa de São Paulo (BP), São Paulo 01323-001, Brazil
| | - Jean de la Rosette
- Department of Urology, Medipol Mega University Hospital, Istanbul Medipol University, 34214 Istanbul, Turkey;
| | | | - Andrea Benedetto Galosi
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
| | - Bhaskar Kumar Somani
- Department of Urology, University Hospitals Southampton, NHS Trust, Southampton SO16 6YD, UK;
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2
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Armugam A, Teong SP, Lim DSW, Chan SP, Yi G, Yew DS, Beh CW, Zhang Y. Broad spectrum antimicrobial PDMS-based biomaterial for catheter fabrication. Biomater Res 2021; 25:33. [PMID: 34674766 PMCID: PMC8529379 DOI: 10.1186/s40824-021-00235-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background In addition to the widespread use of antibiotics in healthcare settings, the current COVID-19 pandemic has escalated the emergence of antibiotic resistance. Nosocomial infections among hospitalized patients is a leading site for such resistant microbial colonization due to prolonged use of invasive devices and antibiotics in therapies. Invasive medical devices, especially catheters, are prone to infections that could accelerate the development of resistant microbes. Often, catheters - particularly urinary catheters - are prone to high infection rates. Antibiotic-coated catheters can reduce infection rates and although commercially available, are limited in efficacy and choices. Methods Herein, a novel and facile method to fabricate PMDS-based biomaterial for the development of antimicrobial eluting catheters is presented. Silicone based organic polymer polydimethylsiloxane (PDMS) was used to prepare a biomaterial containing novel polymeric imidazolium antimicrobial compound. Results It was found that the PDMS-based biomaterials could eradicate microbial colonization even after 60 days in culture with continuous microbial challenge, be recycled over multiple uses, stored at room temperature for long-term usage and importantly is biocompatible. Conclusion The PDMS-based biomaterial displayed biocidal functionality on microbes of clinical origin, which form major threats in hospital acquired infections. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40824-021-00235-5.
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Affiliation(s)
- Arunmozhiarasi Armugam
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Siew Ping Teong
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Diane S W Lim
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Shook Pui Chan
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Guangshun Yi
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Dionis S Yew
- Molecular Engineering Lab, Institute of Molecular and Cell Biology, 61 Biopolis Drive, The Proteos, Singapore, 138673, Singapore
| | - Cyrus W Beh
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore.,Molecular Engineering Lab, Institute of Molecular and Cell Biology, 61 Biopolis Drive, The Proteos, Singapore, 138673, Singapore
| | - Yugen Zhang
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore.
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3
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Baker JE, Seitz AP, Boudreau RM, Skinner MJ, Beydoun A, Kaval N, Caldwell CC, Gulbins E, Edwards MJ, Gobble RM. Doxycycline-Coated Silicone Breast Implants Reduce Acute Surgical-Site Infection and Inflammation. Plast Reconstr Surg 2020; 146:1029-1041. [DOI: 10.1097/prs.0000000000007277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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4
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Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, Eckert LO, Geerlings SE, Köves B, Hooton TM, Juthani-Mehta M, Knight SL, Saint S, Schaeffer AJ, Trautner B, Wullt B, Siemieniuk R. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis 2020; 68:e83-e110. [PMID: 30895288 DOI: 10.1093/cid/ciy1121] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/27/2018] [Indexed: 12/22/2022] Open
Abstract
Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. The 2005 guideline from the Infectious Diseases Society of America recommended that ASB should be screened for and treated only in pregnant women or in an individual prior to undergoing invasive urologic procedures. Treatment was not recommended for healthy women; older women or men; or persons with diabetes, indwelling catheters, or spinal cord injury. The guideline did not address children and some adult populations, including patients with neutropenia, solid organ transplants, and nonurologic surgery. In the years since the publication of the guideline, further information relevant to ASB has become available. In addition, antimicrobial treatment of ASB has been recognized as an important contributor to inappropriate antimicrobial use, which promotes emergence of antimicrobial resistance. The current guideline updates the recommendations of the 2005 guideline, includes new recommendations for populations not previously addressed, and, where relevant, addresses the interpretation of nonlocalizing clinical symptoms in populations with a high prevalence of ASB.
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Affiliation(s)
- Lindsay E Nicolle
- Department of Internal Medicine, School of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Kalpana Gupta
- Division of Infectious Diseases, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, West Roxbury, Massachusetts
| | | | - Richard Colgan
- Department of Family and Community Medicine, University of Maryland, Baltimore
| | - Gregory P DeMuri
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Dimitri Drekonja
- Division of Infectious Diseases, University of Minnesota, Minneapolis
| | - Linda O Eckert
- Department of Obstetrics and Gynecology and Department of Global Health, University of Washington, Seattle
| | - Suzanne E Geerlings
- Department of Internal Medicine, Amsterdam University Medical Center, The Netherlands
| | - Béla Köves
- Department of Urology, South Pest Teaching Hospital, Budapest, Hungary
| | - Thomas M Hooton
- Division of Infectious Diseases, University of Miami, Florida
| | | | - Shandra L Knight
- Library and Knowledge Services, National Jewish Health, Denver, Colorado
| | - Sanjay Saint
- Department of Internal Medicine, Veterans Affairs Ann Arbor and University of Michigan, Ann Arbor
| | | | - Barbara Trautner
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Bjorn Wullt
- Division of Microbiology, Immunology and Glycobiology, Lund, Sweden
| | - Reed Siemieniuk
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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5
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Banaszek D, Inglis T, Ritchie L, Belanger L, Ailon T, Charest-Morin R, Dea N, Kwon BK, Paquette S, Fisher CG, Dvorak MF, Street JT. Effectiveness of silver alloy-coated silicone urinary catheters in patients with acute traumatic cervical spinal cord injury: Results of a quality improvement initiative. J Clin Neurosci 2020; 78:135-138. [PMID: 32536507 DOI: 10.1016/j.jocn.2020.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
Patients with acute traumatic cervical spinal cord injury (ATCSCI) have an increased risk of catheter-associated urinary tract infection (CAUTI). The effectiveness of silver alloy-coated silicone urinary catheters (SACC) in preventing CAUTI in ATCSCI is unknown and was the objective of this study. We performed a quality improvement initiative in an attempt to reduce CAUTI in patients undergoing spine surgery at a single quaternary center. Prior to July 2015, all patients received a latex indwelling catheter (LIC). All patients with ATCSCI with limited hand function (AIS A,B, or C) received a SACC. Incidence of CAUTI, microbiology, duration of infection, antibiotic susceptibility, and catheter-associated adverse events were recorded prospectively. We studied 3081 consecutive patients over the three years, of whom 302 (9.8%) had ATCSCI; 63% of ATCSCI patients were ASIA Impairment Scale (AIS) A or B. The overall rate of CAUTI was 19% (585/3081), and was 38% (116/302) in patients with ATCSCI. Of 178 ATCSCI patients with LIC, 100 (56%) developed a CAUTI compared with 28 of 124 (23%) patients with SACC (p < 0.05). Poly-microbial and gram-positive infection was more common in LIC than in SACC (p < 0.05). Median duration of infection was 9 days in SACC group and 12 days in LIC group (p = 0.08). Resistance to trimethoprim (p < 0.001) and ciprofloxacin (p < 0.05) were more common in LIC group. There was no difference in catheter-associated adverse events or length of stay between the groups. This quality improvement initiative illustrates the effectiveness of antiseptic silver alloy-coated silicone urinary catheters in patients with ATCSCI. In our population, the use of SACC reduces the incidence and the complexity of CAUTI.
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Affiliation(s)
- Dan Banaszek
- Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Tom Inglis
- Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Leanna Ritchie
- Vancouver Spine Program, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Lise Belanger
- Vancouver Spine Program, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Tamir Ailon
- Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Raphaële Charest-Morin
- Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Nicolas Dea
- Department of Orthopaedics, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Brian K Kwon
- Department of Orthopaedics, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Scott Paquette
- Department of Orthopaedics, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Charles G Fisher
- Division of Spine Surgery, Department of Orthopaedics, University of British Columbia, Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Marcel F Dvorak
- Department of Orthopaedics, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - John T Street
- Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
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6
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Yaqoob SB, Adnan R, Rameez Khan RM, Rashid M. Gold, Silver, and Palladium Nanoparticles: A Chemical Tool for Biomedical Applications. Front Chem 2020; 8:376. [PMID: 32582621 PMCID: PMC7283583 DOI: 10.3389/fchem.2020.00376] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/09/2020] [Indexed: 12/15/2022] Open
Abstract
Herein, the role of metal-based nanoparticles (NPs) in biomedical analysis and the treatment of critical deceases been highlighted. In the world of nanotechnology, noble elements such as the gold/silver/palladium (Au/Ag/Pd) NPs are the most promising emerging trend to design bioengineering materials that could to be employed as modern diagnostic tools and devices to combat serious diseases. NPs are considered a powerful and advanced chemical tool to diagnose and to cure critical ailments such as HIV, cancer, and other types of infectious illnesses. The treatment of cancer is the most significant application of nanotechnology which is based on premature tumor detection and analysis of cancer cells through Nano-devices. The fascinating characteristic properties of NPs-such as high surface area, high surface Plasmon resonance, multi-functionalization, highly stable nature, and easy processing-make them more prolific for nanotechnology. In this review article, the multifunctional roles of Au/Ag/Pd NPs in the field of medical science, the physicochemical toxicity dependent properties, and the interaction mechanism is highlighted. Due to the cytotoxicity of Ag/Au/Pd NPs, the conclusion and future remarks emphasize the need for further research to minimize the toxicity of NPs in the bio-medicinal field.
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Affiliation(s)
- Sundas Bahar Yaqoob
- Department of Zoology, Mirpur University of Science and Technology Mirpur, Mirpur, Pakistan
| | - Rohana Adnan
- School of Chemical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Mohammad Rashid
- School of Chemical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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7
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Al-Qahtani M, Safan A, Jassim G, Abadla S. Efficacy of anti-microbial catheters in preventing catheter associated urinary tract infections in hospitalized patients: A review on recent updates. J Infect Public Health 2019; 12:760-766. [DOI: 10.1016/j.jiph.2019.09.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/23/2019] [Accepted: 09/15/2019] [Indexed: 01/01/2023] Open
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8
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Majeed A, Sagar F, Latif A, Hassan H, Iftikhar A, Darouiche RO, Mohajer MA. Does antimicrobial coating and impregnation of urinary catheters prevent catheter-associated urinary tract infection? A review of clinical and preclinical studies. Expert Rev Med Devices 2019; 16:809-820. [PMID: 31478395 DOI: 10.1080/17434440.2019.1661774] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections in hospitals, accounting for 36% of all health care-associated infections. Areas covered: We aimed to address the potential impact of antimicrobial coating of catheter materials for the prevention of CAUTI and to analyze the progress made in this field. We conducted literature searches in the PubMed, Embase, and Cochrane Library databases, and found 578 articles. Data from 60 articles in either the preclinical or clinical stage were analyzed in this expert review. Expert opinion: The literature review revealed many promising methods for preventing CAUTI. Recent studies have suggested the combination of silver-based products and antibiotics, owing to their synergistic effect, to help address the problem of antibiotic resistance. Other coating materials that have been tested include nitric oxide, chlorhexidine, antimicrobial peptides, enzymes, and bacteriophages. Because of heterogeneity among studies, it is difficult to reliably comment on the clinical efficacy of different coating materials. Future research should focus on double-blind randomized clinical trials for evaluating the role of these potential coating agents.
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Affiliation(s)
- Aneela Majeed
- Division of Infectious Diseases, Department of Medicine, Stanford University , Stanford , CA , USA
| | - Fnu Sagar
- Department of Medicine, University of Arizona , Tucson , AZ , USA
| | - Azka Latif
- Department of Medicine, Creighton University , Omaha , NE , USA
| | - Hamza Hassan
- Department of Medicine, Rochester General Hospital , Rochester , NY , USA
| | - Ahmad Iftikhar
- Department of Medicine, University of Arizona , Tucson , AZ , USA
| | - Rabih O Darouiche
- Section of Infectious Diseases, Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine , Houston , TX , USA.,Section of Infectious Diseases, Baylor College of Medicine , Houston , TX , USA
| | - Mayar Al Mohajer
- Section of Infectious Diseases, Baylor College of Medicine , Houston , TX , USA
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9
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Wang L, Zhang S, Keatch R, Corner G, Nabi G, Murdoch S, Davidson F, Zhao Q. In-vitro antibacterial and anti-encrustation performance of silver-polytetrafluoroethylene nanocomposite coated urinary catheters. J Hosp Infect 2019; 103:55-63. [DOI: 10.1016/j.jhin.2019.02.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/16/2019] [Indexed: 10/27/2022]
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10
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Anhydrous polymer-based coating with sustainable controlled release functionality for facile, efficacious impregnation, and delivery of antimicrobial peptides. Biotechnol Bioeng 2018; 115:2000-2012. [DOI: 10.1002/bit.26713] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/28/2018] [Accepted: 04/09/2018] [Indexed: 12/28/2022]
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11
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Aderibigbe BA. Metal-Based Nanoparticles for the Treatment of Infectious Diseases. Molecules 2017; 22:E1370. [PMID: 28820471 PMCID: PMC6152252 DOI: 10.3390/molecules22081370] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/15/2017] [Indexed: 11/16/2022] Open
Abstract
Infectious diseases can be transmitted and they cause a significant burden on public health globally. They are the greatest world killers and it is estimated that they are responsible for the demise of over 17 million people annually. The impact of these diseases is greater in the developing countries. People with compromised immune systems and children are the most affected. Infectious diseases may be caused by bacteria, viruses, and protozoa. The treatment of infectious diseases is hampered by simultaneous resistance to multiple drugs, indicating that there is a serious and pressing need to develop new therapeutics that can overcome drug resistance. This review will focus on the recent reports of metal-based nanoparticles that are potential therapeutics for the treatment of infectious diseases and their biological efficacy (in vitro and in vivo).
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Affiliation(s)
- Blessing Atim Aderibigbe
- Department of Chemistry, University of Fort Hare, Alice Campus, Eastern Cape 5700, South Africa.
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Tian Y, Jian Z, Wang J, He W, Liu Q, Wang K, Li H, Tan H. Antimicrobial activity Study of triclosan-loaded WBPU on Proteus mirabilis in vitro. Int Urol Nephrol 2017; 49:563-571. [DOI: 10.1007/s11255-017-1532-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/25/2017] [Indexed: 10/20/2022]
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13
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Lee KH, Park SJ, Choi S, Uh Y, Park JY, Han KH. The Influence of Urinary Catheter Materials on Forming Biofilms of Microorganisms. ACTA ACUST UNITED AC 2017. [DOI: 10.4167/jbv.2017.47.1.32] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kyoung-Ho Lee
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Su Jung Park
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - SunJu Choi
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Joo Young Park
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyoung-Hee Han
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea
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First report of macroscopic biofilm formation caused by Candida albicans on silver hydrogel-coated urinary catheters. Am J Infect Control 2016; 44:1174-1175. [PMID: 27207160 DOI: 10.1016/j.ajic.2016.03.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/05/2016] [Accepted: 03/07/2016] [Indexed: 11/23/2022]
Abstract
We report macroscopic biofilms on silver hydrogel-coated urinary catheters in 2 patients from 2 different intensive care units. The catheters were removed on observation of a white, jelly layer on the catheters, respectively, 9 and 21 days after insertion. Yeast cells and pseudohyphal structures were observed with microscopy. Both isolates were identified as Candida albicans. To our knowledge, these are the first cases demonstrating the formation of macroscopic biofilm layers on silver nitrate-coated catheters in the literature.
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Abstract
Asymptomatic bacteriuria is very common. In healthy women, asymptomatic bacteriuria increases with age, from <1% in newborns to 10% to 20% of women age 80 years, but is uncommon in men until after age 50 years. Individuals with underlying genitourinary abnormalities, including indwelling devices, may also have a high frequency of asymptomatic bacteriuria, irrespective of age or gender. The prevalence is very high in residents of long-term-care facilities, from 25% to 50% of women and 15% to 40% of men. Escherichia coli is the most frequent organism isolated, but a wide variety of other organisms may occur. Bacteriuria may be transient or persist for a prolonged period. Pregnant women with asymptomatic bacteriuria identified in early pregnancy and who are untreated have a risk of pyelonephritis later in pregnancy of 20% to 30%. Bacteremia is frequent in bacteriuric subjects following mucosal trauma with bleeding, with 5% to 10% of patients developing severe sepsis or septic shock. These two groups with clear evidence of negative outcomes should be screened for bacteriuria and appropriately treated. Asymptomatic bacteriuria in other populations is benign and screening and treatment are not indicated. Antimicrobial treatment has no benefits but is associated with negative outcomes including reinfection with antimicrobial resistant organisms and a short-term increased frequency of symptomatic infection post-treatment. The observation of increased symptomatic infection post-treatment, however, has led to active investigation of bacterial interference as a strategy to prevent symptomatic episodes in selected high risk patients.
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16
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Inhibition of bacterial surface colonization by immobilized silver nanoparticles depends critically on the planktonic bacterial concentration. J Colloid Interface Sci 2016; 467:17-27. [DOI: 10.1016/j.jcis.2015.12.049] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/22/2015] [Accepted: 12/22/2015] [Indexed: 12/18/2022]
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17
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Ivanova K, Fernandes MM, Francesko A, Mendoza E, Guezguez J, Burnet M, Tzanov T. Quorum-Quenching and Matrix-Degrading Enzymes in Multilayer Coatings Synergistically Prevent Bacterial Biofilm Formation on Urinary Catheters. ACS APPLIED MATERIALS & INTERFACES 2015; 7:27066-27077. [PMID: 26593217 DOI: 10.1021/acsami.5b09489] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Bacteria often colonize in-dwelling medical devices and grow as complex biofilm communities of cells embedded in a self-produced extracellular polymeric matrix, which increases their resistance to antibiotics and the host immune system. During biofilm growth, bacterial cells cooperate through specific quorum-sensing (QS) signals. Taking advantage of this mechanism of biofilm formation, we hypothesized that interrupting the communication among bacteria and simultaneously degrading the extracellular matrix would inhibit biofilm growth. To this end, coatings composed of the enzymes acylase and α-amylase, able to degrade bacterial QS molecules and polysaccharides, respectively, were built on silicone urinary catheters using a layer-by-layer deposition technique. Multilayer coatings of either acylase or amylase alone suppressed the biofilm formation of corresponding Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus. Further assembly of both enzymes in hybrid nanocoatings resulted in stronger biofilm inhibition as a function of acylase or amylase position in the layers. Hybrid coatings, with the QS-signal-degrading acylase as outermost layer, demonstrated 30% higher antibiofilm efficiency against medically relevant Gram-negative bacteria compared to that of the other assemblies. These nanocoatings significantly reduced the occurrence of single-species (P. aeruginosa) and mixed-species (P. aeruginosa and Escherichia coli) biofilms on silicone catheters under both static and dynamic conditions. Moreover, in an in vivo animal model, the quorum quenching and matrix degrading enzyme assemblies delayed the biofilm growth up to 7 days.
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Affiliation(s)
- Kristina Ivanova
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya , Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Margarida M Fernandes
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya , Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Antonio Francesko
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya , Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Ernest Mendoza
- Laboratory of Applied Nanomaterials, Center for Research in NanoEngineering, Universitat Politècnica de Catalunya , c/Pascual I Vila 15, 08028 Barcelona, Spain
| | - Jamil Guezguez
- Synovo GmbH , Paul Ehrlich 15, D-72076 Tübingen, Germany
| | - Michael Burnet
- Synovo GmbH , Paul Ehrlich 15, D-72076 Tübingen, Germany
| | - Tzanko Tzanov
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya , Rambla Sant Nebridi 22, 08222 Terrassa, Spain
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Assessment of total silver and silver nanoparticle extraction from medical devices. Food Chem Toxicol 2015; 85:10-9. [DOI: 10.1016/j.fct.2015.08.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/11/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022]
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Salvarci A, Koroglu M, Erayman B. Investigation of Antibacterial Activity and Biofilm Formation of Silicones Coated With Minocycline-Rifampicin, Silver Nitrate, and Nitrofurantoin for Short-term Utilization in In Vitro Urinary System Models. Urology 2015; 88:66-75. [PMID: 26522971 DOI: 10.1016/j.urology.2015.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 09/29/2015] [Accepted: 10/20/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To analyze antimicrobial activity and biofilm formation on silicones coated with antimicrobial substances in in vivo short-term catheterization simulation using our newly developed in vitro urinary system model and to compare minocycline-rifampin (MR)-, silver nitrate-, and nitrofurantoin (NF)-coated silicone discs. MATERIALS AND METHODS Silicone discs were exposed to bacterial urine suspension for 168 hours. The antimicrobial activities were assessed in the medium, and the inhibition zone diameters were measured. The weight of the silicones was measured for biofilm growth assessment before and after the experiment, and confocal microscopy images were taken. RESULTS Although the inhibition zone diameters of silver nitrate silicones were larger than those of pure silicone (PS), MR, and NF silicones, biofilm formation could not be prevented (P < .05). MR and NF silicones were superior to PS in terms of antimicrobial efficacy and prevention of biofilm formation (P < .05). In terms of biofilm prevention, no differences were detected between NF and MR silicones apart from a slightly superior ability of MR silicones to inhibit Escherichia coli (P > .05). Biofilm formation occurred on all silicone discs. CONCLUSION In short-term urinary catheter utilization, antimicrobial efficacy and biofilm formation prevention were superior in coated silicones, regardless of the type of antibiotic used, compared with the control group (PS). As the study was conducted in an in vitro setting, the findings should be substantiated with in vivo studies on the grounds that different results may be obtained in these settings.
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Affiliation(s)
- Ahmet Salvarci
- Department of Urology, Konya Hospital, Karatay, Konya, Turkey.
| | - Mehmet Koroglu
- Department of Medical Microbiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Berna Erayman
- Department of Medical Microbiology, Konya System Laboratory, Selcuklu, Konya, Turkey
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Høiby N, Bjarnsholt T, Moser C, Bassi G, Coenye T, Donelli G, Hall-Stoodley L, Holá V, Imbert C, Kirketerp-Møller K, Lebeaux D, Oliver A, Ullmann A, Williams C. ESCMID∗ guideline for the diagnosis and treatment of biofilm infections 2014. Clin Microbiol Infect 2015; 21 Suppl 1:S1-25. [DOI: 10.1016/j.cmi.2014.10.024] [Citation(s) in RCA: 451] [Impact Index Per Article: 50.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/14/2014] [Accepted: 10/14/2014] [Indexed: 01/22/2023]
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Leuck AM, Johnson JR, Hunt MA, Dhody K, Kazempour K, Ferrieri P, Kline S. Safety and efficacy of a novel silver-impregnated urinary catheter system for preventing catheter-associated bacteriuria: a pilot randomized clinical trial. Am J Infect Control 2015; 43:260-5. [PMID: 25728152 DOI: 10.1016/j.ajic.2014.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/18/2014] [Accepted: 11/19/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the safety of a novel silver-impregnated Foley catheter system designed to prevent catheter-associated bacteriuria and funguria, assess recruitment feasibility for a future pivotal trial, and preliminarily assess efficacy. METHODS This single-center, randomized controlled trial at a university hospital involved adult neurosurgical patients expected to have a urinary catheter for ≥24 hours. Subjects were randomized to a novel silver-impregnated (test) Foley catheter system or a control system. They were followed for 30 days (or until discharge) while catheterized and for up to 48 hours after catheter removal, with daily bacteriuria testing and assessment for symptoms of infection and catheter intolerance. RESULTS Ninety-five subjects were randomized (intention-to-treat [ITT] population). Of these, 61 subjects (64%) had a catheter for ≥24 hours without perioperative antibiotics beyond 24 hours (evaluable population). In the ITT population, 11 of 95 (12%) subjects had an asymptomatic bacteriuria (ABU) event. Compared with controls, test system recipients had a trend toward longer time to ABU in the ITT population (P = .08, log-rank test) and a longer time to ABU in the evaluable population (P = .03). All 6 ABU events caused by gram-negative bacilli occurred in the control group. CONCLUSION In this pilot randomized trial the test system was well tolerated and seemingly effective in preventing catheter-associated bacteriuria, especially with gram-negative bacilli. A pivotal study is warranted.
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Sussman EM, Casey BJ, Dutta D, Dair BJ. Different cytotoxicity responses to antimicrobial nanosilver coatings when comparing extract-based and direct-contact assays. J Appl Toxicol 2015; 35:631-9. [DOI: 10.1002/jat.3104] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 10/31/2014] [Accepted: 11/21/2014] [Indexed: 01/28/2023]
Affiliation(s)
- Eric M. Sussman
- Division of Biology, Chemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health; US Food and Drug Administration; 10903 New Hampshire Ave. Silver Spring MD 20993 USA
| | - Brendan J. Casey
- Division of Biology, Chemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health; US Food and Drug Administration; 10903 New Hampshire Ave. Silver Spring MD 20993 USA
| | - Debargh Dutta
- Division of Biology, Chemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health; US Food and Drug Administration; 10903 New Hampshire Ave. Silver Spring MD 20993 USA
| | - Benita J. Dair
- Division of Biology, Chemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health; US Food and Drug Administration; 10903 New Hampshire Ave. Silver Spring MD 20993 USA
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Nicolle LE. Catheter-Acquired Urinary Tract Infection: The Once and Future Guidelines. Infect Control Hosp Epidemiol 2015; 31:327-9. [DOI: 10.1086/651092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Crnich CJ, Drinka PJ. Does the Composition of Urinary Catheters Influence Clinical Outcomes and the Results of Research Studies? Infect Control Hosp Epidemiol 2015; 28:102-3. [PMID: 17301937 DOI: 10.1086/510875] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lo E, Nicolle L, Classen D, Arias KM, Podgorny K, Anderson DJ, Burstin H, Calfee DP, Coffin SE, Dubberke ER, Fraser V, Gerding DN, Griffin FA, Gross P, Kaye KS, Klompas M, Marschall J, Mermel LA, Pegues DA, Perl TM, Saint S, Salgado CD, Weinstein RA, Wise R, Yokoe DS. Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals. Infect Control Hosp Epidemiol 2015; 29 Suppl 1:S41-50. [DOI: 10.1086/591066] [Citation(s) in RCA: 237] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Burden of CAUTIsa. Urinary tract infection is the most common hospital-acquired infection; 80% of these infections are attributable to an indwelling urethral catheter.b. Twelve to sixteen percent of hospital inpatients will have a urinary catheter at some time during their hospital stay.c. The daily risk of acquisition of urinary infection varies from 3% to 7% when an indwelling urethral catheter remains in situ.2. Outcomes associated with CAUTIa. Urinary tract infection is the most important adverse outcome of urinary catheter use. Bacteremia and sepsis may occur in a small proportion of infected patients.b. Morbidity attributable to any single episode of catheterization is limited, but the high frequency of catheter use in hospitalized patients means that the cumulative burden of CAUTI is substantial.c. Catheter use is also associated with negative outcomes other than infection, including nonbacterial urethral inflammation, urethral strictures, and mechanical trauma.
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Shunmugaperumal T, Kaur V, Thenrajan RS. Lipid- and Polymer-Based Drug Delivery Carriers for Eradicating Microbial Biofilms Causing Medical Device-Related Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 831:147-89. [DOI: 10.1007/978-3-319-09782-4_10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Evidence-Based Prevent Catheter-Associated Urinary Tract Infections Guidelines and Burn-Injured Patients. J Burn Care Res 2015; 36:e1-6. [DOI: 10.1097/bcr.0000000000000193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Parvizian F, Hosseini S, Hamidi A, Madaeni S, Moghadassi A. Electrochemical characterization of mixed matrix nanocomposite ion exchange membrane modified by ZnO nanoparticles at different electrolyte conditions “pH/concentration”. J Taiwan Inst Chem Eng 2014. [DOI: 10.1016/j.jtice.2014.08.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control 2014; 3:23. [PMID: 25075308 PMCID: PMC4114799 DOI: 10.1186/2047-2994-3-23] [Citation(s) in RCA: 278] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 07/07/2014] [Indexed: 12/12/2022] Open
Abstract
Urinary tract infection attributed to the use of an indwelling urinary catheter is one of the most common infections acquired by patients in health care facilities. As biofilm ultimately develops on all of these devices, the major determinant for development of bacteriuria is duration of catheterization. While the proportion of bacteriuric subjects who develop symptomatic infection is low, the high frequency of use of indwelling urinary catheters means there is a substantial burden attributable to these infections. Catheter-acquired urinary infection is the source for about 20% of episodes of health-care acquired bacteremia in acute care facilities, and over 50% in long term care facilities. The most important interventions to prevent bacteriuria and infection are to limit indwelling catheter use and, when catheter use is necessary, to discontinue the catheter as soon as clinically feasible. Infection control programs in health care facilities must implement and monitor strategies to limit catheter-acquired urinary infection, including surveillance of catheter use, appropriateness of catheter indications, and complications. Ultimately, prevention of these infections will require technical advances in catheter materials which prevent biofilm formation.
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Affiliation(s)
- Lindsay E Nicolle
- Departments of Internal Medicine and Medical Microbiology, University of Manitoba, Health Sciences Centre, Room GG443 – 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada
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31
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Preparation and characterization of nanocomposite heterogeneous cation exchange membranes modified by silver nanoparticles. KOREAN J CHEM ENG 2014. [DOI: 10.1007/s11814-014-0051-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vasilev K, Cook J, Griesser HJ. Antibacterial surfaces for biomedical devices. Expert Rev Med Devices 2014; 6:553-67. [DOI: 10.1586/erd.09.36] [Citation(s) in RCA: 403] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Zarrinkhameh M, Zendehnam A, Hosseini SM. Electrochemical, morphological and antibacterial characterization of PVC based cation exchange membrane modified by zinc oxide nanoparticles. JOURNAL OF POLYMER RESEARCH 2013. [DOI: 10.1007/s10965-013-0283-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kasimanickam RK, Ranjan A, Asokan GV, Kasimanickam VR, Kastelic JP. Prevention and treatment of biofilms by hybrid- and nanotechnologies. Int J Nanomedicine 2013; 8:2809-19. [PMID: 23946652 PMCID: PMC3739460 DOI: 10.2147/ijn.s44100] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Bacteria growing as adherent biofilms are difficult to treat and frequently develop resistance to antimicrobial agents. To counter biofilms, various approaches, including prevention of bacterial surface adherence, application of device applicators, and assimilation of antimicrobials in targeted drug delivery machinery, have been utilized. These methods are also combined to achieve synergistic bacterial killing. This review discusses various multimodal technologies, presents general concepts, and describes therapies relying on the principles of electrical energy, ultrasound, photodynamics, and targeted drug delivery for prevention and treatment of biofilms.
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Affiliation(s)
- Ramanathan K Kasimanickam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.
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Al Mohajer M, Darouiche RO. Prevention and treatment of urinary catheter-associated infections. Curr Infect Dis Rep 2013; 15:116-23. [PMID: 23341244 DOI: 10.1007/s11908-013-0316-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Catheter-associated urinary tract infections (CA-UTIs) are the most common nosocomial infection worldwide. Prolonged catheterization is the most important risk factor for CA-UTIs. As is the case with all device-related infections, the biofilm plays a central role in the pathogenesis of CA-UTIs. The diagnosis is often difficult, given the lack of good diagnostic tests. The most effective way to prevent infection is to limit catheter use and discontinue the catheter when no longer needed. Catheter removal or exchange is also useful in management. This review summarizes and analyzes the results of published studies of CA-UTIs and assesses the role of prevention approaches and management strategies.
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Affiliation(s)
- Mayar Al Mohajer
- Section of Infectious Diseases, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA,
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Politano AD, Campbell KT, Rosenberger LH, Sawyer RG. Use of silver in the prevention and treatment of infections: silver review. Surg Infect (Larchmt) 2013; 14:8-20. [PMID: 23448590 DOI: 10.1089/sur.2011.097] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The use of silver for the treatment of various maladies or to prevent the transmission of infection dates back to at least 4000 b.c.e. Medical applications are documented in the literature throughout the 17th and 18th centuries. The bactericidal activity of silver is well established. Silver nitrate was used topically throughout the 1800 s for the treatment of burns, ulcerations, and infected wounds, and although its use declined after World War II and the advent of antibiotics, Fox revitalized its use in the form of silver sulfadiazine in 1968. METHOD Review of the pertinent English-language literature. RESULTS Since Fox's work, the use of topical silver to reduce bacterial burden and promote healing has been investigated in the setting of chronic wounds and ulcers, post-operative incision dressings, blood and urinary catheter designs, endotracheal tubes, orthopedic devices, vascular prostheses, and the sewing ring of prosthetic heart valves. The beneficial effects of silver in reducing or preventing infection have been seen in the topical treatment of burns and chronic wounds and in its use as a coating for many medical devices. However, silver has been unsuccessful in certain applications, such as the Silzone heart valve. In other settings, such as orthopedic hardware coatings, its benefit remains unproved. CONCLUSION Silver remains a reasonable addition to the armamentarium against infection and has relatively few side effects. However, one should weigh the benefits of silver-containing products against the known side effects and the other options available for the intended purpose when selecting the most appropriate therapy.
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Affiliation(s)
- Amani D Politano
- Department of Surgery, University of Virginia, Charlottesville, Virginia 22908, USA.
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Rafienia M, Zarinmehr B, Poursamar SA, Bonakdar S, Ghavami M, Janmaleki M. Coated urinary catheter by PEG/PVA/gentamicin with drug delivery capability against hospital infection. IRANIAN POLYMER JOURNAL 2012. [DOI: 10.1007/s13726-012-0105-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jahn P, Beutner K, Langer G. Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev 2012; 10:CD004997. [PMID: 23076911 DOI: 10.1002/14651858.cd004997.pub3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prolonged urinary catheterization is common amongst people in long-term care settings and this carries a high risk of developing a catheter-related urinary tract infection and associated complications. A variety of different kinds of urethral catheters are available. Some have been developed specifically to lower the risk of catheter-associated infection, for example antiseptic or antibiotic impregnated catheters. Ease of use, comfort and handling for the caregivers and patients, and cost-effectiveness are also important factors influencing choice. OBJECTIVES The primary objective was to determine which type of indwelling urinary catheter is best to use for long-term bladder drainage in adults. SEARCH METHODS We searched the Cochrane Incontinence Group Specialised Register (last searched 31 March 2011), which includes searches of CENTRAL, MEDLINE and handsearching of journals and conference proceedings, and the reference lists of relevant articles. SELECTION CRITERIA All randomised trials comparing types of indwelling urinary catheters for long-term catheterization in adults. Long-term catheterization was defined as more than 30 days. DATA COLLECTION AND ANALYSIS Data extraction has been undertaken by two review authors working independently and simultaneously. Any disagreement has been resolved by a third review author. The included trial data were handled according to the methods of the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS Three trials were included, involving 102 adults in various settings. Two trials had a parallel group design and one was a randomised cross-over trial.Only two of the six targeted comparisons were assessed by these trials: antiseptic impregnated catheters versus standard catheters (one trial) and one type of standard catheter versus another standard catheter (two trials).The single small cross-over trial was inadequate to assess the value of silver alloy (antiseptic) impregnated catheters. In the two trials comparing different types of standard catheters, estimates of differences were all imprecise because the trials also had small sample sizes; confidence intervals (CI) were too wide to rule out clinically important differences. One trial did suggest, however, that the use of a hydrogel coated latex catheter rather than a silicone catheter may be better tolerated (risk ratio (RR) for need for early removal 0.41, 95% CI 0.22 to 0.77). AUTHORS' CONCLUSIONS The updated search could not reveal any additional evidence. Very few trials have compared different types of catheter for long-term bladder drainage. All trials were small and showed methodological weaknesses. Therefore, the evidence was not sufficient as a reliable basis for practical conclusions. Further, better quality trials are needed to address the current lack of evidence in this clinically important area.
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Affiliation(s)
- Patrick Jahn
- Nursing Research and Development, University Hospital Halle, Halle/ Saale, Germany.
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Kowalczuk D, Ginalska G, Piersiak T, Miazga-Karska M. Prevention of biofilm formation on urinary catheters: Comparison of the sparfloxacin-treated long-term antimicrobial catheters with silver-coated ones. J Biomed Mater Res B Appl Biomater 2012; 100:1874-82. [DOI: 10.1002/jbm.b.32755] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Revised: 05/02/2012] [Accepted: 06/07/2012] [Indexed: 01/17/2023]
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Abstract
Catheter-acquired urinary infection is the most common device-associated healthcare-acquired infection. Although most patients are asymptomatic, symptomatic infection may occur and is associated with increased morbidity and costs. Long-term indwelling catheters are associated with more complex microbiology and greater morbidity than short-term catheters. The most effective way to prevent these infections is to restrict indwelling urinary catheter use to limited indications, and to discontinue use of a catheter as soon as feasible. Alternate means of managing bladder emptying, including external condom catheters for men and intermittent catheterization for patients with neurologic impairment of bladder emptying, should be used when possible.
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Affiliation(s)
- Lindsay E Nicolle
- Department of Internal Medicine and Medical Microbiology, University of Manitoba Health Sciences Centre, Room GG443 - 820, Sherbrook Street, Winnipeg, MB R3A 1R9, Canada.
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Wright MO, Kharasch M, Beaumont JL, Peterson LR, Robicsek A. Reporting catheter-associated urinary tract infections: denominator matters. Infect Control Hosp Epidemiol 2011; 32:635-40. [PMID: 21666391 DOI: 10.1086/660765] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate two different methods of measuring catheter-associated urinary tract infection (CAUTI) rates in the setting of a quality improvement initiative aimed at reducing device utilization. DESIGN, SETTING, AND PATIENTS Comparison of CAUTI measurements in the context of a before-after trial of acute care adult admissions to a multicentered healthcare system. METHODS CAUTIs were identified with an automated surveillance system, and device-days were measured through an electronic health record. Traditional surveillance measures of CAUTI rates per 1,000 device-days (R1) were compared with CAUTI rates per 10,000 patient-days (R2) before (T1) and after (T2) an intervention aimed at reducing catheter utilization. RESULTS The device-utilization ratio declined from 0.36 to 0.28 between T1 and T2 (P = .001), while infection rates were significantly lower when measured by R2 (28.2 vs 23.2, P = .02). When measured by R1, however, infection rates trended upward by 6% (7.79 vs. 8.28, P = .47), and at the nursing unit level, reduction in device utilization was significantly associated with increases in infection rate. CONCLUSIONS The widely accepted practice of using device-days as a method of risk adjustment to calculate device-associated infection rates may mask the impact of a successful quality improvement program and reward programs not actively engaged in reducing device usage.
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Affiliation(s)
- Marc-Oliver Wright
- Department of Infection Control, NorthShore University HealthSystem, Evanston, Illinois 60201, USA.
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Preventing catheter-associated urinary tract infection in the zero-tolerance era. Am J Infect Control 2011; 39:817-22. [PMID: 21704427 DOI: 10.1016/j.ajic.2011.01.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 01/27/2011] [Accepted: 01/30/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Catheter-associated urinary tract infection (CAUTI) is one of the most common health care‒associated infections in the critical care setting. METHODS A quasi-experimental study involving multiple interventions to reduce the incidence of CAUTI was conducted in a medical-surgical intensive care unit (ICU) and in 2 step-down units (SDUs). Between June 2005 and December 2007 (phase 1), we implemented some Centers for Disease Control and Prevention‒recommended evidence-based practices. Between January 2008 and July 2010 (phase 2), we intervened to improve compliance with these practices at the same time that performance monitoring was being done at the bedside, and we implemented the Institute for Healthcare Improvement's bladder bundle for all ICU and SDU patients requiring urinary catheters. RESULTS There was a statistically significant reduction in the rate of CAUTI in the ICU, from 7.6 per 1,000 catheter-days (95% confidence interval [CI], 6.6-8.6) before the intervention to 5.0 per 1,000 catheter-days (95% CI, 4.2-5.8; P < .001) after the intervention. There also was a statistically significant reduction in the rate of CAUTI in the SDUs, from 15.3 per 1,000 catheter-days (95% CI, 13.9-16.6) before the intervention to 12.9 per 1,000 catheter-days (95% CI, 11.6-14.2) after the intervention (P = .014). CONCLUSION Our findings suggest that reducing CAUTI rates in the ICU setting is a complex process that involves multiple performance measures and interventions that can be applied to SDU settings as well.
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Møretrø T, Langsrud S. Effects of materials containing antimicrobial compounds on food hygiene. J Food Prot 2011; 74:1200-11. [PMID: 21740725 DOI: 10.4315/0362-028x.jfp-11-042] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Surfaces with microorganisms may transfer unwanted microorganisms to food through cross-contamination during processing and preparation. A high hygienic status of surfaces that come in contact with food is important in order to reduce the risk of cross-contamination. During the last decade, products containing antimicrobial compounds, such as cutting boards, knives, countertops, kitchen utensils, refrigerators, and conveyor belts, have been introduced to the market, claiming hygienic effects. Such products are often referred to as "treated articles." Here we review various aspects related to treated articles intended for use during preparation and processing of food. Regulatory issues and methods to assess antibacterial effects are covered. Different concepts for treated articles as well as their antibacterial activity are reviewed. The effects of products with antimicrobials on food hygiene and safety are discussed.
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Muzzi-Bjornson L, Macera L. Preventing infection in elders with long-term indwelling urinary catheters. ACTA ACUST UNITED AC 2011; 23:127-34. [PMID: 21355945 DOI: 10.1111/j.1745-7599.2010.00588.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To explore selected factors related to the prevention of catheter-associated urinary tract infections (UTIs) in older adults. DATA SOURCES This review of the literature examined multiple studies regarding UTIs, and UTIs in relation to silver-tipped catheters, cranberry juice/extract, and the bacterial lysate Escherichia coli OM-89. CONCLUSIONS Silver-tipped catheters retarded the development of the biofilm. The use of cranberry juice/extract showed few if any adverse reactions and avoided the problems of induced antibiotic resistance or introduction to supra-infections, such as Clostridium difficile infection. The immune stimulant OM-89 shows promise and may lead to simple and inexpensive preventive measures. Further research is needed to include elders, both men and women, and elders with long-term indwelling catheters. IMPLICATIONS FOR PRACTICE Nurse practitioners (NPs) can assure that basic nursing principles regarding long-term indwelling catheter care are upheld, measures such as proper assessment and insertion, as well as the appropriate use of silver-tipped catheters. NPs can prescribe cranberry juice/extract and incur no apparent harm while possibly reducing infection rate. NPs must be aware of the dangers of administering prophylactic antibiotics that increase resistant microorganisms and can also increase susceptibility to C. difficile infection.
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Fontenoy C, Kamel S. Silver in the medical devices/equipments: Marketing or real clinical interest? ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.phhp.2010.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Desai DG, Liao KS, Cevallos ME, Trautner BW. Silver or nitrofurazone impregnation of urinary catheters has a minimal effect on uropathogen adherence. J Urol 2010; 184:2565-71. [PMID: 21030042 DOI: 10.1016/j.juro.2010.07.036] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE Bacterial adherence to the urinary catheter is an early step in biofilm formation and the pathogenesis of catheter associated urinary tract infection. We studied in vitro the effect of silver or nitrofurazone impregnation of urinary catheters on uropathogen ability to adhere to urinary catheters. MATERIALS AND METHODS We studied commercially available nitrofurazone-silicone, silicone only, silver-silicone-hydrogel, silicone-hydrogel, silver-latex-hydrogel and latex-hydrogel catheters. Catheters were incubated in sterile broth for 0, 3, 5, 7 and 10 days, respectively, before inoculation and overnight incubation with Escherichia coli or Enterococcus faecalis. RESULTS Adherence of E. coli and E. faecalis to nitrofurazone catheters was significantly decreased compared to that of silicone-only catheters when catheters were fresh. The anti-adherence effect of nitrofurazone on E. coli decreased with time but was still significant at 5 days. For E. faecalis the effect of nitrofurazone was lost by 3 days of pre-incubation. E. coli adherence was not significantly decreased on silver impregnated catheters compared to that on control catheters of the same base material. Silver was associated with a significant decrease in E. faecalis adherence to latex-hydrogel catheters but not to silicone-hydrogel catheters. The adherence of each species to silicone catheters with hydrogel was significantly lower than that to silicone-only control catheters. CONCLUSIONS Silver impregnation had little effect on bacterial adherence in our model and nitrofurazone impregnation had a significant effect only for the first 5 days. Our results do not support a role for silver urinary catheters to prevent catheter associated urinary tract infection by decreasing bacterial adherence.
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Affiliation(s)
- Devak G Desai
- Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA
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Rothfeld AF, Stickley A. A program to limit urinary catheter use at an acute care hospital. Am J Infect Control 2010; 38:568-71. [PMID: 20381918 DOI: 10.1016/j.ajic.2009.12.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Revised: 12/04/2009] [Accepted: 12/07/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Urinary catheters are the major cause of catheter-associated urinary tract infections (CAUTIs) and often may be unnecessary. We attempted to reduce the number of CAUTIs by limiting the use of urinary catheters. METHODS The number of catheters and CAUTIs were recorded during a control period of 7 months. A program was implemented limiting these catheters to patients who had urinary tract obstruction, orders for hourly output measurements, breakdown of skin in areas exposed to urine in patients with documented urinary tract infections, or urine- associated skin irritation that was unresponsive to barrier measures. In patients who did not meet these criteria, the physician was asked for a catheter removal order, and superabsorbent pads or diapers were used. Urinary catheter use and CAUTIs were then recorded during a subsequent 5-month intervention period. Nursing personnel were queried regarding their experience after 4 months of the intervention period. RESULTS Urinary catheter use decreased by 42% (P < .01), and the incidence of CAUTIs decreased by 57% (P < .05). There was some improvement in nursing satisfaction. CONCLUSION Limiting urinary catheter use can reduce the incidence of CAUTI with no deterioration in nursing satisfaction.
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Affiliation(s)
- Alan F Rothfeld
- Hollywood Presbyterian Medical Center, Los Angeles, CA, USA.
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Abstract
Reducing the number of catheter-associated urinary tract infections (CAUTI) in the National Health Service (NHS) has the potential for large cost savings. This review identifies factors which affect the incidence rate of CAUTI, as well as the need for further studies investigating cost-effectiveness, particularly in the areas of silver alloy catheters and education.
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Affiliation(s)
- Bevan Michael Scott
- University College London Hospitals NHS Foundation Trust, The Heart Hospital, 16 - 18 Westmoreland Street, London W1G 8PH.
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