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Chadha J, Thakur N, Chhibber S, Harjai K. A comprehensive status update on modification of foley catheter to combat catheter-associated urinary tract infections and microbial biofilms. Crit Rev Microbiol 2024; 50:168-195. [PMID: 36651058 DOI: 10.1080/1040841x.2023.2167593] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/01/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
Present-day healthcare employs several types of invasive devices, including urinary catheters, to improve medical wellness, the clinical outcome of disease, and the quality of patient life. Among urinary catheters, the Foley catheter is most commonly used in patients for bladder drainage and collection of urine. Although such devices are very useful for patients who cannot empty their bladder for various reasons, they also expose patients to catheter-associated urinary tract infections (CAUTIs). Catheter provides an ideal surface for bacterial colonization and biofilm formation, resulting in persistent bacterial infection and severe complications. Hence, rigorous efforts have been made to develop catheters that harbour antimicrobial and anti-fouling properties to resist colonization by bacterial pathogens. In this regard, catheter modification by surface functionalization, impregnation, blending, or coating with antibiotics, bioactive compounds, and nanoformulations have proved to be effective in controlling biofilm formation. This review attempts to illustrate the complications associated with indwelling Foley catheters, primarily focussing on challenges in fighting CAUTI, catheter colonization, and biofilm formation. In this review, we also collate scientific literature on catheter modification using antibiotics, plant bioactive components, bacteriophages, nanoparticles, and studies demonstrating their efficacy through in vitro and in vivo testing.
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Affiliation(s)
- Jatin Chadha
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Navdisha Thakur
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Sanjay Chhibber
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Kusum Harjai
- Department of Microbiology, Panjab University, Chandigarh, India
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Taylor Z, Snow Z, Musallam S, Thomas B, Zeltser I. Is Urethral Catheterization Necessary in Retzius-sparing Robot-assisted Radical Prostatectomy? Urology 2023; 182:133-135. [PMID: 37742850 DOI: 10.1016/j.urology.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE To analyze whether urethral catheter (UC)-free anastomosis during Retzius-sparing radical prostatectomy (RP) results in worsening immediate perioperative and postoperative complications. METHODS We retrospectively reviewed records of patients undergoing robotic-assisted RP with or without indwelling UC placement by a single surgeon between January 2020 and March 2022. Clinical and pathological characteristics were evaluated. An independent t-test was used to compare continuous variables, and Pearson's chi-square test or Fisher exact test was used to compare categorical variables. RESULTS One hundred fifteen patients underwent robotic prostatectomy from January 2020 to June 2022. Sixty-two patients had both a UC for 12 hours postoperatively and a suprapubic catheter for 6days, while in 53 patients a UC was omitted. There was no significant difference noted between the groups regarding age, body mass index, American Society of Anesthesiology score, prostate-specific antigen, stage, node status, or positive margins. There were no significant differences in the rates of anastomotic leak, ileus, or urethral stricture. Patients had a significantly higher pad-free rate in the suprapubic catheter-only group (P = .04) at 3months. There was no difference in average number of pads used or the number using more than 1 pad/day. CONCLUSION Omission of urethral catheterization during Retzius-sparing RP is safe and doesn't result in an increased risk in perioperative or postoperative complications, but rather appears to be associated with a significantly improved 3-month pad-free rate.
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Affiliation(s)
| | - Zachary Snow
- Main Line Health System, MidLantic Urology, Wynnewood, PA
| | - Sami Musallam
- Main Line Health System, MidLantic Urology, Wynnewood, PA
| | - Brian Thomas
- Main Line Health System, MidLantic Urology, Wynnewood, PA
| | - Ilia Zeltser
- Main Line Health System, MidLantic Urology, Wynnewood, PA
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Perdana MA, Wahyuni DD, Yunita R. Characteristics and susceptibility pattern of catheter-associated urinary tract infections (CAUTI) bacteria in Indonesia: A study in a national reference hospital of Sumatra region 2020-2021. NARRA J 2023; 3:e436. [PMID: 38450331 PMCID: PMC10914051 DOI: 10.52225/narra.v3i3.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 12/19/2023] [Indexed: 03/08/2024]
Abstract
Catheter-associated urinary tract infection (CAUTI) is defined as a urinary tract infection associated with catheter placement for more than two consecutive days. Hence, antibiotic resistance in the context of CAUTIs represents a substantial challenge. The aim of this study was to present the characteristics of patients with CAUTI and the susceptibility pattern of CAUTI bacteria in the national reference hospital of the Sumatra region of Indonesia. A cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, Indonesia, from 2020 to 2021, using a total sampling. All CAUTI patients included were on catheterization and diagnosed based on the Centers for Disease Control and Prevention (CDC) guidelines. The patient's urine culture and antibiotic susceptibility test were carried out on the patient's admitted urine sample for further assessment. Identification of bacteria, antibiotic susceptibility test, and the extended-spectrum beta-lactamase (ESBL) test for Escherichia coli and Klebsiella pneumoniae were conducted using the VITEK-2 Compact. A total of 74 CAUTI patients were included in the study, 59.5% were female, 54.1% were 46-65 years old, and a third had cardiovascular disease comorbidities (33.8%). A total of 83 CAUTI-associated bacteria were isolated. The majority were Gram-negative bacteria (74.7%), and the most bacteria isolated was E. coli (31.3%), followed by K. pneumoniae, Enterococcus faecalis, Acinetobacter baumannii, and Enterococcus faecium. The ESBL test was positive mostly in K. pneumoniae (100%) and E. coli (76.9%). CAUTI-associated E. coli was susceptible to tigecycline, meropenem, ertapenem, nitrofurantoin, and gentamicin. The isolated K. pneumoniae was susceptible to tigecycline, meropenem, ertapenem, and amikacin. While E. faecalis showed susceptibility to tigecycline, nitrofurantoin, vancomycin, imipenem, linezolid, ampicillin, piperacillin/tazobactam, amoxicillin/clavulanic acid, ampicillin/sulbactam, and piperacillin.
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Affiliation(s)
| | - Dian D Wahyuni
- Department of Microbiology, Universitas Sumatera Utara, Medan, Indonesia
- Department of Clinical Microbiology, H. Adam Malik General Hospital, Medan, Indonesia
| | - Rina Yunita
- Department of Microbiology, Universitas Sumatera Utara, Medan, Indonesia
- Department of Clinical Microbiology, H. Adam Malik General Hospital, Medan, Indonesia
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Wang F, Wang X, Shi Y, Li L, Zheng Y, Liu H, Zeng M, Jiang F, Wu Z. Development of a risk nomogram predicting urinary tract infection in patients with indwelling urinary catheter after radical surgery for cervical cancer. Prog Urol 2023; 33:492-502. [PMID: 37634960 DOI: 10.1016/j.purol.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/06/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Cervical cancer (CC) patients receiving indwelling catheterization after radical hysterectomy (RH) are vulnerable to urinary tract infection (UTI). However, no model or method is available to predict the risk of UTIs. Therefore, our aim was to develop and verify a risk model to predict UTI for patients receiving indwelling catheterization after radical cervical cancer surgery (ICa-RCCS). METHODS We first collected clinical information of 380 patients receiving ICa-RCCS from January 2020 to December 2021 as a training cohort to develop the risk nomogram. UTI was then evaluated using 19 UTI predictor factors. The least absolute shrinkage and selection operator (LASSO) method was utilized for the extraction characteristics. Multivariable logistic regression analysis was then conducted to create the risk model for UTI prediction. The consistency coefficient and calibration curve were utilized to assess the model's fit accuracy. We performed bootstrapping with 1000 random samples for internal validation of the model, and decision curve analysis (DCA) for clinical application. RESULTS Predictors in the risk nomogram included indwelling catheterization duration, whether it is secondary indwelling catheterization, history of UTIs, age, and history of chemotherapy before surgery. The risk nomogram presented good discrimination and calibration (C-index: 0.810, 95% CI: 0.759-0.861). During interval validation, the model reached a high C-index up to 0.7930. DCA revealed the clinical utility of predictive model for UTI. Clinical benefit was initiated at the decision threshold≥3%. CONCLUSION We developed a novel UTI nomogram incorporating the age, history of chemotherapy before surgery, indwelling catheterization duration, whether it is secondary indwelling catheterization, and history of UTI to predict UTI risk for patients receiving ICa-RCCS. LEVEL OF EVIDENCE B: 3a.
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Affiliation(s)
- Fang Wang
- Chong Qing Three Gorges Medical College, Chongqing, China
| | - Xiaoli Wang
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - YuanXiang Shi
- Department of Gynecology and Obstetrics, Third Military Medical University Southwest Hospital Chongqing, Chongqing, China
| | - Ling Li
- Department of Gynecology and Obstetrics, Third Military Medical University Southwest Hospital Chongqing, Chongqing, China
| | - Yu Zheng
- Department of Gynecology and Obstetrics, Third Military Medical University Southwest Hospital Chongqing, Chongqing, China
| | - Huaying Liu
- Department of Gynecology and Obstetrics, Third Military Medical University Southwest Hospital Chongqing, Chongqing, China
| | - Min Zeng
- Department of Gynecology and Obstetrics, Third Military Medical University Southwest Hospital Chongqing, Chongqing, China
| | - Feng Jiang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fu dan University, Shanghai, China.
| | - Zhimin Wu
- Department of Gynecology and Obstetrics, Third Military Medical University Southwest Hospital Chongqing, Chongqing, China.
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Li Y, Liu Y, Huang Y, Zhang J, Ma Q, Liu X, Chen Q, Yu H, Dong L, Lu G. Development and validation of a user-friendly risk nomogram for the prediction of catheter-associated urinary tract infection in neuro-intensive care patients. Intensive Crit Care Nurs 2023; 74:103329. [PMID: 36192313 DOI: 10.1016/j.iccn.2022.103329] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to develop a user-friendly nomogram model to evaluate the risk of catheter-associated urinary tract infections in neuro-critically ill patients. METHODS A retrospective cohort analysis was conducted on 537 patients with indwelling catheters admitted to the neuro-intensive care unit. Patients' general information, laboratory examination findings, and clinical characteristics were collected. Multivariate regression analysis was applied to develop the nomogram for the prediction of catheter-associated urinary tract infections in this group of patients. The discriminative capacity, calibration ability, and clinical effectiveness of the nomogram were evaluated. RESULTS The occurrence of catheter-associated urinary tract infections was 3.91 % and Escherichia coli was the major causative pathogen. Multivariate regression analysis showed that age ≥ 60 years (odds ratio: 35.2, 95 % confidence interval: 2.3-550.8), epilepsy (39.3, 5.1-301.4), a length of neuro-intensive care stay > 30 days (272.2, 8.3-8963.5), and low albumin levels (<35 g/L) (12.1, 2.1-69.9) were independent risk factors associated with catheter-associated urinary tract infection in neuro-intensive care patients. The nomogram demonstrated good calibration and discrimination in both the training and the validation sets. The model exhibited good clinical use since the decision curve analysis covered a large threshold probability. CONCLUSIONS We developed a user-friendly nomogram to predict catheter-associated urinary tract ibfection in neuro-intensive care patients. The nomogram incorporated clinical variables collected on admission (age, admission diagnosis, and albumin levels) and the length of stay and enabled the effective prediction of the likelihood of catheter-associated urinary tract infections.
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Affiliation(s)
- Yuping Li
- Neuro Intensive Care Unit, Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, China; Clinical Medical College of Yangzhou University, Yangzhou 225009, China
| | - Yuting Liu
- School of Nursing, Yangzhou University, Yangzhou 225009, China
| | - Yujia Huang
- Neuro Intensive Care Unit, Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, China; Clinical Medical College of Yangzhou University, Yangzhou 225009, China
| | - Jingyue Zhang
- School of Nursing, Yangzhou University, Yangzhou 225009, China
| | - Qiang Ma
- Neuro Intensive Care Unit, Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, China
| | - Xiaoguang Liu
- Neuro Intensive Care Unit, Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, China
| | - Qi Chen
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou 225009, China
| | - Hailong Yu
- Neuro Intensive Care Unit, Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, China
| | - Lun Dong
- Neuro Intensive Care Unit, Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou 225001, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou 225009, China.
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Amer WH, Abd Elghafar MS, Abd-El-monsef MME. Comparison of Methods for Detecting Methicillin-Resistant Coagulase-Negative Staphylococci in Device-Associated Infections. ANTI-INFECTIVE AGENTS 2022; 20. [DOI: 10.2174/2211352519666210715150507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/07/2021] [Accepted: 06/22/2021] [Indexed: 09/01/2023]
Abstract
Background:
Coagulase-negative Staphylococci (CoNS) is one of the major causes of infections
in hospitals. Methicillin resistance has greatly increased in different CoNS species in previous
years. Here, we evaluated the performance of four phenotypic tests for detecting mecA-mediated
methicillin resistance rate in CoNS isolated from different device-associated infections in Tanta
University Hospitals, Egypt.
Methodology:
One hundred and fifteen CoNS isolates were examined for mecA-mediated methicillin
resistance using polymerase chain reaction (PCR) as the standard gold test. Susceptibility to
methicillin was investigated using VITEK 2 assay, oxacillin broth microdilution, and cefoxitin disc
diffusion tests.
Results:
Of all isolates, 98.3% were mecA-positive. The sensitivities of the different methods examined
were as follows: 100% for the VITEK cefoxitin test, 97.4% for the VITEK oxacillin test,
93.8% for the oxacillin broth microdilution, and 82.3% for the cefoxitin disc diffusion test. The test
specificity could not be accurately determined because of the small number of mecA-negative isolates
(n = 2).
Conclusion:
The rate of methicillin resistance reached 98.3% among CoNS isolates. Our results demonstrate
that the VITEK 2 assay is rapid and has high sensitivity compared to other phenotypic
methods for detecting methicillin resistance among different species of CoNS. Therefore, we recommend
the dual measurement of both cefoxitin and oxacillin susceptibilities using the VITEK 2
assay for best results.
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Affiliation(s)
- Wesam Hatem Amer
- Medical Microbiology and Immunology, Faculty of Medicine, Tanta University,Egypt
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Rokhani R, Suharjono, Kuntaman, Akram M. Analysis of prophylactic antibiotic use and risk factor of postoperative infection in urological surgery patients. J Basic Clin Physiol Pharmacol 2021; 32:789-794. [PMID: 34214331 DOI: 10.1515/jbcpp-2021-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/12/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The widespread use of inappropriate prophylactic antibiotics in urological surgery patients can increase the risk of resistance and development of postoperative infection. This study was aimed to analyze the quality of prophylactic antibiotics use and identify the risk factor of postoperative nosocomial infection in urological surgery patients. METHODS Observational prospective data were obtained from patients' medical records. Data were the pattern of prophylactic antibiotic use in surgical patients' urology in Dr. H. Slamet Martodirdjo Hospital, Pamekasan, for the period of April-June 2020. Inclusion criteria included patients hospitalized with urological surgery and received prophylactic antibiotics before surgery. Exclusion criteria consisted of medical records that were incomplete, and the patient disagreed to participate in the research. Analysis qualitative antibiotic prophylactic used the Gyssens method and risk factor used Chi square. RESULTS Seventeen patients were not administered for antibiotic prophylactic and nine patients with skin incision were observed to determine the incidence of surgical site infection (SSI) and 55 patients with urethral incision were observed to determine the incidence of urinary tract infection (UTI) postoperative. There was no incidence of SSI and there were three incidences of UTI. The qualitative analysis of the Gyssens method showed that category-0 was of 51 (79.7%) and category-I was of 13 (20.31%). CONCLUSIONS The quality of the use of prophylactic antibiotics with the Gyssens method shows that there is an appropriate category (category-0) and a few are in category-I (inappropriate administration time) and no incidence of surgical wound infection.
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Affiliation(s)
- Ratri Rokhani
- Clinical Pharmacy, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Suharjono
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
| | - Kuntaman
- Department of Clinical Microbiology, School of Medicine-Dr. Soetomo Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mohammad Akram
- Surgical Department, Slamet Martodirdjo Hospital, Pamekasan, East Java, Indonesia
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Sánchez-Ortiz M, García-Simón E, Mateo-Abad A, Soguero-Pérez MDM, Castro-Vilela ME. [Bladder catheterization in the hospitalized elderly people]. Rev Esp Geriatr Gerontol 2021; 56:96-99. [PMID: 33303258 DOI: 10.1016/j.regg.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/27/2020] [Accepted: 09/25/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To determine the prevalence of patients with bladder catheterization in a geriatrics service and to analyze the factors associated with the use of urinary catheterization in hospitalized elderly people. MATERIAL AND METHOD This descriptive and retrospective study (January to December 2019) included all the patients admitted to a geriatric service, with bladder catheterization during their hospital admission. Sociodemographic and clinical data were collected. RESULTS In 2019, 10.20% of the patients admitted required urinary catheters. Most of these patients were males (60.6%), with an average age of 86.5 years (SD: 8.65). 43.4% of the urinary catheters that were placed temporarily were indicated in the geriatric unit, 28.9% in another medical service and 26.3% in the emergency department. The median of days with a urinary catheter was 7.5 days. The most common reason to indicate a urinary catheter was acute urinary retention (AUR) (67.7%). At hospital discharge, 22.3% of the patients needed to continue with a urinary catheter at home, without needing it prior to admission. CONCLUSIONS In our study, a high percentage of bladder catheterization was needed during the hospitalization, the most common cause being AUR. The average use (in days) of urinary catheters is high, with the consequent risk of nosocomial urinary tract infections. It is necessary to improve the prescribing habits of urinary catheterization and its early withdrawal through specific educational efforts and avoiding their inappropriate use.
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Affiliation(s)
| | | | - Ana Mateo-Abad
- Servicio de Geriatría, Hospital San José, Teruel, España
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