Prevention Of Urinary Tract Infections Research Articles

The use of D-mannose in the prevention of recurrent urinary tract infections

The use of D-mannose in the prevention of recurrent urinary tract infections

The role of uromodulin in cardiovascular disease: a review

Uromodulin, also referred to as Tamm Horsfall protein (THP), is a renal protein exclusively synthesized by the kidneys and represents the predominant urinary protein under normal physiological conditions. It assumes a pivotal role within the renal system, contributing not only to ion transport and immune modulation but also serving as a critical factor in the prevention of urinary tract infections and kidney stone formation. Emerging evidence indicates that uromodulin may serve as a potential biomarker extending beyond renal function. Recent clinical investigations and Mendelian randomization studies have unveiled a discernible association between urinary regulatory protein levels and cardiovascular events and mortality. This review primarily delineates the intricate relationship between uromodulin and cardiovascular disease, elucidates its predictive utility as a novel biomarker for cardiovascular events, and delves into its involvement in various physiological and pathophysiological facets of the cardiovascular system, incorporating recent advancements in corresponding genetics.

The role of uromodulin in cardiovascular disease: a review

Uromodulin, also referred to as Tamm Horsfall protein (THP), is a renal protein exclusively synthesized by the kidneys and represents the predominant urinary protein under normal physiological conditions. It assumes a pivotal role within the renal system, contributing not only to ion transport and immune modulation but also serving as a critical factor in the prevention of urinary tract infections and kidney stone formation. Emerging evidence indicates that uromodulin may serve as a potential biomarker extending beyond renal function. Recent clinical investigations and Mendelian randomization studies have unveiled a discernible association between urinary regulatory protein levels and cardiovascular events and mortality. This review primarily delineates the intricate relationship between uromodulin and cardiovascular disease, elucidates its predictive utility as a novel biomarker for cardiovascular events, and delves into its involvement in various physiological and pathophysiological facets of the cardiovascular system, incorporating recent advancements in corresponding genetics.

The Effect of Nitrofurantoin on Tonic Seizures Induced by MES in Male Mice

Antibiotics are medicines that fight against bacterial infections and are usually considered safe drugs. However, they can simultaneously cause several adverse reactions. Nitrofurantoin, which is mainly administered for treatment and prevention of urinary tract infections, causes seizure reportedly. Therefore, further research is required to be conducted to simulate the case report situations and examine whether nitrofurantoin is the main factor leading to seizures. To do this, NMRI male mice (20-30 gr) were chosen and classified into different groups in both acute and chronic phases. Each phase contained mice treated with nitrofurantoin, phenytoin and the combination of both drugs as well as untreated control group. An Electroshock device was used to induce seizure in mice and then the effect of nitrofurantoin and phenytoin was examined in acute and chronic phases. Seizure induction in mice was examined 30 minutes and one week after injection in acute and chronic phases, respectively. Results indicated that THE (Tonic Hind-limb Extension) duration was different among the studied groups. Nitrofurantoin-injected mice were revealed to have a higher THE duration in comparison with control group, while phenytoin-injected group showed a lower THE duration. Furthermore, administration of nitrofurantoin and phenytoin combination reduced THE duration in both acute and chronic phases. Our conclusion is that nitrofurantoin can possess convulsive effects and cause seizure as a side effect.

The Diagnosis, Treatment, and Prevention of Recurrent Urinary Tract Infection.

Urinary tract infection has a one-year prevalence of 11% in women and ranges among the most common reasons for consulting a primary care physician and for receiving a prescription for antibiotics. In the case of recurrent urinary tract infection (rUTI), there are questions about the further work-up, treatment, and preventive measures. The systematic literature search performed for the update of the German clinical practice guideline on uncomplicated urinary tract infection (043-044) (up to February 2022) was supplemented with a selective search for clinical trials (up to August 2023). Urine culture and ultrasonography are reasonable steps in the diagnostic evaluation of rUTI. Further invasive testing is suggested for men but is not routinely indicated for women. Antibiotics are among the most effective preventive measures (risk ratio [RR] 0.15, 95% confidence interval [0.1; 0.3]) but carry a high risk of side effects. Non-antibiotic preparations such as cranberry juice (RR 0.74 [0.5; 0.99]), mannose (RR 0.23 [0.14; 0.37]), and vaginal estrogen (RR, 0.42 [0.30; 0.59]) can also reduce the infection rate, with a low risk of side effects. Increased daily fluid intake has been shown to lower infection rates in the short term (odds ratio [OR] 0.13 [0.07; 0.25]); the use of hygienically advisable wiping techniques after passing stool or urine has been little studied but can be implemented with no risk. rUTI poses a challenge for the treating physician. The measures to be taken must be considered on an individual basis. Vulnerable groups, such as older patients, need special attention.

Shuangdong Capsule Activates Insulin Signal Pathway to Improve Urinary Tract Infection in Diabetic Rats.

Diabetes and Urinary Tract Infections (UTIs) are both common and serious health problems. Shuangdong capsule, a Chinese patent medicine, has been used to treat these conditions. This study assesses its efficacy and mechanism in treating diabetes combined with UTIs. We induced diabetes in rats using streptozotocin and UTIs with Escherichia coli, dividing the rats into five groups: control, model, levofloxacin, Shuangdong capsule, and levofloxacin + Shuangdong capsule. After two weeks, we measured blood glucose, insulin, infection indicators, and bladder histology. We also detected the expression of insulin receptor substrate 1 (IRS1)-phosphoinositide 3-kinase (PI3K)-protein kinase B (Akt)-C-X-C motif chemokine ligand 2 (CXCL2) signaling pathway by Western Blot and the myeloperoxidase (MPO) levels by Enzyme-Linked Immunosorbent Assay (ELISA). Additionally, we conducted a Mendelian randomization study using genetic variants of the insulin receptor to assess its causal effect on UTI risk. Shuangdong capsule improved bladder pathology and infection indicators, similar to levofloxacin. It did not affect blood glucose or insulin levels. Moreover, it reversed the suppression of the IRS1-PI3K-Akt-CXCL2 pathway and MPO levels caused by UTI in diabetic rats. The Mendelian randomization study showed that increased insulin receptor expression reduced UTI risk, which was consistent with the results of the animal experiments. The Shuangdong capsule was effective in treating diabetes with UTIs. It may function by activating the IRS1-PI3K-Akt signaling pathway, thereby increasing CXCL2 and MPO levels, enhancing innate immunity, and promoting bacterial clearance. The Mendelian randomization study provided further evidence supporting the causal role of the insulin receptor in UTI prevention.

Differences in P-Type and Type 1 Uropathogenic Escherichia coli Urinary Anti-Adhesion Activity of Cranberry Fruit Juice Dry Extract Product and D-Mannose Dietary Supplement

Background Urinary tract infection (UTI) prevention benefits of cranberry intake are clinically validated, especially for women and children. To ensure the benefits of cranberry dietary supplement products, the anti-adhesion activity (AAA) against uropathogenic bacteria is routinely used in in vitro bioassays to determine the activity in whole product formulations, isolated compounds, and ex vivo bioassays to assess urinary activity following intake. D-mannose is another dietary supplement taken for UTI prevention, based on the anti-adhesion mechanism. Objective Compare the relative AAA of cranberry and D-mannose dietary supplements against the most important bacterial types contributing to the pathogenesis of UTI, and consider how certain components potentially induce in vivo activity. Methods The current study used a crossover design to determine ex vivo AAA against both P- and Type 1-fimbriated uropathogenic Escherichia coli of either D-mannose or a cranberry fruit juice dry extract product containing 36 mg of soluble proanthocyanidins (PACs), using bioassays that measure urinary activity following consumption. AAA of extracted cranberry compound fractions and D-mannose were compared in vitro and potential induction mechanisms of urinary AAA explored. Results The cranberry dietary supplement exhibited both P-type and Type 1 in vitro and ex vivo AAA, while D-mannose only prevented Type 1 adhesion. Cranberry also demonstrated more robust and consistent ex vivo urinary AAA than D-mannose over each 1-week study period at different urine collection time points. The means by which the compounds with in vitro activity in each supplement product could potentially induce the AAA in urines was discussed relative to the data. Conclusions Results of the current study provide consumers and healthcare professionals with additional details on the compounds and mechanisms involved in the positive, broad-spectrum AAA of cranberry against both E. coli bacterial types most important in UTIs and uncovers limitations on AAA and effectiveness of D-mannose compared to cranberry.

Cranberries and the Prevention and Treatment of Urinary Tract Infections

Clinical Question: Can urinary tract infections be treated effectively with cranberry juice?

Piezoelectrically-activated antibacterial catheter for prevention of urinary tract infections in an on-demand manner

Catheter-associated urinary tract infection (CAUTI) is a common clinical problem, especially during long-term catheterization, causing additional pain to patients. The development of novel antimicrobial coatings is needed to prolong the service life of catheters and reduce the incidence of CAUTIs. Herein, we designed an antimicrobial catheter coated with a piezoelectric zinc oxide nanoparticles (ZnO NPs)-incorporated polyvinylidene difluoride-hexafluoropropylene (ZnO-PVDF-HFP) membrane. ZnO-PVDF-HFP could be stably coated onto silicone catheters simply by a one-step solution film-forming method, very convenient for industrial production. In vitro, it was demonstrated that ZnO-PVDF-HFP coating could significantly inhibit bacterial growth and the formation of bacterial biofilm under ultrasound-mediated mechanical stimulation even after 4 weeks. Importantly, the on and off of antimicrobial activity as well as the strenth of antibacterial property could be controlled in an adaptive manner via ultrasound. In a rabbit model, the ZnO-PVDF-HFP-coated catheter significantly reduced the incidence CAUTIs compared with clinically-commonly used catheters under assistance of ultrasonication, and no side effect was detected. Collectively, the study provided a novel antibacterial catheter to prevent the occurrence of CAUTIs, whose antibacterial activity could be controlled in on-demand manner, adaptive to infection situation and promising in clinical application.

Secondary Analysis of Interstitial Cystitis/Bladder Pain Syndrome Patients Enrolled in a Recurrent Urinary Tract Infection Prevention Study Provides a Novel Paradigm for Etio-Pathogenesis and Practical Management of This Infection Phenotype.

A subset of interstitial cystitis/bladder pain syndrome (IC/BPS) patients experience recurrent urinary tract infection (rUTI) associated with symptom flares. Recurrent UTI subjects with associated IC/BPS were enrolled in the first North American early clinical experience trial evaluating a new sublingual UTI preventative vaccine, MV140. It has been shown that women with rUTI develop an imbalance in the T helper 1 and 2 (Th2 over-expression) in the bladder mucosa. Our hypothesis-generating secondary analysis will suggest that this infection subcategory of IC/BPS patients develop a similar imbalance of Th1-Th2 response type to bacteria present in their urinary microbiome, leading to a bladder hypersensitivity that responds to mucosal immune modulation. Female participants with ≥3 documented UTI/year underwent a 3-month vaccination treatment period with a 9-month efficacy period after completion of vaccine treatment (total 12 months). There were no exclusion criteria for subjects in relation to baseline urinary symptoms and/or discomfort/pain. Primary outcome was no UTI following vaccination. Secondary outcomes included change in UTI incidence, overall patient-reported subjective global assessment (SGA responder defined as moderately or markedly improved on 7-point scale), and safety. Sixteen subjects with IC/BPS-related symptoms and rUTI (mean age 47; range 23-74 years; mean number of UTI episodes in previous year 6.1 +/- 4.2) were eligible to be included in the Health Canada-approved MV140 vaccine study for prevention of rUTI. All subjects completed the 3-month vaccination period. One subject was lost to follow-up after their 6-month visit. Six subjects were UTI-free, while all 16 subjects had a reduction in UTI episodes compared to the year pre-vaccination. The total post-vaccination reduction in UTI episodes compared to pre-vaccination was 80% (0.1 UTI/subject/month from 0.5 UTI/subject/month, respectively). At 12 months, 13 subjects (81%) were SGA responders (moderately or markedly improved), and the responders reported a reduction in IC/BPS symptoms, with 8 subjects reporting significant or almost complete resolution of their specific long-term bladder discomfort/pain and bothersome urinary frequency or urgency. Four subjects reported mild and self-limited adverse events during vaccination period, but none were related to MV140 vaccine. Sublingual MV140 vaccine in IC/BPS patients with rUTI not only achieved UTI-free or reduced UTI incidence status but also, after approximately 9 months post vaccination, resolution of patients' long-term treatment-refractory IC/BPS symptoms. This suggests some cases of IC/BPS may be etiologically based on Th2-driven hypersensitivity to bacteria within or entering the urinary microbiome that responds to a vaccine whose mechanism of action is to normalize or balance the bladder Th1/Th2 mucosal immune system.

Current and emerging strategies to curb antibiotic-resistant urinary tract infections.

Rising rates of antibiotic resistance in uropathogenic bacteria compromise patient outcomes and prolong hospital stays. Consequently, new strategies are needed to prevent and control the spread of antibiotic resistance in uropathogenic bacteria. Over the past two decades, sizeable clinical efforts and research advances have changed urinary tract infection (UTI) treatment and prevention strategies to conserve antibiotic use. The emergence of antimicrobial stewardship, policies from national societies, and the development of new antimicrobials have shaped modern UTI practices. Future UTI management practices could be driven by the evolution of antimicrobial stewardship, improved and readily available diagnostics, and an improved understanding of how the microbiome affects UTI. Forthcoming UTI treatment and prevention strategies could employ novel bactericidal compounds, combinations of new and classic antimicrobials that enhance bacterial killing, medications that prevent bacterial attachment to uroepithelial cells, repurposing drugs, and vaccines to curtail the rising rates of antibiotic resistance in uropathogenic bacteria and improve outcomes in people with UTI.

To Assess Knowledge and Practice among Nurses Regarding Prevention of Catheter-Associated Urinary Tract Infection

Background:Catheter-associated urinary tract infections (CAUTIs) are a common healthcare-associated infection among patients with indwelling urinary catheters. The role of nursing staff is crucial in preventing these infections through proper knowledge and practices. Objective:To assess the knowledge and practices among nurses regarding the prevention of catheter-associated urinary tract infections in a tertiary hospital in Lahore, Pakistan. Methods:This descriptive cross-sectional study was conducted among 164 nurses from various departments, including medical, surgical, and gynecological units. Nurses with more than one year of experience were included, while student nurses and head nurses not directly involved in patient care were excluded. Data were collected through a survey assessing knowledge and practices related to CAUTIs. The sample size was determined using Solvin's formula. Ethical approval was obtained, and participants gave informed consent. The data were analyzed using IBM SPSS Statistics Version 25.0 for descriptive statistics, including frequencies and percentages. Results:The majority of participants were female (85.4%), and most were aged between 31 and 35 years (50%). About 51.2% of the nurses had 6 to 10 years of experience, and 46.2% had received prior information or training on catheter-related urinary tract infections. The majority of participants (92.8%) knew that CAUTIs result from prolonged catheter use, and 95.7% were aware that aseptic technique with sterile equipment is crucial for catheter insertion. However, only 67.4% used a sterile technique for insertion, and 79.3% did not perform daily catheter care. The overall knowledge level was low for 29.3% of participants, moderate for 43.5%, and high for 16.3%, while the practice level was poor for 52.2% and good for 37%. Conclusion:Nurses demonstrated moderate knowledge but poor practices in preventing catheter-related urinary tract infections, indicating the need for targeted interventions and educational programs to bridge the gap and enhance patient care.

Urinary tract infections in pregnant women

Urinary tract infections (UTIs) are the most common pathology among pregnant women and are associated with maternal and foetal complications. According to some authors, the incidence of UTIs increased 4 times in the last decades of the 20th century. Escherichia coli is the most predominant pathogen causing up to 80% of UTIs, Klebsiella is ranked second causing up to 8% of UTIs, and pathogenic staphylococcus and mixed microflora are ranked third. To diagnose UTIs, laboratory, physical and radiological diagnostic methods are applied. According to most authors, informative value yielded by lab tests is more than 90%. The prescription of antibacterial chemotherapy should be based on the results of urine culture and sensitivity testing. Before the test results are obtained, broad-spectrum antibacterial drugs (ABs) are usually prescribed. The most commonly used therapy regimens are third-generation cephalosporins with dose adjustments, as may be necessary, after sensitivity is determined. Some authors recommend to continue treatment with urinary tract antiseptics after AB therapy is completed. The impaired urine output should be restored before AB therapy is prescribed. This review presents an analysis of the literature that was found in the databases PubMed (the National Library of Medicine), The Cochrane Library, as well as in the research citation databases (Scopus, Web of Science). The etiological factors and features of the pathogenesis of UTIs in pregnant women, as well as diagnostic standards, are described. The current guidelines for the treatment and prevention of UTIs in pregnant women are considered and antibacterial therapy regimens with current dosage forms are presented. The benefits of using cefixime dispersible forms are described in detail.

Analysis of Risk Factors for Urinary Tract Infection after Lumbar Interbody Fusion.

Urinary tract infection (UTI) is a common postoperative complication, so exploring its risk factors is helpful to provide a basis for clinical prevention. This study aims to analyse the risk factors for UTI after lumbar interbody fusion (LIF). A single-centre retrospective study was conducted on the clinical data of 358 patients treated with LIF from April 2020 to April 2023. In accordance with the results of postoperative urine culture, the patients were divided into UTI group (n = 19, those with UTI after LIF) and control group (n = 332, those without UTI after LIF). Binary logistic regression analysis was carried out through collecting the medical records of the two groups to probe into the risk factors for UTI after LIF. After seven patients were excluded, the remaining 351 patients were included in the analysis. In this study, 19 patients (5.41%) developed postoperative UTI, whereas 332 patients (94.59%) had no UTI. Regression analysis results showed drinking (odds ratio (OR) = 16.193, 95% confidence interval (CI): 1.017-257.860) and high preoperative C-reactive protein (CRP) level (OR = 3.237, 95% CI: 1.213-8.636) as risk factors for UTI after LIF. A high professional title of main surgeon (OR = 0.095, 95% CI: 0.010-0.932) and preoperative red blood cell (RBC) count (OR = 0.001, 95% CI: 0.000-0.198) were protective factors for UTI after LIF (p < 0.05). This study advocated strengthening the prevention and treatment of UTI in patients who had drinking history, high preoperative CRP level and low preoperative RBC count, and received LIF based on the study results. Attention should be paid to the training of physicians with low professional title.

Urinary Tract Infections in Children.

Despite the American Academy of Pediatrics guidelines for the evaluation, treatment, and management of urinary tract infections (UTIs), UTI diagnosis and management remains challenging for clinicians. Challenges with acute UTI management stem from vague presenting signs and symptoms, diagnostic uncertainty, limitations in laboratory testing, and selecting appropriate antibiotic therapy in an era with increasing rates of antibiotic-resistant uropathogens. Recurrent UTI management remains difficult due to an incomplete understanding of the factors contributing to UTI, when to assess a child with repeated infections for kidney and urinary tract anomalies, and limited prevention strategies. To help reduce these uncertainties, this review provides a comprehensive overview of UTI epidemiology, risk factors, diagnosis, treatment, and prevention strategies that may help pediatricians overcome the challenges associated with acute and recurrent UTI management.

When Infections Are Found: A Qualitative Study Characterizing Best Management Practices for Central Line-Associated Bloodstream Infection and Catheter-Associated Urinary Tract Infection Performance Monitoring and Feedback.

Healthcare-associated infections (HAIs) remain a significant patient safety problem that can lead to illness and death, despite the implementation of clinical bundles to prevent HAIs. Management practices can support HAI prevention, but their role in HAI performance monitoring and feedback is not well understood. To address this knowledge gap, we previously conducted semi-structured interviews with staff at 18 hospitals to examine the role of management practices around the prevention of central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). Interview transcripts were analyzed to identify themes related to HAI performance monitoring and feedback. The current analysis focuses on 10 higher-performing hospitals that were successful in preventing CLABSIs and CAUTIs. These institutions had robust practices including timely event analysis, leadership engagement, and multidisciplinary participation in HAI reviews. Across these sites, we found common goals including investigating HAIs without blame and identifying opportunities for improvement. Management practices such as timely analysis of HAIs, collaboration between facility leadership and multidisciplinary team members, and a focus on identifying the failure of a procedure or protocol, rather than the failure of staff members, are all approaches that can support infection prevention efforts. These management practices may be especially important as hospitals attempt to address increases in CLABSI and CAUTI rates that may have occurred during the coronavirus pandemic.

Nanozyme-reinforced hydrogel coatings for prevention of catheter-associated urinary tract infection

Catheter-associated urinary tract infection (CAUTI) presents a significant clinical challenge globally, given its elevated infection risk, substantial treatment costs, and the emergence of drug-resistant strains. Despite extensive clinical endeavors, such as the development of antimicrobial catheters and prophylactic approaches, addressing CAUTI remains intricate due to the microenvironment complexity, sustained antimicrobial requirements, the necessity for antibiofilm strategies, and concurrent inflammatory responses. Herein, an innovative solution involving an ultra-low loading gold/iron co-doped silver peroxide nanozyme-reinforced hydrogel coating is introduced for the prevention of CAUTI. The silicone urinary catheter is modified through a straightforward and cost-effective chemical process to impart multienzyme-like activities, including peroxidase- and catalase-like functions, which exhibit antimicrobial, antibiofilm, and anti-inflammatory properties tailored to the unique urinary tract microenvironment. Additionally, the hydrogel coating enhances the hydrophilicity of catheter, thereby improving patient comfort. In vitro and in vivo experiments substantiate the efficacy of the modified catheter in inhibiting bacterial colonization, curtailing biofilm formation, enhancing oxygen supply, and modulating immune responses. This study not only proposes an alternative strategy for prevention and treatment of CAUTI but also provides a promising therapy that addresses multifaceted therapeutic needs through the utilization of multienzyme-like nanozymes.

Prediction of Postoperative Urinary Tract Infection Following Benign Gynecologic Surgery.

The objective was to develop a prediction model for urinary tract infection (UTI) after pelvic surgery. We utilized data from three tertiary care centers of women undergoing pelvic surgery. The primary outcome was a UTI within 8weeks of surgery. Additional variables collected included procedural data, severity of prolapse, use of mesh, anti-incontinence surgery, EBL, diabetes, steroid use, estrogen use, postoperative catheter use, PVR, history of recurrent UTI, operative time, comorbidities, and postoperative morbidity including venous thromboembolism, surgical site infection. Two datasets were used for internal validation, whereas a third dataset was used for external validation. Algorithms that tested included the following: multivariable logistic regression, decision trees (DTs), naive Bayes (NB), random forest (RF), gradient boosting (GB), and multilayer perceptron (MP). For the training dataset, containing both University of British Columbia and Mayo Clinic Rochester data, there were 1,657 patients, with 172 (10.4%) UTIs; whereas for the University of Calgary external validation data, there were a total of 392 patients with a UTI rate of 16.1% (n = 63). All models performed well; however, the GB, DT, and RF models all had an area under the curve (AUC) > 0.97. With external validation the model retained high discriminatory ability, DT: AUC = 0.88, RF: AUC = 0.88, and GB: AUC = 0.90. A model with high discriminatory ability can predict UTI within 8weeks of pelvic surgery. Future studies should focus on prospective validation and application of randomized trial models to test the utility of this model in the prevention of postoperative UTI.

To Assess the Effectiveness of Structured Teaching Program on Knowledge Regarding the Prevention of Urinary Tract Infection among Adolescent Girls

Urinary Tract Infection (UTI) is common affecting throughout their life. It occurs in all populations from neonates to geriatric patients but it has a particular impact on females of all ages especially during the adolescent period. UTIs are much more common in adults than in children but about 1-2% of children do get UTIs. A short urethra in women is mostly responsible for the high incidence of UTI among them. This study examines the effectiveness of structured teaching programs in the prevention of UTI among adolescent girls. The objectives of the study were, to identify the knowledge regarding the prevention of UTI among adolescent girls, to provide &amp; evaluate the effectiveness of structured teaching programs on the prevention of UTI among adolescent girls &amp; to determine the association between knowledge regarding the prevention of UTI among adolescent girls and selected demographic variables. This study was conducted at Nehru College of Nursing Panyoor post-Vaniyamkulam. The research design adopted for the study was a pre-experimental one-group pre-test post-test design. A sample of 40 students in the age group of thirteen to nineteen years was selected conveniently for the study. The data was collected by using a socio-demographic profile and a structured knowledge questionnaire regarding UTI following which, a planned teaching program on “prevention of UTI” was administered to adolescent girls on the second day. In the pretest score, about of sample 15% had good knowledge in pretest, 75% had average knowledge, and 10% had poor knowledge. After the teaching program (posttest) 87.5% had good knowledge and 12.5% had average knowledge. The previous episodes of UTI and previous knowledge regarding UTI are significant. As it is a problem focused on adolescent girls might support reducing the occurrence of UTIs.

Implementatie van de Infectierisicoscan in een ziekenhuisnetwerk door het Hospital Outbreak Support Team

Implementation of the Infection Risk Scan in a hospital network by the Hospital Outbreak Support Team The Infection Risk Scan (IRIS) assesses the quality of infection prevention and control (IPC) and antimicrobial stewardship (AMS) in a hospital ward by the standardized measurement of a broad range of quality indicators. IRIS was implemented in the geriatric wards of the 4 hospitals of the Plexus healthcare network ‘Oost-Vlaams-Brabant’ (Belgium). The goal was to compare the IPC and AMS policies of the hospitals in order to define common improvement strategies within the Hospital Outbreak Support Team (HOST), a federal project concerning IPC and AMS. In the first part of IRIS, the risk profile of the patient population is determined by a point prevalence measurement of 4 variables. In the second part, the improvement plot is created based on the measurement of 7 quality indicators. Improvement actions can be deduced from quality indicators with higher improvement potentials. The risk profiles of the 4 hospitals were highly comparable and the improvement plots showed an intermediate to high improvement potential for the use of AMT and hand hygiene compliance. There were important differences in the appropriate use of transurethral and intravascular catheters, with 2 hospitals having a low and 2 hospitals having a high improvement potential. IRIS was a useful tool in the early phase of the HOST project to benchmark the IPC and AMT policies between the Plexus hospitals and to decide what future projects could be collaborated on. As a result of IRIS, it was decided to define common care bundles for the prevention of catheter-associated urinary tract and blood stream infections and to determine hospital-specific actions with regard to the optimisation of AMS.