Prevention Of Urinary Tract Infections Research Articles

Knowledge on Urinary Tract Infection among the adolescent girls of age group of 13-16 years in Carmel School, Digboi, Tinsukia, Assam

A Urinary tract Infection is bacterial infection that can affect any part of the urinary tract. This includes the kidneys, which make urine, ureters, tubes that carry urine from kidney and the urethra, the tube that carries urine from bladder out of body.1 Urinary tract infections (UTI) are common problems in the female population.8 They are familiar to many women. Approximately 50 % of all women have at least one such infection in their lifetime. Study by Fakhria J. M showed that girl students sometimes use analgesic to reduce the pain caused due to UTI.2,5 According to WHO, Urinary Tract Infections is one of the leading cause of morbidity. About half female population report UTI during some point in their lives. It has high mortality and morbidity rates as well. Generally, women are 10 to 30 times prone to develop UTI as compared to men. UTI is treatable and preventable. But majority of the adolescent girls do not have adequate knowledge on Causes and preventive measures of urinary tract infection.3,4 Parents of adolescent girls should have adequate knowledge on adolescent health so that common diseases that may occur during adolescent period e.g urinary tract infection can be prevented. But research study by Hepsi Bai J revealed that some parents of adolescent girls do not have adequate knowledge regarding adolescent health. The study found that 60% of the parents had adequate knowledge regarding adolescent health.6 Study by Alphonsa Pascal also found that adolescent girls don’t have adequate knowledge on prevention of urinary tract infection and adolescent girls gained knowledge on UTI after planned teaching programme on UTI.7 Aims and Objectives: To assess the knowledge regarding Urinary Tract Infections among the adolescent girls of age group of 13-16 years in Carmel School, Digboi, Assam, to find out association between the knowledge Urinary Tract Infection among the adolescent girls of age group of 13-16 years and selected demographic variables in Carmel School, Digboi, Assam. Research methodology: This was a non-experimental quantitative descriptive research design. This study was conducted among adolescent girls of age group 13-16 years of Carmel School, Digboi. Self structured validated questionnaire in English language were prepared for demographic pro-forma; to assess the knowledge on Urinary Tract Infection. It includes 12 questions on demographic pro-forma, 22 questions on knowledge on Urinary Tract Infection. Results: Researcher assess the level of knowledge on Urinary Tract Infection among the adolescent girls of 13-16 years in Carmel School, Digboi and found that among 40 girls, most of them 32(80%) had moderately adequate knowledge, 5(12.5%) had adequate knowledge and 3(7.5%) had inadequate knowledge on Urinary Tract Infection. Level of Knowledge was not significantly associated between the knowledge regarding Urinary Tract Infection among the adolescent girls and selected demographic variables. Conclusion: The adolescent girls have moderately adequate knowledge on Urinary Tract Infection. It is found that there is no significant association between level of knowledge and selected demographic variables.

Patient perspectives on treatment and prevention of recurrent urinary tract infections: a focus group study.

We sought to understand factors that are important to patients for the management of recurrent urinary tract infections (UTI) during both an acute episode and for the prevention of future episodes. This was a qualitative study with focus groups in women with recurrent UTIs. Participants filled out information about prior recurrent UTI treatment and the Belief about Medicines Questionnaire (BMQ). Each 90-minute focus group was moderated by a nonphysician psychologist. Line-by-line coding of each transcript by three independent physicians was used to develop emergent concepts and themes using Grounded Theory methodology. Twenty-six women participated in six focus groups. The average age of participants was 62 years and 77% were post-menopausal. All women had already tried multiple prevention strategies for their recurrent UTIs. The average BMQ-specific scores indicated a net positive attitude toward medicines specifically prescribed for recurrent UTI prevention. Several themes emerged from the focus groups. First, patients wanted providers to acknowledge the high burden imposed by frequent interactions with the health care system for the management of recurrent UTI. Second, patients wanted earlier access to providers knowledgeable in the management of this condition. Third, patients wanted to self-manage their condition through a structured treatment plan with support from their providers. Finally, patients wanted greater emphasis on education and prevention strategies to reduce their antibiotic intake. Patients with recurrent UTI want more efficient workflows, a framework that promotes self-management in partnership with their providers, and a greater emphasis on prevention.

Cranberries for preventing urinary tract infections.

Cranberries contain proanthocyanidins (PACs), which inhibit the adherence of p-fimbriated Escherichia coli to the urothelial cells lining the bladder. Cranberry products have been used widely for several decades to prevent urinary tract infections (UTIs). This is the fifth update of a review first published in 1998 and updated in 2003, 2004, 2008, and 2012. To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. We searched the Cochrane Kidney and Transplant Specialised Register up to 13 March 2023 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov. All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products compared with placebo, no specific treatment or other intervention (antibiotics, probiotics) for the prevention of UTIs were included. At least two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) with 95% confidence intervals (CI) were calculated where appropriate. Study quality was assessed using the Cochrane risk of bias assessment tool. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. For this update, 26 new studies were added, bringing the total number of included studies to 50 (8857 randomised participants). The risk of bias for sequence generation and allocation concealment was low for 29 and 28 studies, respectively. Thirty-six studies were at low risk of performance bias, and 23 studies were at low risk of detection bias. Twenty-seven, 41, and 17 studies were at low risk of attrition bias, reporting bias and other bias, respectively. Forty-five studies compared cranberry products with placebo, water or no specific treatment in six different groups of participants. Twenty-six of these 45 studies could be meta-analysed for the outcome of symptomatic, culture-verified UTIs. In moderate certainty evidence, cranberry products reduced the risk of UTIs (6211 participants: RR 0.70, 95% CI 0.58 to 0.84; I² = 69%). When studies were divided into groups according to the treatment indication, cranberry products probably reduced the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs (8 studies, 1555 participants: RR 0.74, 95% CI 0.55 to 0.99; I² = 54%), in children (5 studies, 504 participants: RR 0.46, 95% CI 0.32 to 0.68; I² = 21%) and in people with a susceptibility to UTIs due to an intervention (6 studies, 1434 participants: RR 0.47, 95% CI 0.37 to 0.61; I² = 0%). However, there may be little or no benefit in elderly institutionalised men and women (3 studies, 1489 participants: RR 0.93, 95% CI 0.67 to 1.30; I² = 9%; moderate certainty evidence), pregnant women (3 studies, 765 participants: RR 1.06, 95% CI 0.75 to 1.50; I² = 3%; moderate certainty evidence), or adults with neuromuscular bladder dysfunction with incomplete bladder emptying (3 studies, 464 participants: RR 0.97, 95% CI 0.78 to 1.19; I² = 0%; low certainty evidence). Other comparisons were cranberry products with probiotics (three studies) or antibiotics (six studies), cranberry tablets with cranberry liquid (one study), and different doses of PACs (two studies). Compared to antibiotics, cranberry products may make little or no difference to the risk of symptomatic, culture-verified UTIs (2 studies, 385 participants: RR 1.03, 95% CI 0.80 to 1.33; I² = 0%) or the risk of clinical symptoms without culture (2 studies, 336 participants: RR 1.30, 95% CI 0.79 to 2.14; I² = 68%). Compared to probiotics, cranberry products may reduce the risk of symptomatic, culture-verified UTIs (3 studies, 215 participants: RR 0.39, 95% CI 0.27 to 0.56; I = 0%). It is unclear whether efficacy differs between cranberry juice and tablets or between different doses of PACs, as the certainty of the evidence was very low. The number of participants with gastrointestinal side effects probably does not differ between those taking cranberry products and those receiving a placebo or no specific treatment (10 studies, 2166 participants: RR 1.33, 95% CI 1.00 to 1.77; I² = 0%; moderate certainty evidence). There was no clear relationship between compliance with therapy and the risk for repeat UTIs. No difference in the risk for UTIs could be demonstrated between low, moderate and high doses of PACs. This update adds a further 26 studies, taking the total number of studies to 50 with 8857 participants. These data support the use of cranberry products to reduce the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions. The evidence currently available does not support its use in the elderly, patients with bladder emptying problems, or pregnant women.

Antibiotic prophylaxis for onabotulinum toxin A injections: systematic review and meta-analysis.

To our knowledge, there are no evidence-based recommendations regarding the optimal prophylactic antibiotic regimen for intradetrusor onabotulinum toxin type A (BTX) injections. This systematic review and meta-analysis was aimed at investigating the optimal prophylactic antibiotic regimen to decrease urinary tract infection (UTI) in patients undergoing BTX for overactive bladder syndrome (OAB). A systematic search of MEDLINE, Embase, CINAHL, and Web of Science was conducted from inception through 30 June 2022. All randomized controlled trials and prospective trials with > 20 subjects undergoing BTX injections for OAB in adults that described prophylactic antibiotic regimens were included. Meta-analysis performed to assess UTI rates in patients with idiopathic OAB using the inverse variance method for pooling. A total of 27 studies (9 randomized controlled trials, 18 prospective) were included, representing 2,100 patients (69% women) with 19 studies of idiopathic OAB patients only, 6 of neurogenic only, and 2 including both. No studies directly compared antibiotic regimens for the prevention of UTI. Included studies favor the use of antibiotics in patients with idiopathic OAB and favor continuing antibiotics for 2-3days after the procedure for prevention of UTI. Given the heterogeneity of the data, direct comparisons of antibiotic type or duration could not be performed. Meta-analysis found a 10% UTI rate at 4 weeks and 15% at 12 weeks post-injection. Although there are insufficient data to support the use of a specific antibiotic regimen, available studies favor the use of prophylactic antibiotics for 2-3days in idiopathic OAB patients undergoing BTX injection. Future trials are needed to determine the optimal regimens to prevent UTI in patients undergoing BTX for OAB.

Water intake and recurrent urinary tract infections prevention: economic impact analysis in seven countries

BackgroundTo estimate the economic impact of preventing urinary tract infections (UTI) by increasing water intake among women with recurrent UTI and low fluid intake across seven countries: France, United Kingdom, Spain, United States of America, Mexico, China and Australia.MethodsA Markov model was developed to compare costs and outcomes of UTIs associated with low fluid intake in women versus a strategy of primary prevention by increasing water intake. Model inputs were based on randomized controlled trial data which found that increasing water intake by 1.5 L/day decreased the risk of developing cystitis by 48% in women with low fluid intake and recurrent UTI. A time horizon of 10 years was used; outcomes were from the payer perspective and included both direct and indirect costs, reported in 2019 United States dollars ($). Discounting rates varied by country. Scenarios of increasing levels of compliance to the increased water intake strategy were evaluated.ResultsThe total cost of one UTI episode, including diagnostics, treatment and complications, ranged from $2164 (Mexico) to $7671 (Australia). Assuming 80% compliance with the increased water intake strategy over a 10-year time horizon, the number of UTIs prevented ranged from 435,845 (Australia) to 24150,272 (China), resulting in total savings of 286 million (Australia) to $4.4 billion (China). Across all countries, increased water intake resulted in lower cost and fewer UTIs compared with low water intake.ConclusionPreventing recurrent UTIs by increasing water intake would reduce both the clinical and economic burden associated with UTI. Public, healthcare professionals and patients should be made aware about the preventive positive impact of appropriate water intake on UTIs.

Improved in vitro Hemagglutination Assays Utilizing P-Type and Type 1 Uropathogenic Escherichia coli to Evaluate Bacterial Anti-Adhesion Activity of Cranberry Products

Cranberries have a long history of use in the prevention of urinary tract infections. Cranberry products vary in proanthocyanidin content, a compound implicated in preventing the adhesion of uropathogenic Escherichia coli (E. coli) to uroepithelial cells. Testing is routinely done by cranberry product formulators to evaluate in vitro bacterial anti-adhesion bioactivity, shelf-life, and potential efficacy of cranberry products for consumer use to maintain urinary tract health. Hemagglutination assays evaluate the anti-adhesion bioactivity of cranberry products by determining how effectively the products prevent agglutination of specific red blood cells with E. coli expressing P-type and Type 1 fimbriae. The current study sought to improve upon an established anti-adhesion assay method by expanding the number of E. coli strains used to broaden potential in vivo efficacy implications and presenting results using photomicrographic data to improve accuracy and build databases on products that are routinely tested. Different lots of cranberry powder ingredient and two formulated products were tested independently for anti-adhesion activity using the established method and the improved method. Positive harmonization of results on the same samples using rigorous controls was achieved and provides the substantiation needed for the cranberry industry to utilize the improved, rapid in vitro testing method to standardize cranberry products for sufficient anti-adhesion bioactivity and maintain consumer confidence.

MV140 sublingual vaccine reduces recurrent urinary tract infection in women Results from the first North American clinical experience study.

This is the first North American clinical evidence for MV140, a novel bacterial sublingual vaccine, developed for prevention of recurrent urinary tract infection (UTI) in women. Female subjects with ≥3 documented UTIs/year underwent three-month vaccination treatment, nine-month efficacy period, and optional three-month followup (total 15 months). Primary outcome was no clinically diagnosed UTI following vaccination (UTI-free rate). Secondary outcomes included absolute, mean, and median overall reduction in UTI compared to pre-vaccination, quality of life, global response assessment, patient satisfaction, microbiology, and safety. Sixty-seven subjects (mean age 56 years, range 18-80) were enrolled; 64 completed the vaccination period and at least one post-vaccination assessment. Prior to vaccination, subjects reported a mean 6.8 UTIs/year. The UTI-free rate for the nine-month efficacy period was 40.6%. Compared to the infection rate in the year prior to vaccination, the reduction was 75.3% for the nine-month efficacy period post-vaccination. At 12-month followup, 80.3% reported that they were moderately/markedly improved; 58.1% were mostly satisfied, pleased, or delighted, while mean quality of life score improved by 1.5 points. Fourteen of the adverse events in nine subjects were potentially related to the vaccine - all mild and resolved by three months. None of the 13 serious adverse events were related to vaccine. This first-in-North-America, prospective case series with the sublingual vaccine, MV140, adds further clinical evidence to its safety and effectiveness in reducing recurrent UTIs in women.

Cranberry Supplements for Urinary Tract Infection Prophylaxis in Pregnant Women: A Systematic Review of Clinical Trials and Observational Studies on Efficacy, Acceptability, Outcomes Measurement Methods, and Studies' Feasibility.

Cranberry supplements are commonly used to prevent urinary tract infections (UTIs).However, their usefulness is uncertain in pregnant women.We aimed to comprehensively summarize the current knowledge on cranberry supplements' efficacy and acceptability during pregnancy in addition to the outcomes measurementmethods and studies' feasibility. To achieve it, wesearched PubMed, PMC, and Europe PMC databases plus screened citations followed bycritical appraisal of included eligible English-written primary studies that(1) focused on pregnant women supplemented with any cranberry supplements; (2) provided data on cranberry supplements' efficacy, acceptability, outcomes measurementmethods, and studies' feasibility;(3) included human subjects; and (4) published worldwide.Two randomized clinical trials (RCTs) and one nested cohort study, including 1156 pregnant women in total, contributed to our analysis.A tendency toward UTI reduction was demonstrated, although the results' validity was impacted by significantjuice-induced gastrointestinal intolerance(23%; 44 of 188 subjects).Changing the form of supplementation from cranberry juice to capsules reduced the issue,causing side effects inone of 49subjects (2%). Nevertheless, both RCTs still experienced significant recruitment andretention problems, which wereat 33% and59% onaverage, respectively.Newly acquired safety data on 919 more subjects suggests no increased risks of all malformations, vaginal bleeding, and neonatal complications. Investigating cranberry capsules' efficacy as a non-antibacterial option for UTI prevention in pregnant women has become a feasible and important direction with the current advancement in understanding cranberry supplements' actions, recommended doses plus regimens, and their safety in the population. We reviewed the challenges and discovered knowledge gaps and the implementation strategies for future studies.

Возможности неантибактериальной терапии и профилактики инфекций мочевыводящих путей.

Introduction. Recurrent urinary tract infections (RUTI) are one of the most common nosologies in the practice of a urologist. About half of all women will have at least one episode of urinary tract infection (UTI) during their lifetime. Antibiotic therapy remains the mainstay of treatment for UTI. The need to search for alternative options for the treatment and prevention of UTIs is dictated by the frequent use of antibacterial drugs. Most often they talk about the use of D-mannose and herbal remedies. The purpose of this literature review is to critically analyze clinical studies conducted to date that have examined the effectiveness and safety of D-mannose and herbal medicines for the prevention and treatment of RUTI. Materials and methods. 13 studies were analyzed that assessed the effectiveness of D-mannose and a combined herbal medicine with antibacterial therapy. Results. Herbal preparations from centaury herb, lovage roots, rosemary herb and lingonberry leaves in combination with D-mannose and antibacterial therapy had a number of advantages in clinical practice in the form of a decrease in the titer of pathogenic microflora. Conclusions. The NephroBest phytocomplex together with the polysaccharide D-mannose is well tolerated, has no side effects and demonstrates excellent clinical results in the form of reducing the risk of relapse, eliminating the pathogen, quickly reducing symptoms and improving laboratory parameters.

Recurrent urinary tract infection management and prevention techniques among a population-based cohort of women.

Recurrent urinary tract infection (rUTI), defined as three or more UTIs in 12 months, has psychological, physical, and financial burden. Many women with rUTI are not satisfied with care and report only starting preventative measures after several infections. The goal of this study is to elucidate current UTI management trends and the implementation of UTI prevention strategies. A web-based study was sent to a national sample of adult women enrolled in ResearchMatch.org. Women were recruited to participate if they had a self-reported UTI in the past 12 months. Of the 755 subjects, nearly 30% reported rUTI. Among women with rUTI, more than 50% reported being peri- or postmenopausal, and two-thirds reported vaginal symptoms. 15.8% of women with rUTI reported dissatisfaction with care versus 7.9% of women without rUTI. Most women see their primary care physician for UTI management and only 26% of women with rUTI follow with a urologist. More than 65% of women increase their fluid intake, wipe from front to back, and urinate after sexual activity to prevent UTIs. Significantly more women with rUTI use transvaginal estrogen, cranberry extract, and low-dose prophylactic antibiotics. These interventions appear to be driven by urologists. Most women who have had a UTI in the last 12 months implement lifestyle changes to prevent future infections. Most women see their PCP for UTI management and women with rUTI are twice as likely to report dissatisfaction with care. Despite urologists optimizing medical rUTI prevention, they appear to be underutilized.

Роль фитоэстрогенов в комплексной терапии и профилактике рецидивирующей инфекции нижних мочевых путей у пациенток в климактерии

Роль фитоэстрогенов в комплексной терапии и профилактике рецидивирующей инфекции нижних мочевых путей у пациенток в климактерии

A practical guide on the non-antibiotic options available in the prevention of recurrent urinary tract infections in women.

Urinary Tract infection (UTI) is one of the most common infections worldwide, patients present to multiple different specialities in the community, primary and secondary care. Antibiotics are considered standard first line therapy in the treatment of urinary tract infections, however there is an alarming rise in global antibiotic resistance rates, so much so that the World Health Organisation has labelled antibiotic resistance as one of the biggest challenges to public health in our lifetime, publishing a global action plan to tackle this challenge. As a result, there is an increasing need to discover non-antibiotic alternatives, recently a number of novel therapies have been introduced into clinical practice. These are divided into oral, topical, intravesical and immunomodulation therapies. The aim of this paper is to summarise the current non-antibiotic treatments as a practical guide to utilise in patient care.

Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: A mixed-methods study.

US policies require robust nursing home (NH) infection prevention and control (IPC) programs to ensure safe care. We assessed IPC resources and practices related to catheter and non-catheter-associated urinary tract infection (CAUTI and UTI) prevention among NHs. We conducted a mixed-methods study from April 2018 through November 2019. Quantitative surveys assessed NH IPC program resources, practices, and communication during resident transfer. Semistructured qualitative interviews focused on IPC programs, CAUTI and UTI prevention practices, and resident transfer processes. Using a matrix as an analytic tool, findings from the quantitative survey data were combined with the qualitative data in the form of a joint display. Representatives from 51 NHs completed surveys; interviews were conducted with 13 participants from 7 NHs. Infection preventionists (IPs) had limited experience and/or additional roles, and in 36.7% of NHs, IPs had no specific IPC training. IP turnover was often mentioned during interviews. Most facilities were aware of their CAUTI and UTI rates and reported using prevention practices, such as hydration (85.7%) or nurse-initiated catheter discontinuation (65.3%). Qualitative interviewees confirmed use of these practices and expressed additional concerns about overuse of urine testing and antibiotics. Although transfer sheets were used by 84% to communicate about infections, the information received was described as suboptimal. NHs identified IP challenges related to turnover, limited education, and serving multiple roles. However, most NHs reported awareness of their CAUTI and UTI rates as well as their use of prevention practices. Importantly, we identified opportunities to enhance communication between NHs and hospitals to improve resident care and safety.

Novel Key Ingredients in Urinary Tract Health-The Role of D-mannose, Chondroitin Sulphate, Hyaluronic Acid, and N-acetylcysteine in Urinary Tract Infections (Uroial PLUS®).

Urinary tract infections represent a common and significant health concern worldwide. The high rate of recurrence and the increasing antibiotic resistance of uropathogens are further worsening the current scenario. Nevertheless, novel key ingredients such as D-mannose, chondroitin sulphate, hyaluronic acid, and N-acetylcysteine could represent an important alternative or adjuvant to the prevention and treatment strategies of urinary tract infections. Several studies have indeed evaluated the efficacy and the potential use of these compounds in urinary tract health. In this review, we aimed to summarize the characteristics, the role, and the application of the previously reported compounds, alone and in combination, in urinary tract health, focusing on their potential role in urinary tract infections.

P08 Preventing and managing urinary tract infections: using thematic analysis to explore interventions and strategies implemented by NHS commissioning organizations in English primary care, 2017–22

Abstract Objectives To identify and explore strategies, interventions and activities used by English Clinical Commissioning Groups (CCGs) to improve prevention and management of urinary tract infections (UTIs) from 2017–22. Methods Online questionnaires were sent to primary care chief nurses and medicines optimization leads via regional infection prevention control (IPC) and antimicrobial stewardship (AMS) leads August–September 2022. Qualitative data were mapped to the Theoretical Domains Framework. Results Response rate was 14.1% (56/397 participants approached), with representation from 29.2% (31/106) English CCGs. Respondents provided 201 examples of UTI interventions. Themes identified included: (i) populations and settings; (ii) aspects of UTI targeted; (iii) types and functions of interventions and activities; (iv) resources, tools and policies; and (v) implementation strategies. Education and training were the most used type of intervention, while changing the environment to facilitate ideal behaviours was the least used intervention type. Most interventions targeted general practice staff and patients accessing primary care, followed by care home staff and residents and their families. The most used success measures included reduction in antibiotic prescribing (54.5%, 97/178 intervention examples); positive feedback from stakeholders (42.1%, 75/178); and increased adherence to national diagnostic guidelines (32.6%, 58/178). However, 48.8% (20/41) stated their team’s UTI activities had not been evaluated, indicating that success was determined using informal data or perceived outcomes. Barriers to implementation of UTI interventions included: lack of resources and time; low staff engagement, inaccurate data due to lack of clinical coding; inconsistent systems and processes; and lack of dedicated roles. Facilitators to implementation included: availability of tools; financial incentives; multidisciplinary collaboration; sharing of information; staff motivation; embedding resources into systems; digitalization; and dedicated roles. Conclusions Multidisciplinary teams and cross-sector collaboration are key facilitators for implementation of UTI interventions. Although some teams are already using robust success measures, there is a need to improve how interventions are evaluated to inform resource allocation and planning. Education and training interventions should address or leverage the barriers and facilitators identified, including clinical coding skills, embedding resources and tools into existing systems and auditing adherence to diagnostic and antibiotic prescribing guidance. There may be missed opportunities for intervention types that are less widely used e.g. changing environmental factors.

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update.

The intent of this document is to highlight practical recommendations in a concise format designed to assist physicians, nurses, and infection preventionists at acute-care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates the Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute-Care Hospitals published in 2014. It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission.

Prevention of urinary tract infection using a silver alloy hydrogel-coated catheter in critically ill patients: A single-center prospective randomized controlled study

BackgroundA new type of silver alloy hydrogel-coated (SAH) catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent, and to block the retrograde infection pathway. However, these have only been confirmed in ordinary patients. This study aims to evaluate the effectiveness of a SAH catheter for preventing urinary tract infections in critically ill patients. MethodsThis was a prospective single-center, single-blind, randomized, controlled study. A total of 132 patients requiring indwelling catheterization in the intensive care unit (ICU) of the First Affiliated Hospital of the University of Science and Technology of China between October 2022 and February 2023 and who met the study inclusion/exclusion criteria were randomly divided into two groups. Patients in the SAH catheter group received a SAH catheter, while patients in the conventional catheter group received a conventional siliconized latex Foley catheter. The main outcome measure was the incidence of catheter-associated urinary tract infections (CAUTIs). Secondary outcome indicators included urine positivity for white blood cells and positive urine cultures on 3 days, 7 days, 10 days, and 14 days after catheterization, number of viable bacteria in the catheter biofilm on day 14, pathogenic characteristics of positive urine cultures, length of ICU stay, overall hospital stay, ICU mortality, and 28-day mortality. All the data were compared between the two groups. ResultsA total of 68 patients in the conventional catheter group and 64 patients in the SAH catheter group were included in the study. On day 7 after catheter placement, the positivity rate for urinary white blood cells was significantly higher in the conventional catheter group than in the SAH catheter group (33.8% vs. 15.6%, P=0.016). On day 10, the rates of positive urine cultures (27.9% vs. 10.9%, P=0.014) and CAUTIs (22.1% vs. 7.8%, P=0.023) were significantly higher in the conventional catheter group than in the SAH catheter group. On day 14, the numbers of viable bacteria isolated from the catheter tip ([3.21±1.91]×106 colony-forming units [cfu]/mL vs. [7.44±2.22]×104 cfu/mL, P <0.001), balloon segment ([7.30±1.99]×107 cfu/mL vs. [3.48±2.38]×105 cfu/mL, P <0.001), and tail section ([6.41±2.07]×105 cfu/mL vs. [8.50±1.46]×103 cfu/mL, P <0.001) were significantly higher in the conventional catheter group than in the SAH catheter group. The most common bacteria in the urine of patients in both groups were Escherichia coli (n=13) and Pseudomonas aeruginosa (n=6), with only one case of Candida in each group. There were no significant differences between the two groups in terms of ICU hospitalization time, total hospitalization time, ICU mortality, and 28-day mortality. ConclusionSAH catheters can effectively inhibit the formation of catheter-related bacterial biofilms in critically ill patients and reduce the incidence of CAUTIs, compared with conventional siliconized latex Foley catheters; however, regular replacement of the catheter is still necessary.

Impact of sociodemographic status and UTI symptoms on women's health-care seeking and management in England: findings from an e-survey conducted during the first year of the COVID-19 pandemic.

Multiple factors may influence women's experiences of urinary tract infection (UTI) and its clinical management. To explore how women's background, symptoms, and severity of symptoms influence UTI reporting and management. Internet questionnaire targeting women in England, focusing on UTI symptoms, care seeking, and management. A total of 1096 women aged ≥16 years with UTI symptoms in the previous year completed the questionnaire in March and April 2021. Multivariable logistic regression was ued to estimate the odds of relevant outcomes while adjusting for background characteristics. Women with children in their household, who were aged under 45 years, or who were married or cohabitating were more likely to experience UTI symptoms. The odds of antibiotic prescribing were lower if women reported dysuria (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] = 0.49 to 0.85), frequency (AOR = 0.63, 95% CI = 0.48 to 0.83), or vaginal discharge (AOR = 0.69, 95% CI = 0.50 to 0.96), but higher if reporting haematuria (AOR = 2.81, 95% CI = 1.79 to 4.41), confusion (AOR = 2.14, 95% CI = 1.16 to 3.94), abdominal pain (AOR = 1.35, 95% CI = 1.04 to 1.74), or systemic symptoms (AOR = 2.04, 95% CI = 1.56 to 2.69). Those with abdominal pain or two or more of nocturia, dysuria, or cloudy urine had lower odds of receiving a delayed antibiotic, while those with incontinence, confusion, unsteadiness, or low temperature had higher odds of a delayed prescription. Increasing symptom severity was associated with greater odds of receiving antibiotics. Except for reduced prescribing if a woman had dysuria and frequency, antibiotic prescribing followed an expected pattern, aligning generally with national guidance. Symptom severity and the likelihood of systemic infection probably influenced care seeking and prescribing. Sexual intercourse and childbirth may be key times to target women with messages about UTI prevention.

Knowledge, attitude and practice of antenatal mothers toward urinary tract infection in selected health facilities in Ekiti state, Nigeria.

Urinary Tract Infections (UTIs) during gravidity are among the most preponderant contagion globally and can culminate in fetal and maternal mortality. Lack of awareness and poor preventive practices can exacerbate this outcome. This study assessed the knowledge and preventive practices of antenatal mothers' towards UTIs in pregnancy. This was a cross-sectional descriptive survey involving antenatal mothers in selected health care facilities in Ekiti State. A pre-tested adapted questionnaire was used for data collection. Data was analyzed using descriptive statistics and Chi-square at p < 0.05. The mean respondents' age was 24.6 ± 2.1 years and barely less than half (43.8%) were multigravida. The findings of the study revealed that 64.0% of the respondents had good knowledge of UTIs. Overall, majority (78.9%) of the respondents exhibit good preventive practices toward UTIs in pregnancy, although the prevalence of UTIs among the studied subjects was found to be high (54.1%), with nearly half (48.7%) of the respondents reported been tested once for UTIs in the current pregnancy. Furthermore, there was a statistically significant relationship between educational level and respondents' knowledge on the prevention of UTIs in pregnancy (p = 0.00; p < 0.05). Respondents had good knowledge and good preventive practices toward UTIs. However, the high prevalence of UTIs reported among respondents justifies the need for implementation of knowledge enhancement program, routine testing and prompt treatment of UTIs among antenatal mothers.

Review of Scientific Literature on External Collection Devices (ECD) in the Prevention of Catheter-Associated Urinary Tract Infections (CAUTI)

Review of Scientific Literature on External Collection Devices (ECD) in the Prevention of Catheter-Associated Urinary Tract Infections (CAUTI)