Prevention Of Urinary Tract Infections Research Articles

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)

Engagement with Electronic Medical Record Documentation for Prevention of Catheter-Associated Urinary Tract Infections

Engagement with Electronic Medical Record Documentation for Prevention of Catheter-Associated Urinary Tract Infections

A Study to Determine the Effectiveness of Planned Teaching Programme on Knowledge regarding prevention of Urinary Tract Infection among Adolescent Girls at Selected Colleges in Gulbarga

Backgrouund of the study: Urinary tract infection is common disease affecting all age groups, from newborn to old age.6 Among adolescent girls acute uncomplicated urinary tract infection is more prevalevent. This is the fourth main reason for out patient visit among adolescent women. Objectives: 1. To assess knowledge regarding prevention of urinary tract infection among adolescent girls in experimental and control group before and after the administration of planned teaching programme. 2. To determine the effectiveness of planned teaching programme regarding prevention of urinary tract infection in terms of gain in knowledge scores of adolescent girls.3. To find the association of pre test level of knowledge of adolescent girls with their selected personal variables viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere. Method: A Quasi Experimental study was conducted among Adolescent girls from selected colleges of Gulbarga, A total of 100 adolescent girls were chosen by Purposive sampling technique and wee divided into two groups as Experimental group and Control group (50 Each). Structured Knowledge questionnaire was used to collect the data from the samples on Knowledge regarding Urinary tract infection followed by Planned teaching Programme was conducted on7th day Post test was conducted. Results: The results of the studies revealed during Pre-test the knowledge of the Adolescent girls in Experimental group was 12.04 and in Control group was 11.38 and in Post-test the Experimental group was 23.52 and in Control group was 11.42. The Calculated Paired `t`- test was 27.14 at 0.05 level which was found to be significant implying Planned teaching programme was effective in enhancing Knowledge of Adolescent girls regarding Urinary tract infections.

Epidemiological Study and Clinical Presentation of Urinary Tract Infection

A urinary tract infection (UTI) is an immune response of the urothelium to bacterial invasion, bacteriuria (presence of bacteria in urine) and pyuria (presence of white blood cells in urine) are characteristic indicators of UTI. Prompt and effective management of UTIs is crucial to prevent complications, such as kidney infections and recurrent infections, and to alleviate symptoms, improve quality of life, and minimize antibiotic resistance. The aim of this study was to investigate the incidence, antibiotic resistance, medical treatment, causative agents, diagnosis, and prevention of urinary tract infections (UTIs) in Sulaymaniah city. A total of 60 patients from Sulaymaniah Teaching Hospital were included in the study. The most commonly diagnosed conditions were acute pyelonephritis and cystitis. Various evaluations were conducted, including history taking, physical examination, and diagnostic tests. Mid-stream urine samples were collected for culture and sensitivity analysis.The duration of symptoms such as dysuria, fever, and frequency varied, ranging from 1 to 3 days. During medical examinations, suprapubic tenderness was the most commonly observed finding. Dysuria was reported as the predominant symptom by 19 patients. The majority of patients fell within the age range of 21-40 years. The study findings indicated a higher prevalence of UTIs among females. The most frequently identified causative microorganism was Escherichia coli (E. coli), which accounted for approximately 90% of cases. Gentamycin emerged as the most commonly used antibiotic due to its effectiveness against E. coli. The high prevalence of antibiotic resistance among other pathogens necessitates ongoing surveillance and appropriate antibiotic stewardship to combat UTIs effectively. In conclusion, this study provides valuable insights into the incidence, antibiotic resistance, and management of UTIs in Sulaymaniah city. It emphasizes the need for tailored treatment approaches considering the prevalent causative agents and their susceptibility patterns.

Young Women's Attitudes and Behaviors in Treatment and Prevention of UTIs: Are Biomedical Students at an Advantage?

We wanted to investigate whether students who study within biomedical fields (i.e., medicine, pharmacy science) differ from those whose studies are not connected to the biomedical field in terms of their attitudes and behaviors related to urinary tract infections (UTIs). This was a cross-sectional survey-based study conducted among 392 female students, of whom 243 attended a biomedical school and 149 (38.0%) attended a non-biomedical school, using a previously published tool. The survey was distributed as an online link via student representatives at different faculties. Only 22 (5.6%) of women felt that they could not recognize a UTI. A greater proportion of biomedical students wiped front to back, while significantly more non-biomedical students chose cotton underwear and avoided daily sanitary pads compared to biomedical students. As many as 215 (54.8%) women stated that they used cranberry preparations. Biomedical students showed greater awareness about possible resistance to repeated treatment (p = 0.002) and greater knowledge of possible interactions of antibiotics (p < 0.001). This study reveals that young women are confident in recognizing an UTIs, are open to alternative treatments, and would consider UTI management in a pharmacy setting. However, it reveals that there might be gaps in their knowledge regarding antibiotic resistance risks, possible interactions, and efficacy of available preparations, as participants from the group of biomedical students showed greater knowledge and different behaviors.

An oldie but a goodie: Methenamine as a nonantibiotic solution to the prevention of recurrent urinary tract infections.

An oldie but a goodie: Methenamine as a nonantibiotic solution to the prevention of recurrent urinary tract infections.

Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group.

Background: Urinary tract infection (UTI) represents one of the most common infectious diseases and a major cause of antibiotic prescription in children. To prevent recurrent infections and long-term complications, low-dose continuous antibiotic prophylaxis (CAP) has been used. However, the efficacy of CAP is controversial. The aim of this document was to develop updated guidelines on the efficacy and safety of CAP to prevent pediatric UTIs. Methods: A panel of experts on pediatric infectious diseases, pediatric nephrology, pediatric urology, and primary care was asked clinical questions concerning the role of CAP in preventing UTIs in children. Overall, 15 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results: The use of CAP is not recommended in children with a previous UTI, with recurrent UTIs, with vesicoureteral reflux (VUR) of any grade, with isolated hydronephrosis, and with neurogenic bladder. CAP is suggested in children with significant obstructive uropathies until surgical correction. Close surveillance based on early diagnosis of UTI episodes and prompt antibiotic therapy is proposed for conditions in which CAP is not recommended. Conclusions: Our systematic review shows that CAP plays a limited role in preventing recurrences of UTI in children and has no effect on its complications. On the other hand, the emergence of new antimicrobial resistances is a proven risk.

Epidemiological screening of pathogenicity factors associated with multidrug-resistant bacteria isolated in uroculture of hospitalized neonates in the lakes region from Rio de Janeiro.

The discovery of antimicrobials revolutionized the treatment of infectious diseases caused by bacteria, as they are drugs that contribute to reducing morbidity and mortality rates associated with infectious diseases (JANEBRO, et al., 2008). However, the irrational use of antimicrobial drugs represents one of the main concerns worldwide, since the misuse of these drugs accelerates the natural process of bacteria resistance to antibiotics (ZIMERMAN, 2010). In view of all these problems, the objective of this study was to evaluate the profile of resistance of bacteria identified in the urine culture of neonates who are hospitalized, based on the records of the Laboratory of Clinical Analysis of a hospital in the lakes region from Rio de Janeiro. To do so, we used the following methodologies: (i) literature review for contextualization of the problem and basis for discussion; (ii) and monitoring of a descriptive observational study that had as instrument the reports of records containing results of urine culture and antibiogram of neonatal patients, referring to the period from January 2020 to September 2021. The results showed a higher incidence of Escherichia coli (44% - 2020; 56% - 2021) among the microorganisms isolated in the analyzed urine cultures, followed by Klebsiella pneumoniae (14% - 2020; 28% - 2021). Antimicrobials from the β-lactam group caused high bacterial resistance, among the strains of different microorganisms analyzed, increasingly indicating the need for the replacement of these drugs in the clinic, in order to choose a better therapy for the patient. As in any infectious pathology, to establish appropriate prevention and treatment of community-acquired urinary tract infections, effective and continuous research is needed, with the goal of defining in detail the etiology and profile of bacterial resistance in regional, national, and international standards. It is hoped that these new data profiling the level of resistance in which microorganisms isolated from neonatal patients admitted under hospital regimen are found will be of great value to the academic community and to health professionals, providing users with increasingly accurate and quality treatment.

D-Mannose for Recurrent Urinary Tract Infection Prevention in Postmenopausal Women Using Vaginal Estrogen: A Randomized Controlled Trial

(Abstracted from Urogynecology (Phila) 2023;29:367–377 Up to 25% of women experience recurring urinary tract infections, which are typically managed through long-term antibiotic prophylaxis intended for common urogenital pathogens. Unfortunately, prolonged use of antibiotics can lead to several adverse effects such as allergic reactions, sequelae from microbiome alterations, drug interactions/toxicities, and antibiotic resistance. One commonly prescribed prophylactic therapy, vaginal estrogen therapy (VET), is used as a first-line nonantibiotic therapy for rUTIs.

Knowledge of Nursing Students on Catheter-Associated Urinary Tract Infection Prevention

Catheter-associated urinary tract infections (CAUTIs) are a significant problem in healthcare settings, leading to increased morbidity, mortality, and healthcare costs. Nursing students are crucial in preventing CAUTIs, as they are often responsible for inserting and maintaining urinary catheters in patients. Objective: To assess the nursing students' knowledge regarding the prevention of CAUTIs. Methods: This descriptive cross-sectional was conducted at the Horizon School of Nursing and Health Sciences in Karachi, Pakistan, over a period of two months from November to December 2022. A total of 67 nursing students were recruited using a convenient sampling technique. Data were collected using a self-administered questionnaire that assessed the students' knowledge of CAUTIs. Results: The results showed that 19% of the nursing students had low knowledge, 65% had moderate knowledge, and 16% had a high level of knowledge regarding the prevention of CAUTIs. Conclusions: The findings suggest that most nursing students have moderate knowledge regarding preventing CAUTIs prevention. Educators and administrators can use these findings to develop targeted interventions that address the gaps in knowledge and promote best practices for preventing and managing CAUTIs in nursing students.

(105) The Discovery of New Incredible Positive Actions of Hormone Replacement Therapy and Sex in Menopause

Abstract Introduction Every year, two or more benefits of the use of hormone replacement therapy (HRT) in menopause and andropause appear in medical literature. We present an extensive review of the literature describing the classical and novel benefits of hormonal replacement therapy and sex in menopause. Additionally, we present recent findings from our own patient population. Objective To contribute to the presently known benefits of the use of HRTs, and additionally to present new findings from our own practice not previously described. Methods We conducted an extensive literature review and described our own experience and findings within our centers. Results `- In the area of prevention and treatment of genitourinary syndrome of menopause, we have found: - Prevention and treatment of false positive cervical dysplasia in perimenopause. - Prevention and treatment of vulvar, labial, and vaginal occlusion in late menopause. - Prevention and treatment of recurrent urinary tract infections in geriatric patients for prevention of sepsis, secondary pneumonia, and even death. - Prevention and treatment of clitoral atrophy, phimosis, and urethral caruncles - Dermatology: We have found: - Prevention and treatment of wrinkles, alopecia related, postmenopause. - Prevention in prostrated geriatric patients of decubitus ulcers. - Internal Medicine: prevention of obesity, decreased metabolic rate, and insulin resistance. - Ophthalmology: - Prevention and treatment of macular degeneration. - Prevention of glaucoma (increased intraocular pressure), most notably in primary open- angle glaucoma. - The prevention of aging of optic nerve and neuroprotection of retinal cells. - Oncology: - Prevention of kidney cancers, and breast cancer (only estrogen hormone replacement therapy). - Enhanced visualization of the transformation zone during cervical cancer screening - Gastroenterology: protection of the gut microbiome and serum metabolome, especially in premature ovarian insufficiency - Dentistry: prevention of tooth loss through decreased gingival inflammation and periodontitis, mandibular bone loss, and oral dysesthesia. - Neurology: - Protection against intracranial aneurysm rupture in ovariectomized mice. - The prevention of Parkinson’s and Alzheimer’s disease - Rheumatology: prevention of rheumatoid arthritis. Conclusions To demonstrate the number of studies with the anti-aging mechanism of the use of HRT. How this knowledge, alongside our own findings of hundreds of menopausal women within our centers justify the generalized use of this therapy. Disclosure No

Non-Antibiotic Prophylaxis for Recurrent UTIs in Neurogenic Lower Urinary Tract Dysfunction (NAPRUN): Study Protocol for a Prospective, Longitudinal Multi-Arm Observational Study.

Patients with neurogenic lower urinary tract dysfunction (NLUTD) reliant on intermittent self-catheterization for bladder emptying are at an increased risk of recurrent urinary tract infections (rUTI). So far, the most common practice in the prevention of rUTIs is long-term low-dose antibiotic prophylaxis, phytotherapy, and immunomodulation, whereby antibiotic prophylaxis inevitably leads to the emergence of drug-resistant pathogens and difficulty in treating infections. Therefore, non-antibiotic alternatives in the prevention of rUTIs are urgently required. We aim to identify the comparative clinical effectiveness of a non-antibiotic prophylaxis regimen in the prevention of recurrent urinary tract infections in patients with neurogenic bladder dysfunction who practice intermittent self-catheterization. In this multi-centre, prospective longitudinal multi-arm observational study, a total of 785 patients practising intermittent self-catheterisation due to NLUTD will be included. After inclusion, non-antibiotic prophylaxis regimens will be instilled with either UroVaxom® (OM-89) standard regimen, StroVac® (bacterial lysate vaccine) standard regimen, Angocin®, D-mannose (oral dose 2 g), bladder irrigation with saline (once per day). The management protocols will be pre-defined, but the selection of the protocol will be at the clinicians' discretion. Patients will be followed for 12 months from the onset of the prophylaxis protocol. The primary outcome is to identify the incidence of breakthrough infections. The secondary outcomes are adverse events associated with the prophylaxis regimens and the severity of breakthrough infections. Other outcomes include the exploration of change in susceptibility pattern via the optional rectal and perineal swab, as well as health-related quality of life over time (HRQoL), which will be measured in a random subgroup of 30 patients. Ethical approval for this study has been granted by the ethical review board of the University Medical Centre Rostock (A 2021-0238 from 28 October 2021). The results will be published in a peer-reviewed journal and presented at relevant meetings. German Clinical Trials Register: Number DRKS00029142.

(002) The Effects of Vaginal Testosterone versus Placebo on Female Sexual Function: Interim Analysis of the PIVoT Trial (Prevention of Recurrent Urinary Tract Infection using Vaginal Testosterone)

Abstract Introduction Post-menopasual women experience changes in vaginal flora and vaginal atrophy that have been associated with declining estrogen levels. These changes to the vaginal microenvironment often lead to significant genital pain and discomfort during sexual intercourse. Vaginal estrogen treats atrophy thereby restoring flora, which prevents UTIs and improves sexual function in post-menopausal women. While estrogen is effective, some patients have contraindications or are unwilling to use it. Vaginal testosterone cream (VT) has been shown to improve vaginal atrophy, however, its effects on overall vaginal health and sexual function have not been fully described. Objective The purpose of this study was to determine if VT is more effective than placebo cream in restoring the vaginal flora, improving the vaginal health index (VHI), and the sexual function of postmenopausal women with recurrent UTIs. Methods This is an interim analysis of a randomized, double- blind placebo-controlled pilot study enrolling postmenopausal women with recurrent UTIs. Vaginal health index (VHI) and swab to assess flora via DNA sequencing were collected. Patients were randomized to VT or placebo. Female sexual function index (FSFI) questionnaires were administered at baseline, one month, and nine months post treatment. Results A total of 44 women have been enrolled. Average VHI at enrollment was 13.66 +/− 0.4. There was no difference in baseline characteristics among the groups. Results show an improvement in female sexual function index scores in both groups from baseline. In the VT arm, improvements were seen in the desire (2.18 to 2.85), lubrication (1.74 to 2.175), orgasm (1.64 to 2.5) and pain (0.91 to 1.3) domains of the FSFI. Interestingly, improvements in all domains were seen in the placebo group, however, more patients in this group reported being sexually active. In terms of VHI, there was a statistically significant increase in VHI scores at 9 months post-treatment with VT (14.65 +/−4.20 to 17.50 +/− 4.43, p = 0.04). This increase in vaginal health index was not observed in the placebo arm. Conclusions Initial data demonstrates improvement in vaginal pH and VHI after 9 months of treatment with VT. Improvement in sexual function scores were also seen in both the treatment and the placebo groups. Higher patient enrollment and longer treatment follow up will be valuable in understanding the effects of VT versus placebo on sexual function among postmenopausal women. Disclosure No