Urinary Ghrelin Concentration in Children With Urinary Tract Infections Before and After Treatment

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Mostafa Sharifian ◽  
Mohammad Reza Shiva ◽  
Mohsen Akhavan Sepahi ◽  
Shirin Shohadaee ◽  
Nasrin Esfandiar ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Ghrelin Concentration ◽  
Before And After ◽  
Tract Infections

scholarly journals Knowledge and Practice Discordance in Treating Urinary Tract Infections

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
David W. Bauer ◽  
Julie Adkison ◽  
Heather Hamilton
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Educational Intervention ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Intervention Site ◽  
Before And After ◽  
Knowledge And Practice ◽  
Tract Infections ◽  
Practice Methods

Background and Objectives: Urinary tract infections (UTIs) are a common condition in women. Guidelines have been published on the diagnosis and management of such infections with the twin goals of improved patient safety and avoiding unnecessary health care costs. In this study we evaluated both physicians’ knowledge of these guidelines, and whether that knowledge translates to their clinical practice. Methods: We performed a retrospective chart review of UTI management before and after an educational intervention in a family medicine residency. Two control sites were also included. We also assessed physicians’ knowledge of current UTI management guidelines using an anonymous quiz. Results: At the intervention site, guideline adherence improved following the educational session. Inappropriate culture use decreased from 88% to 68% (P<.005) while first-line antibiotic use increased from 68% to 92% (P<.005). No such benefits were seen at the control sites. The control and intervention site providers did not differ in knowledge of antibiotic choice on the quiz (86% and 88% correct respectively, P=.85), but all control providers felt routine cultures were appropriate, whereas only 38% of the intervention providers did (P<.05). Conclusions: A simple educational intervention made an impact on the management of UTI. Our results also highlighted that knowledge and practice are not always aligned.

scholarly journals Evaluation of a Disease State Stewardship Intervention for Urinary Tract Infections at an Academic Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s226-s226
Author(s):  
Xhilda Xhemali ◽  
Derek Forster ◽  
Bryant Clemons ◽  
Sarah Cotner ◽  
Jeremy VanHoose ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Real Time ◽  
Urinary Tract Infections ◽  
Guideline Adherence ◽  
Medical Center ◽  
Academic Medical Center ◽  
Disease State ◽  
Academic Medical ◽  
Before And After ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are often misdiagnosed and mismanaged. Disease state stewardship initiatives targeting UTIs through the development of institutional guidelines and real-time prospective audit and feedback (PAAF) on provider management may have a significant impact on the overuse of antimicrobials. Objective: Our study evaluated the effectiveness of a UTI focused disease state stewardship intervention by assessing institutional guideline adherence before and after implementation. Methods: This retrospective quasi-experimental study was conducted at a tertiary-care academic medical center. Patients >18 years of age receiving antimicrobials for a UTI were included. A previously performed retrospective review of UTI management from September-November 2017 was used as the baseline. The UTI management guideline was implemented in July 2018, and service lines were educated. A PAAF initiative began in June 2019, whereby the antimicrobial stewardship team performed daily reviews of patients receiving antimicrobials for UTIs. Data was collected on their management, and providers were contacted in real time with recommendations based on the institutional guideline. Patients reviewed June–October 2019 were included in the postimplementation analysis. Patients were excluded if they were pregnant, underwent a urological procedure with risk of mucosal bleeding, or were an outside hospital transfer already on UTI therapy. The primary outcome of this study was to evaluate guideline adherence before and after the implementation of PAAF for the management of UTIs. Results: In total, 198 patients in the preintervention group and 246 in the PAAF group were included. The emergency department was the primary ordering service of urinalyses (60.1% vs 66.1%; P = .2287) in both periods and altered mental status as the main indication for testing (35.2% vs 31.3%; P = .5465). Treatment of asymptomatic bacteriuria and pyuria decreased significantly between the 2 periods: 74.8% versus 36.2% (P = .0001). Appropriate ordering of urinalyses (33.8% vs 68.3%; P = .0001) and urine cultures (29.3% vs 61.0%; P = .0001) also improved in the PAAF group. Recommendations made during PAAF included therapy discontinuation (66.7%), antimicrobial therapy change (15.5%), or duration modification (15.5%), and 59.5% of first interventions were accepted. Overall guideline compliance significantly improved from 13.1% in the preintervention period to 26.1% in the PAAF period (P = .0011). Conclusions: A UTI disease state intervention was associated with significant reductions in the treatment of asymptomatic presentations as well as an improvement in overall guideline adherence. We believe that this approach represents a powerful stewardship strategy for decreasing unnecessary antimicrobial usage.Funding: NoneDisclosures: None

scholarly journals Effective Treatment for Uncomplicated Urinary Tract Infections with Oral Fosfomycin, Single Center Four Year Retrospective Study

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 511
Author(s):  
Miroslav Fajfr ◽  
Michal Balik ◽  
Eva Cermakova ◽  
Pavel Bostik
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Clinical Efficacy ◽  
Therapeutic Use ◽  
Bacterial Isolates ◽  
The Czech Republic ◽  
Drug Registration ◽  
Before And After ◽  
Tract Infections ◽  
Efficacy Of Treatment

Fosfomycin represents a relatively old antibiotic, but it is experiencing a comeback in recent years. According to some studies, the increasing therapeutic use of this drug led to a rapid increase in the levels of resistance in bacteria causing urinary tract infection. In the presented study, levels of resistance to fosfomycin in more than 3500 bacterial isolates before and after fosfomycin introduction into therapeutic use in the Czech Republic and the clinical efficacy of treatment in 300 patients using this drug were assessed. The results show that the resistance levels to fosfomycin in Escherichia coli isolates before and after the drug registration were not significantly different (3.4% and 4.4%, respectively). In some other Gram-negative rods, such as otherwise susceptible Enterobacter, resistance to fosfomycin increased significantly from 45.6% to 76.6%. Fosfomycin treatment of urinary tract infections showed an excellent seven-day clinical efficacy (79.7%). However, when used to treat recurrent or complicated urinary tract infections, fosfomycin treatment was associated with high levels of infection relapse, leading to relapse in a total of 20.4% of patients during the first two months. This indicates that fosfomycin exhibits good efficacy only for the treatment of uncomplicated urinary tract infections

scholarly journals Effect of an External Urinary Collection Device on Catheter Associated Urinary Tract Infections in Hospitalized Women

2020 ◽  
Vol 41 (S1) ◽  
pp. s199-s199
Author(s):  
Lindsey Rearigh ◽  
Mark Rupp ◽  
Trevor Craig Van Schooneveld ◽  
Gayle Gillett ◽  
Adrienne Sy ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Model Risk ◽  
Indwelling Catheter ◽  
Collection Device ◽  
Excess Morbidity ◽  
Before And After ◽  
Perineal Skin ◽  
Quasi Experimental ◽  
Tract Infections

Background: Catheter-associated urinary tract infections (CAUTIs) are a common hospital-acquired infection (HAI) resulting in excess morbidity, mortality, and cost. Urine management can be a challenging issue, particularly in women, due to limited options for control of urinary incontinence. Issues with urinary leakage and worry for subsequent skin break down often leads to indwelling catheter insertion. In the spring of 2018, our facility implemented a female external urine collection device (EUCD) in efforts to decrease catheter days and to limit CAUTIs. Methods: Retrospective, 32-month (January 2017–August 2019), quasi-experimental, before-and-after study. Catheter use and CAUTI were defined according to CDC NHSN criteria. Poisson regression was used to model the rate of CAUTI (per 1,000 patient days [PD] and per 1,000 catheter days [CD]) comparing the 14 months prior to EUCD introduction with the 14 months after introduction and allowing a 3-month introduction period. Results: The CAUTI rate did not change significantly. The overall CAUTI rate per 1,000 PD decreased slightly from 0.24 to 0.20 (P = 0.44; model risk, 0.86; 95% CI, 0.58–1.26) whereas the rate per 1,000 CD increased slightly 1.5 to 1.6 (P = 0.76; model risk, 1.06; 95% CI, 0.73-–1.56). The CAUTI rate for men increased from 0.09 to 0.11 per 1,000 PD (P = 0.42; model risk, 1.29) and from 0.99 to 1.55 per 1,000 CD (P = 0.17; model risk, 1.56). For women, the rate of CAUTI decreased from 0.15 to 0.09 per 1,000 PD (P = 0.10; model risk, 0.61) and from 2.12 to 1.65 per 1,000 CD (P = 0.38; model risk, 0.38). A significant decrease in catheter days (CD per 1,000 PD; P < .0001) was observed for all hospitalized patients (from 158.56 to 128.3; model risk, 0.81), for men (from 87.06 to 72.15; model risk, 0.83), and for women (from 71.49 to 56.15; model risk, 0.79). Of 2,347 adverse events, 5 (0.2%) involved perineal skin breakdown and redness. Three events were related to malposition of the ECUD or inappropriate level of suction and 1 event was related to latex allergy and EUCD use. Conclusions: The introduction of a EUCD for women was associated with a significant decrease in indwelling catheter usage. A trend toward a decrease in CAUTI per 1,000 PD for women was observed (P = .10). Additional studies on whether the EUCD is associated with changes in UTI rates (both CAUTIs and noncatheter UTIs) as well as cost implications of EUCD are warranted.Funding: NoneDisclosures: None

90: A Systematic Review of Urinary Tract Infections Following Transposition of Bowel Segments into Urinary Tract

2004 ◽  
Vol 171 (4S) ◽  
pp. 24-24 ◽  
Author(s):  
Nabi Ghulam ◽  
Sze M. Yong ◽  
Eng Ong ◽  
Adrian Grant ◽  
Gladys C. McPherson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tract Infections ◽  
Bowel Segments

89: How Should we Investigate Community Treated Men with Urinary Tract Infections?

2004 ◽  
Vol 171 (4S) ◽  
pp. 23-24
Author(s):  
Jay Khastgir ◽  
Mark Mantle ◽  
Andrew Dickinson
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tract Infections
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