Aspects of Prevention of Urinary Tract Infections Associated with Urinary Bladder Catheterisation and Their Implementation in Nursing Practice

In the case of the prevention of catheter-associated urinary tract infections (CAUTI) related to healthcare provision, high-quality and comprehensively provided nursing care is essential. Implementation of preventive strategies is based on recommended procedures, and the introduction of whole sets of measures has been shown to be effective. The objective of this research is to find out whether the providers of acute bed care have implemented the steps of CAUTI prevention, and specifically which measures leading to improved quality of care in the area of urinary infections are already in place. To determine this, we carried out quantitative research. Data were collected using a questionnaire-based investigation; we used two non-standardised and one standardised questionnaire, and the respondents were general nurses in management positions (n = 186). The results revealed that result-related CAUTI indicators are monitored by only one-third of the respondents, and records of catheterisation indication are not kept by 17.3% of general nurses. The results of the research showed deficiencies in the monitoring of CAUTI outcome and process indicators, and a weakness of the implemented preventive measures is the maintenance of catheterisation documentation. Periodic CAUTI prevention training is not implemented as recommended. It is positive that there are well-working teams of HAI prevention experts in hospitals.

The In Vitro Ability of Klebsiella pneumoniae to Form Biofilm and the Potential of Various Compounds to Eradicate it from Urinary Catheters

Urinary infections related to the presence of bacterial biofilm on catheters are responsible for loss of patients’ health and, due to their high frequency of occurrence, generate a significant economic burden for hospitals. Klebsiella pneumoniae is a pathogen frequently isolated from this type of infection. In this study, using a cohesive set of techniques performed under stationary and flow conditions, we assessed the ability of 120 K. pneumoniae strains to form biofilm on various surfaces, including catheters, and evaluated the usefulness of clinically applied and experimental compounds to remove biofilm. The results of our study indicate the high impact of intraspecies variability with respect to K. pneumoniae biofilm formation and its susceptibility to antimicrobials and revealed the crucial role of mechanical flushing out of the biofilm from the catheter’s surface with use of locally active antimicrobials. Therefore, our work, although of in vitro character, may be considered an important step in the direction of efficient reduction of K. pneumoniae biofilm-related hospital infections associated with the presence of urine catheters.

99. Presence of Chronic Diseases and Compliance with Québec Provincial Guidelines for Outpatient Antibiotic Prescription, Québec, Canada, 2010-2017

Background In Québec primary care, antimicrobial use is higher in patients with chronic diseases, but it is unclear whether this utilization may be reduced. We aimed to measure the proportion of compliant antimicrobial prescriptions according to the provincial guidelines for the treatment of common respiratory and urinary infections and measure variations in this proportion with certain chronic diseases. Methods Antimicrobial dispensing covered by the public drug insurance plan between April 2010 and March 2017, delivered within 2 days of an outpatient consultation for an infection was included. Infections targeted by provincial guidelines were studied: otitis media, pharyngitis, pneumonia, sinusitis, bronchitis and chronic obstructive pulmonary disease exacerbations, cystitis, and acute pyelonephritis. The proportion of prescriptions compliant with guidelines (right antimicrobial for children, and right antimicrobial and dosage for adults) was computed by age group (children or adults) and per category of chronic disease (respiratory, cardiovascular, diabetes, mental disorder, none of previous). For each infection and age group, multivariate robust Poisson regression was used to measure the impact of categories of chronic diseases on proportions of prescriptions compliant with guidelines. Results Between 14 677 and 312 786 prescriptions were included, for each infection. Compliance to guidelines was above 87% in children and was significantly lower (≤ 3% bellow) in children with asthma. In adults, the choice of agent was compliant for at least 73% of prescriptions, except for cases of pharyngitis (between 53% and 61%). Accounting for dosage led to lower proportions of compliance, which varied between 19% (cystitis with diabetes) and 77% (pyelonephritis with none of the studied chronic disease categories). Compliant prescriptions were 2,4% to 20,4% less frequent in the presence of chronic diseases (statistically significant). Conclusion Non-compliant prescriptions could still be appropriate, but their high frequency suggests there is room for improvement. Dosage seems particularly problematic. Additional support could be offered to clinicians for the prescription of antimicrobials to patients with chronic diseases. Disclosures All Authors: No reported disclosures

Phytochemical and Potential Pharmacological Properties of Pavetta indica Linn

Background: Pavetta indica Linn is a medicinal plant that belongs to the family of Rubiaceae. The parts of this plant are used in indigenous clinical practices, especially for treating visceral obstruction, haemorrhoidal pains, rheumatism and eye diseases, and in the preferential treatment of liver disease, pain from piles, urinary infections, and fever. Despite its usage in indigenous clinical practices, there is limited available information on comparative pharmacognostic, physicochemical, phytochemical, ethnopharmacological data and antioxidant capacity of this herb. Aim: To review and summarize the medicinal properties of Pavetta indica Linn after critically evaluating the published studies reporting and to identify potential research areas from the existing data. Methodology: In the first phase, a comprehensive literature search was carried out in several databases under the PRISMA (Preferred Reporting Project for Systematic Reviews and Meta-Analysis) guidelines. Results: The plant reported various classes of bioactive compounds with the main components: carbohydrates, glycosides, alkaloids, phytosterols, saponins, tannins, proteins and amino acids, phenolic and flavonoids. Extracts of this plant possess multiple pharmacological activities such as hepatoprotective, anti-inflammatory, antioxidant, antidiabetic, neuroprotective and wound healing factors, anti-dementia, anti-cancer, antimicrobial, antihelminthic and diuretic properties. Conclusion: This review gives vital information on the traditional uses and, on the other hand, modern discoveries such as phytochemistry and pharmacology of Pavetta indica Linn. The therapeutic value of the plant was discovered based on the information gathered during the review process. As a result, greater research on this plant should be encouraged to identify new useful drugs and therapeutic effects and test using clinical studies.