...2 Urinary tract infection is one of the most common infections diagnosed among women in the world. There has been increasing concern for alternative method to treat urinary tract infection over antibiotics since misuse of antibiotics can led to bacterial resistance(Scholes et al., 2004). This essay will establish PICO (population, intervention, comparison and outcome) question in the given scenario where a 22 year old Susan visits the GP with symptoms of urinary frequency, dysuria, lower back pain and shivering. She was diagnosed with Urinary tract infection (hereby referred as UTI) and antibiotics were prescribed. However after developing thrush due to antibiotics for urinary tract infection previously, she is reluctant to take antibiotics. On surfing the internet she read about cranberry juice being used to treat UTI and is considering to stop her antibiotics. PICO question development In order to provide the right pathway to commence our research and ensuring that every questions are suitable and relevant, PICO model will be used which is Population, Intervention, Comparison and Outcome(Bronson and Davis, 2011). In the given scenario, population would be women suffering from UTI. Similarly intervention is using cranberry juice to prevent UTI and comparison is to use antibiotics. Richardson et al., 2014 mentioned that the outcome would analyze the effectiveness of the intervention. Therefore the outcome would be effectiveness of cranberry juice to prevent UTI. After...
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...Flores Seriousness of Bladder Infections on Infants I. Introduction A. (Attention Getter) UTI (unary tract infection) is the most common serious bacterial infection in childhood, in which is bacteria that travels up to the urethra into the bladder and multiply, resulting in an infection; many affected children, particularly infants, have severe symptoms Approximately 7 to 8% of girls and 2% of boys have a urinary tract infection during the first 8 years of life. B. (Reason to Listen) Antibiotic treatment of children with urinary tract infections has almost eliminated the risk of death, which was approximately 20% among children hospitalized for severe kidney infections in the early 20th century. Some 50 years ago, one study described scarring found in the functional tissue of the kidney in 210 of 597 children treated for recurrent urinary tract infections. Another study in that era reported on an 11-to-27-year follow-up of 72 children hospitalized for urinary tract infections; 18% had died, 8% had progressive kidney damage, and 22% had persistent untreated or recurrent infection. C. (Speaker Credibility) The North American Pediatric Renal Trials and Collaborative Studies21 list primary diagnoses for 9854 children who had received transplants over the previous 20 years. D. (Preview) 1. First, I will discuss what’s the long term consequences a UTI can have if left untreated. 2. Second, I will cover the cause of a UTI. 3. Third, I will talk about...
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...Urinary Tract Infection in the Geriatric Population Elizabeth Shultz Abstract The geriatric population is very vulnerable to Urinary Tract Infection (UTI) and its negative consequences. If left untreated, UTI in the elderly patient can have negative consequences such as delirium or even death. UTI can also contribute to the onset of acute or chronic kidney infections, which could permanently damage the kidneys and result in renal failure. In view of this, the purpose of this paper is to review related literature to find current evidence or best practices related to UTI in the geriatric population and to objectively critique the evidence. CINAHL and MEDLINE computer databases were mainly searched from January, 2005 to January, 2015 using a combination of manual and computer-based methods. Keywords: elderly, urinary tract, elderly infection management, urinary tract infection prevention, elderly and UTI. Introduction By convention, a Urinary tract infection (UTI) is defined either as a lower tract (acute cystitis) or upper tract (acute pyelonephritis) infection (Nicolle, 2014). Urinary tract infection (UTI) is the most common infectious problem among older adults both in the community and institutional settings (Midthun, Paur, Bruce, & Midthun, 2005). The elderly population is most likely to experience UTI due to many reasons, not the least of which is their overall susceptibility to all infections...
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...prevent bacteria from sticking to the walls of the bladder. This may help reduce bladder and other urinary tract infections.” (Craig, et. al, 1998) The use of cranberry juice to effectively treat a Urinary Tract Infection (UTI) is not a heavily studied topic, but some people believe that it can be used to treat a UTI. This essay will discuss the scenario of a 22-year-old woman, Susan, who is suffering from a UTI, who wishes to drink cranberry juice as part of her treatment, instead of taking her prescribed antibiotics. Wanting to receive the best treatment for her condition, she decides to investigate further about the use of cranberry juice as a treatment for UTI’s. PICO Question Development The research that is being undertaken is using the framework of a PICO question. A PICO question is framed by studying the four elements of a clinical investigation: Population, Intervention, Comparison and Outcome. (Liampattong, 2013). The population in this scenario is Females aged 18-30. This age range is the most common ages for females to contract a UTI. It is important that the age range is specific so that the PICO question can be answered. Intervention for this scenario would be the use of antibiotics and the comparison would be to drink cranberry juice. The outcome is based on the ability to compare the between the two groups, and so is if cranberry juice would effectively treat a UTI. From the PICO steps we can develop the PICO question of: do females between the ages of 18-30...
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...An APIC Guide 2008 Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs) Developing and Applying Facility-Based Prevention Interventions in Acute and Long-Term Care Settings About APIC APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The Association’s more than 12,000 members have primary responsibility for infection prevention, control and hospital epidemiology in healthcare settings around the globe. APIC’s members are nurses, epidemiologists, physicians, microbiologists, clinical pathologists, laboratory technologists and public health professionals. APIC advances its mission through education, research, consultation, collaboration, public policy, practice guidance and credentialing. Look for other topics in APIC’s Elimination Guide Series, including: • • • • Catheter-Related Bloodstream Infections Clostridium difficile Mediastinitis MRSA in Long-Term Care Copyright © 2008 by APIC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the publisher. All inquires about this document or other APIC products and services may be addressed to: APIC Headquarters 1275 K Street, NW Suite 1000 Washington, DC 20005 Phone: 202.789.1890 Email: APICinfo@apic.org Web: www.apic.org ISBN: 1-933013-39-7 ...
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...prescribe them as the traditional drug of choice for urinary tract infections and sexually transmitted diseases. Currently, the new development of antibiotics to combat illnesses caused by bacterial resistant strains and have limited the usefulness of Sulfa medications. Objectives Upon successful completion of this presentation you should be able to: • Understand and communicate your knowledge of Sulfonamides mode of action and bacterial resistance • Identify and understand the contra indications, common signs and symptoms of allergic reactions to Sulfonamides. • Identify 3 common trade names for sulfonamides and select indication for use between different patient population. Type and class of Pathogen Sulfonamides have been in use since the 1930's , these drugs are effective against both gram- negative and gram - positive bacteria. Sulfonamides are know as broad spectrum antimicrobial drugs; they are effective against a wide variety of microorganisms most Enterobacteriaceae, Chlamydia trachomatis, Nisseria, Haemophilus influenzae,, Norcardia, E.Coli , P. mirabilis some staphylococci, and many streptococci (with exception of Enterococcus faecalis). They are used for treatment of Protozoan such as Toxoplasma gondii, and mycobacterial. Sulfonamides are use for treatment and prophylaxis of Pneumocytis carinii and Shigella small bowel infections. Mode of Action Sulfonamides are bacteriostatic...
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...problems and issues that the healthcare setting have encountered. Theses guidelines reduce or decrease, “Never Events”, while improving quality care and patient safety. The purpose of this paper is to review the guidelines that has been developed to address the Urinary Tract Infections (UTI) problem, it’s importance and significance to nursing practice, as well as its impact on the patients and community, and the differences in care based on evidence. “Patients with indwelling catheters, even with current standards of care and evidence-based practice, urinary tract infections continue to be a problem”(Kevin J. Ribby, June 2006). Practice setting problem Urinary tract infections continue to be a problem in healthcare. The numbers of patient’s with urinary tract infections are still too high. “A plethora of articles have been written about nosocomial urinary catheter-related infections, management of the catheter, and proper placement of the indwelling catheter in the male patient 4 but little about the impact of nursing education on outcomes related to decreasing UTIs and usage of indwelling urinary catheters” (Doyle B, Zubina M, Horgan M, 2001). There are a various reasons for why nurses continue to see urinary tract infections like incorrect perineal cleaning, a break in aseptic technique when inserting urethral catheters, and the amount of time a urethral catheter remains in a patient. There have been various evidence-based practices that...
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...Catheter associated urinary tract infection Introduction: A urinary tract infection is an infection, most commonly caused by E. coli, of either the lower or upper urinary tract. Urinary tract infections are the most common hospital acquired infection and the majority of the urinary tract infections acquired are associated with an indwelling urinary catheter. Recently, hospitals and other healthcare facilities have taken a special interest in the prevention of catheter associated urinary tract infections which is likely due to recent healthcare reforms. Facilities will usually have to cover the cost of any hospital acquired catheter associated urinary tract infection, hence why most facilities now have strict guidelines to prevent CAUTI. CAUTI not only is a financial problem for healthcare facilities but it is also a serious problem for the health of their patients. CAUTI increases mortality and morbidity on those who acquire it. The CDC has published a guideline to prevent CAUTI. CAUTI statistics: * Accounts for 36% of all hospital acquired infections * 10% mortality rate with 13000 associated deaths annually * It increases the length of a patient’s stay at the hospital to about 2-4 days on average * Urinary catheters are used on about 60-90% of the patients on an ICU * About 40-50% of urinary catheters do not have a valid indication for use * The risk of getting a UTI while catheterized increases about 3-10% daily, so by day 30 you will have...
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...ORIGINAL ARTICLE Factors associated with catheter-associated urinary tract infections and the effects of other concomitant nosocomial infections in intensive care units EKREM TEMIZ1, NIHAL PISKIN2, HANDE AYDEMIR2, NEFISE OZTOPRAK2, DENIZ AKDUMAN2, GUVEN CELEBI2 & FURUZAN KOKTURK3 From the 1Departments of Infectious Diseases and Clinical Microbiology, Bitlis Government Hospital, Bitlis, 2Departments of Infectious Diseases and Clinical Microbiology, and 3Department of Biostatistics, School of Medicine, Zonguldak Karaelmas University, Zonguldak,Turkey Abstract Background: Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial infections in inten- sive care units (ICUs). The objectives of this study were to describe the incidence, aetiology, and risk factors of CAUTIs in ICUs and to determine whether concomitant nosocomial infections alter risk factors. Methods: Between April and Octo- ber 2008, all adult catheterized patients admitted to the ICUs of Zonguldak Karaelmas University Hospital were screened daily, and clinical and microbiological data were collected for each patient. Results: Two hundred and four patients were included and 85 developed a nosocomial infection. Among these patients, 22 developed a CAUTI alone, 38 developed a CAUTI with an additional nosocomial infection, either concomitantly or prior to the onset of the CAUTI, and 25 devel- oped nosocomial infections at other sites. The CAUTI rate was 19.02 per 1000 catheter-days. A...
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... ------------------------------------------------- Urinary tract infection (UTI) incorporates a range of conditions including acute pyelonephritis or kidney infection. It is almost invariably caused by bacteria (Brown et al 2005, Le 2004). The incidence of this disease in pregnancy has decreased in recent years (Dawkins et al 2012), possibly due to improved antenatal care. However, it remains one of the most common complications in pregnancy (Hill et al 2005) affecting 1-2% of pregnant women (Dawkins et al 2012, Hill et al 2005, McCormick 2008). Acute Pylonephritis is the most serious urinary tract infection in pregnancy (Le 2004, McCormick et al 2008) and successful treatment usually requires hospital admission (Jolly and Wing 2010). It is most often seen in nullparous and younger women and there appears to be a link with lower socioeconomic status, diabetes and sickle cell disease, although not with ethnicity (Hill et al 2005, Jolley et al 2012). It is more common in the 2nd and 3rd trimester (Archabald et al 2009, Hazhir 2007, Hill et al 2005) as the presence of urinary pathogens seems to increase as pregnancy advances (Hill et al 2005). There does appear to be an association between repeated urinary tract infections and sexual activity (Bernard et al 2011, Pfau and Sacks 1992). If not effectively treated, acute pyelonephritis may have serious consequences for both the mother and fetus. Urinary tract infections in pregnancy may lead to septic shock, anaemia, respiratory...
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...Introduction Catheter associated urinary tract infections (CAUTIs) are a common problem found in patients who endure long-term indwelling urinary catheterization. However, some research has started to prove that the use of clean intermittent catheterization (CIC), and or the use of adult briefs can decrease the incidence of CAUTIs in acute care settings by reducing the use of indwelling catheters. CAUTIs are known the be caused by the buildup of bacteria around the urinary catheter due to improper hygiene, and or its long-term use. The use of clean intermittent catheterization in patients with urinary retention will reduce the number of unnecessary long-term indwelling catheters, which will in turn reduce the number of CAUTIs. Also, for patients who are incontinent of their bladder functions, it is proven that the use of adult briefs will reduce the number of catheter associated UTIs. It is thought that with the use of alternative methods such as...
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...& Management of Urinary Tract Infections UTI - Topics Ø Epidemiology Ø Definition/ Classification Ø Diagnosis Ø Pathogenesis/ l Risk Factors GU “Zones”: Perineal, Bladder, Ureteral, Renal Ø Radiological Evaluation/ Management 2 UTI Epidemiology Ø Only during 1st year of life, males have more UTI than females Ø Uncircumcised boys 10X risk than noncircumcised Ø U.S. Healthcare Cost and Utilization Project (HCUP) (Freedman, 2004) l l 51/100,000 children & 174/100,000 infants hospitalized annually with UTI Girls hospitalized 2.5X more than boys 3 UTI Epidemiology Ø UTI = 2.4 – 2.8% of physician visits Ø Cost: (HCUP + National Association of Children’s Hospitals and Related Institutions [NACHRI]) l l l 40,000 admissions for UTI per year Mean cost of $4500 per child for each UTI = $180 million/year without factoring the ambulatory visits 4 Definition of UTI Ø What defines a “significant” clinical UTI controversial Ø Urinary tract normally sterile Ø “Colonization” v. “Infection” is debatable Ø Collection technique is related to the reliability for UTI diagnosis 5 Classification of UTI Ø Many vague classification systems in use: complicated v. uncomplicated, upper v. lower tract, persistent v. reinfections, symptomatic v. aysmptomatic Ø Most useful clinically: first infection v. recurrent or “other” infections 6 UTI - Diagnosis Ø ...
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...Keizzie Collins UTI June 6, 2011 Mrs. Kern The urinary tract is a body filtering system, that helps get rid of unwanted waste (Berkowits, 2007). A UTI can occur anywhere in genitourinary tract (Berkowitz, 2007). Although infectious agents can enter via hamatogenously into the urinary tract, most infections will start at the urethra then ascend (Berkowits, 2007). Most predisposing factor for an UTI includes catheterization, congenitally abnormalities of the genitourinary system or because of neurologic dysfunction in the bladder (Berkowitz, 2007). If a patient has a secondary spinal cord injury or diabetic neuropathy their susceptible to UTIs also (Berkowits, 2007). Women are more prone to getting UTIs than men, simply due to having a shorter urethra (Timby, 2010). Escherichia coli cause about 80% of all UTIs (Swearingen, 2008). Women experience more problems with Staphylococcus saprophyticus then any other type of bacteria (Swearingen, 2008). The bacteria survive by the dark moist warm environment in the urinary tract (Swearing, 2008). The urinary tract is created to keep out unwanted microscopic invaders, which does not always take action (Swearingen, 2008). The symptoms of an UTI can vary from person to person. A UTI depends on the patient, age, sex and where the infection is located. Most people experience dysuria, urinary frequency or urgency, back pain, difficulty walking, foul smelling urine (Timby, 2010). The color of the urine also can appear cloudy...
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...Urinary tract infections (UTIs) are the most common nosocomial infection; accounting for up to 40% of infections reported by acute care hospitals. Up to 80% of UTIs are associated with the presence of an indwelling urinary catheter. Catheter associated urinary tract infections (CAUTIs) represent the largest proportion of healthcare associated infections (HAI). Catheter-associated urinary tract infection (CAUTI) increases hospital cost and is associated with increased morbidity and mortality .CAUTIs are considered by the Centers for Medicare and Medicaid Services to represent a reasonably preventable complication of hospitalization. As such, no additional payment is provided to hospitals for CAUTI treatment-related costs.CAUTIs can lead to complications including cystitis, pyelonephritis, gram-negative bacteremia, prostatitis, epididymitis, septic arthritis, endophthalmitis, urosepsis and even death (Centers for Disease Control [CDC], 2009). The Centers for Medicare and Medicaid Services (CMS) considers CAUTI a preventable complication and no longer reimburses for the extra costs of treatment (CMS, 2010). Nursing as a profession has an interest in following the best evidence based practice to improve outcomes and decrease cost, including reducing CAUTIs. The indwelling urinary catheter increases access of micro-organism to the bladder and inhibits complete bladder emptying. The inflated balloon which keeps the catheter in the bladder allows a small amount of urine to remain un-drained...
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...URINARY TRACT INFECTION IN PREGNANCY: BACKGROUND The occurrence of acute pyelonephritis within the duration of pregnancy increases lower urinary tract infection that has been closely associated with the upper urinary tract infection. The association of asymptomatic bacteriuria includes risk factors for lower urinary tract infection in pregnancies with multiparity, diabetes mellitus, urinary tract malformations, low socioeconomic status, and preterm labor delivery. The detrimental asymptomatic bacteriuria within the upper urinary tract as well as the lower urinary tract that may cause issues of adverse perinatal outcomes includes preterm delivery and low neonatal birth weight (5-8). The progression of pyelonephritis in nonpregnant women is only 1% to 2% whereas ASB in pregnant women will progress into pyelonephritis in 20-40% cases. This increasing chance of infection in the maternal body is due to immunosuppression normally during pregnancy; Allowing increase growth of Escherichia coli in association to the lower and upper UTIs, the acute pyelonephritis in pregnancy continues to scale significant numbers in maternal and fetal morbidity. Maternal sepsis, renal failure, and respiratory insufficiency are among the associations found between pyelonephritis and maternal-fetal compromise [3]. Due to most pyelonephritis cases presented in the second to third trimester of gestational period, the threat of preterm delivery can result in tocolytic administration, which risks for pulmonary...
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