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Urinary tract infection and antimicrobial stewardship

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https://www.readbyqxmd.com/read/29351769/protocol-to-disseminate-a-hospital-site-controlled-intervention-using-audit-and-feedback-to-implement-guidelines-concerning-inappropriate-treatment-of-asymptomatic-bacteriuria
#1
Barbara W Trautner, Pooja Prasad, Larissa Grigoryan, Sylvia J Hysong, Jennifer R Kramer, Suja Rajan, Nancy J Petersen, Tracey Rosen, Dimitri M Drekonja, Christopher Graber, Payal Patel, Paola Lichtenberger, Timothy P Gauthier, Steve Wiseman, Makoto Jones, Anne Sales, Sarah Krein, Aanand Dinkar Naik
BACKGROUND: Antimicrobial stewardship to combat the spread of antibiotic-resistant bacteria has become a national priority. This project focuses on reducing inappropriate use of antimicrobials for asymptomatic bacteriuria (ASB), a very common condition that leads to antimicrobial overuse in acute and long-term care. We previously conducted a successful intervention, entitled "Kicking Catheter Associated Urinary Tract Infection (CAUTI): the No Knee-Jerk Antibiotics Campaign," to decrease guideline-discordant ordering of urine cultures and antibiotics for ASB...
January 19, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#2
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29305250/diagnosis-and-treatment-of-urinary-tract-infections-across-age-groups
#3
REVIEW
Christine M Chu, Jerry L Lowder
Urinary tract infections (UTI) are the most common outpatient infections, but predicting the probability of UTI through symptoms and test results can be complex. The most diagnostic symptoms of UTI include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but UTIs may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29249216/pathogen-distribution-and-antimicrobial-resistance-among-pediatric-healthcare-associated-infections-reported-to-the-national-healthcare-safety-network-2011-2014
#4
Jason G Lake, Lindsey M Weiner, Aaron M Milstone, Lisa Saiman, Shelley S Magill, Isaac See
OBJECTIVE To describe pathogen distribution and antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) from pediatric locations during 2011-2014. METHODS Device-associated infection data were analyzed for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI). Pooled mean percentage resistance was calculated for a variety of pathogen-antimicrobial resistance pattern combinations and was stratified by location for device-associated infections (neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], pediatric oncology and pediatric wards) and by surgery type for SSIs...
December 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29229015/risk-factors-for-acquisition-of-multidrug-resistant-escherichia-coli-and-development-of-community-acquired-urinary-tract-infections
#5
U V Ukah, M Glass, B Avery, D Daignault, M R Mulvey, R J Reid-Smith, E J Parmley, A Portt, P Boerlin, A R Manges
We examined risk factors associated with the intestinal acquisition of antimicrobial-resistant extraintestinal pathogenic Escherichia coli (ExPEC) and development of community-acquired urinary tract infection (UTI) in a case-control study of young women across Canada. A total of 399 women were recruited; 164 women had a UTI caused by E. coli resistant to ⩾1 antimicrobial classes and 98 had a UTI caused by E. coli resistant to ⩾3 antimicrobial classes. After adjustment for age, student health service (region of Canada) and either prior antibiotic use or UTI history, consumption of processed or ground chicken, cooked or raw shellfish, street foods and any organic fruit; as well as, contact with chickens, dogs and pet treats; and travel to Asia, were associated with an increased risk of UTI caused by antimicrobial resistant E...
December 12, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/29226170/inappropriate-management-of-asymptomatic-patients-with-positive-urine-cultures-a-systematic-review-and-meta-analysis
#6
Myrto Eleni Flokas, Nikolaos Andreatos, Michail Alevizakos, Alireza Kalbasi, Pelin Onur, Eleftherios Mylonakis
Background: Mismanagement of asymptomatic patients with positive urine cultures (referred to as asymptomatic bacteriuria [ASB] in the literature) promotes antimicrobial resistance and results in unnecessary antimicrobial-related adverse events and increased health care costs. Methods: We conducted a systematic review and meta-analysis of studies that reported on the rate of inappropriate ASB treatment published from 2004 to August 2016. The appropriateness of antimicrobial administration was based on guidelines published by the Infectious Diseases Society of America...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29189614/acquired-infection-and-antimicrobial-utilization-during-initial-nicu-hospitalization-in-infants-with-congenital-diaphragmatic-hernia
#7
Sarah Keene, Karna Murthy, Eugenia Pallotto, Beverly Brozanski, Jason Gien, Isabella Zaniletti, Cheryl Hulbert, Ruth Seabrook, Natalie Rintoul, Louis Chicoine, Nicolas Porta, Theresa R Grover
BACKGROUND: In addition to substantial medical and surgical intervention, neonates with congenital diaphragmatic hernia (CDH) often have concurrent concerns for acquired infection. However, few studies focus on infection and corresponding antimicrobial utilization in this population. METHODS: The Children's Hospital Neonatal Database was queried for CDH infants hospitalized from Jan 2010- Feb 2016. Patient charts were linked to the Pediatric Health Information Systems (PHIS) database...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29179565/american-urological-association-antibiotic-best-practice-statement-and-ureteroscopy-does-antibiotic-stewardship-help
#8
Daniel J Greene, Bradley C Gill, Bryan Hinck, Yaw A Nyame, Nima Almassi, Venkatesh Krishnamurthi, Mark Noble, Sri Sivalingam, Manoj Monga
PURPOSE: To determine compliance with the American Urological Association (AUA) antimicrobial prophylaxis best practice statement and whether the use of postoperative antibiotics is associated with lower rates of postoperative urinary tract infection (UTI) in patients with nephroureterolithiasis and a negative preoperative urine culture undergoing ureteroscopy. MATERIALS AND METHODS: A retrospective review of all adult patients undergoing ureteroscopy from 2013 to 2014 for stone disease with a negative preoperative urine was conducted...
January 3, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29177489/disease-based-antimicrobial-stewardship-a-review-of-active-and-passive-approaches-to-patient-management
#9
Farnaz Foolad, Jerod L Nagel, Gregory Eschenauer, Twisha S Patel, Cynthia T Nguyen
Although new antimicrobial stewardship programmes (ASPs) often begin by targeting the reduction of antimicrobial use, an increasing focus of ASPs is to improve the management of specific infectious diseases. Disease-based antimicrobial stewardship emphasizes improving patient outcomes by optimizing antimicrobial use and increasing compliance with performance measures. Directing efforts towards the comprehensive management of specific infections allows ASPs to promote the shift in healthcare towards improving quality, safety and patient outcome metrics for specific diseases...
December 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29141775/impact-of-interventions-by-an-antimicrobial-stewardship-program-team-on-appropriate-antimicrobial-therapy-in-patients-with-bacteremic-urinary-tract-infection
#10
Mitsuru Yanai, Maiko Ogasawara, Yuta Hayashi, Kiyozumi Suzuki, Hiromichi Takahashi, Atsushi Satomura
BACKGROUND: Inappropriate antimicrobial therapy often leads to poor outcomes. This study aimed to evaluate the impact of an antimicrobial stewardship program (ASP) team on appropriate therapy, in patients with bacteremic urinary tract infection (UTI). PATIENTS AND METHODS: We retrospectively reviewed the interventions by the ASP team in 807 patients with bacteremic UTI. Interventions were divided into 3 groups: group A (conventional report), group B (conventional report and written alert on the chart), and group C (conventional report and oral recommendation with/without written alert)...
November 12, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29026619/16s-rrna-deep-sequencing-identifies-actinotignum-schaalii-as-the-major-component-of-a-polymicrobial-intra-abdominal-infection-and-implicates-a-urinary-source
#11
Andrew Bryan, Lindsey M Kirkpatrick, John J Manaloor, Stephen J Salipante
Introduction. It can be difficult to catalogue the individual organisms comprising polymicrobial patient infections, both because conventional clinical microbiological culture does not facilitate the isolation and enumeration of all members of a complex microbial community, and because fastidious organisms may be mixed with organisms that grow rapidly in vitro. Empiric antimicrobial treatment is frequently employed based on the anatomical site and the suspected source of the infection, especially when an appropriately collected surgical specimen is not obtained...
May 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28923621/extended-spectrum-beta-lactamase-producing-enterobacteriaceae-related-urinary-tract-infection-in-kidney-transplant-recipients-risk-factors-treatment-and-long-term-outcome
#12
S Brakemeier, S I Taxeidi, B Zukunft, D Schmidt, J Gaedeke, M Dürr, S Hansen, K Budde
BACKGROUND: Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) has risen in kidney transplant (KT) patients, with no long-term data so far on graft function or survival. METHODS: KT patients with ESBL-E-positive urine culture were retrospectively analyzed regarding initial adequate antimicrobial therapy, recurrent infection, transplant function, and survival compared with an ESBL-E-negative KT control cohort. RESULTS: ESBL-E-positive KT patients (n = 93) were older (55...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28859935/urinary-tract-infections-recurrence-and-development-of-urinary-specific-antibiogram-for-kidney-transplant-recipients
#13
Ghazwa B Korayem, Tirdad T Zangeneh, Kathryn R Matthias
INTRODUCTION: Urinary tract infections (UTI) recurrence and antimicrobial resistance remain a common problem in kidney transplant recipients. While the use of annual institutional antibiograms may help guide appropriate empiric antibiotic selection, these non-disease specific antibiograms do not always account for patient-specific risk factors or disease-specific resistance patterns. OBJECTIVES: To determine the frequency of UTI recurrence during the first-year after kidney transplantation and whether antimicrobial susceptibility differs between an institutional antibiogram and the disease-specific antibiogram for patients after kidney transplantation...
August 28, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28844374/urinary-tract-infection-surveillance-in-residential-aged-care
#14
Susan Ryan, Elizabeth Gillespie, Rhonda L Stuart
OBJECTIVES: The aim of this research was to determine the prevalence of urinary tract infections (UTIs) in 2 aged care homes (ACHs) and examine the extent to which presumed UTIs met the 2012 McGeer infection surveillance definitions. DESIGN: Retrospective observational study. SETTING: Two ACHs: a 30-bed facility and a 100-bed facility PARTICIPANTS: Residents of the 2 ACHs diagnosed with UTI. METHODS: A retrospective review was conducted of UTIs clinically diagnosed at the 2 facilities over a 16-month period, utilizing surveillance and microbiologic data, resident progress notes, and medication charts...
August 22, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28782707/extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-colonisation-in-long-term-care-facilities-a-systematic-review-and-meta-analysis
#15
REVIEW
Myrto Eleni Flokas, Michail Alevizakos, Fadi Shehadeh, Nikolaos Andreatos, Eleftherios Mylonakis
The objectives of this study were to estimate the colonisation rate by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) among residents of long-term care facilities (LTCFs) and to identify pertinent risk factors. A systematic search of PubMed and EMBASE databases for studies published up to May 2016 that provided raw data for gastrointestinal colonisation by ESBL-PE among LTCF residents was performed. Twenty-three studies reporting data on 9775 screened subjects met the inclusion criteria...
August 3, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28781507/development-of-antibiotic-stewardship-practices-targeting-urinary-tract-infections-in-a-hospital-with-consultant-based-infectious-disease-services
#16
Kristine Sobolewski, Jennifer Costello, Lincoln Miller
PURPOSE: Ensuring proper use of antimicrobials through the development and implementation of stewardship programs translates to improved patient outcomes. This article will describe the development of an antibiotic stewardship program at a facility with consultant-based infectious disease services. METHODS: Program development involved a multifaceted approach, including identification of a physician stewardship champion, design of a retrospective analysis, development of a physician scoring card, and creation and auditing of a real-time reporting system targeting prospective de-escalation opportunities...
August 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28706384/antimicrobial-susceptibility-risk-factors-and-prevalence-of-bla-cefotaximase-temoneira-and-sulfhydryl-variable-genes-among-escherichia-coli-in-community-acquired-pediatric-urinary-tract-infection
#17
Kallyadan V Nisha, Shetty A Veena, Shenoy D Rathika, Shenoy M Vijaya, Shetty K Avinash
INTRODUCTION: The emergence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has become an important challenge among pediatric patients with community-acquired urinary tract infection (UTI). OBJECTIVES: The aim of this study was to assess the antimicrobial susceptibility patterns, associated risk factors and to survey the frequency of bla cefotaximase (CTX-M), bla temoneira (TEM), and bla sulfhydryl variable (SHV) genotypes in ESBL-producing E...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28697159/outpatient-parenteral-antimicrobial-therapy-and-judicious-use-of-pediatric-emergency-resources
#18
Michael Xu, Quynh Doan
BACKGROUND: Pediatric returns to the emergency department (RTED) vary between 3% and 13% of the total ED volume of visits. However, the incidence and contribution of scheduled RTED on pediatric emergency department (PED) utilization is less clear. Antimicrobial stewardship programs on inpatient wards have been shown to improve judicious use of outpatient parenteral antimicrobial therapy (OPAT) in upon discharge. The implementation of such programs in PEDs has yet to be reported. The objectives of this study are to quantify the burden of scheduled RTED for OPAT on PED utilization and to examine how frequently OPAT use are supported by published practice standards for 3 common pediatric infections-cellulitis, pneumonia, and urinary tract infections...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28628930/-rational-use-of-antibiotics-data-form-a-survey-from-2014-within-the-mrdo-network-compared-to-nationwide-data-from-2009
#19
Luba Lendowski, Peter Walger, Christoph Hoeser, Martin Exner, Claudia Roesing, Steffen Engelhart
Introduction To combat multi-resistant gram-negative bacteria as the cause of life-threatening infections, antibiotic stewardship activities are of great importance. Objective To detect weaknesses when prescribing antibiotics in hospitals and compare the situation between 2009 and 2014. Methods In 2014, a questionnaire was sent to all 380 physicians employed in 7 hospitals. Primary, secondary and tertiary care hospitals were included. Investigated were: demographic data, position, certified specialization, presence of antibiotic prescription rules and behavior to follow them...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28577933/impact-of-selective-reporting-of-antibiotic-susceptibility-test-results-on-the-appropriateness-of-antibiotics-chosen-by-french-general-practitioners-in-urinary-tract-infections-a-randomised-controlled-case-vignette-study
#20
Loic Bourdellon, Nathalie Thilly, Sébastien Fougnot, Céline Pulcini, Sandrine Henard
Selective reporting of antibiotic susceptibility test (AST) results is a potential intervention for laboratory-based antibiotic stewardship. The aim of this study was to assess the impact of AST reporting on the appropriateness of antibiotics selected by French general practitioners for urinary tract infections (UTIs). A randomised controlled case-vignette study in a region of northeast France surveyed general practitioners between July and October 2015 on treatment of four clinical cases of community-acquired Escherichia coli UTIs (two cases of complicated cystitis, one of acute pyelonephritis and one male UTI)...
August 2017: International Journal of Antimicrobial Agents
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