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Asymptomatic bacteriuria

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https://www.readbyqxmd.com/read/28636060/developing-mobile-clinical-decision-support-for-nursing-home-staff-assessment-of-urinary-tract-infection-using-goal-directed-design
#1
Wallace Jones, Cynthia Drake, David Mack, Blaine Reeder, Barbara Trautner, Heidi Wald
BACKGROUND: Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. OBJECTIVES: We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff...
June 20, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28624753/treatment-of-asymptomatic-uti-in-older-delirious-medical-in-patients-a-prospective-cohort-study
#2
Monidipa Dasgupta, Chris Brymer, Sameer Elsayed
BACKGROUND: Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. OBJECTIVE: To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. METHODS: Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms...
May 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28601885/safety-and-efficacy-of-intravesical-bacillus-calmette-gu%C3%A3-rin-immunotherapy-in-patients-with-non-muscle-invasive-bladder-cancer-presenting-with-asymptomatic-bacteriuria-a-systematic-review
#3
Sławomir Poletajew, Piotr Zapała, Piotr Radziszewski
Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy in bladder cancer patients with asymptomatic bacteriuria (ABU) remains a matter of debate. The aim of this systematic review was to present available evidence on the safety and efficacy of BCG immunotherapy in patients with ABU. A literature search within the Medline and the Embase databases was conducted with the following search terms: adverse events, bacteriuria, BCG, bladder cancer, cystitis, infection, pyuria, side effects and urinary tract infection (UTI)...
June 10, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28573366/-antibiotic-stewardship%C3%A2-2-0-individualization-of-therapy
#4
REVIEW
M W Pletz, E Tacconelli, T Welte
Antibiotic resistance is a part of bacterial evolution and therefore unavoidable. In the context of missing novel treatment options, the restrictive use of available antibiotics in order to decelerate the spread of resistance is of high importance. This is the aim of Antibiotic Stewardship (ABS). ABS consists of two sides: a structural one and an individual one. The former deals with the formation of ABS teams, the analysis of antibiotic usage and resistance development, and the implementation of certain measures to improve antibiotic use; the latter is reflected by concrete bedside decisions: How can (broad) spectrum antibiotics be spared without harming the patient? This can be achieved, for example, by de-escalation, limiting duration of treatment, and avoiding nonindicated use...
June 1, 2017: Der Internist
https://www.readbyqxmd.com/read/28542707/-urinary-tract-infection-requiem-for-a-heavyweight
#5
Thomas E Finucane
"Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few...
May 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28531289/management-of-bacteriuria-in-veterans-affairs-hospitals
#6
Emily S Spivak, Muriel Burk, Rongping Zhang, Makoto M Jones, Melinda M Neuhauser, Matthew Bidwell Goetz, Francesca E Cunningham
Background: Bacteriuria contributes to antibiotic overuse through treatment of asymptomatic bacteriuria (ASB) and long durations of therapy for symptomatic urinary tract infections (UTIs), yet large-scale evaluations of bacteriuria management among inpatients are lacking. Methods: Inpatients with bacteriuria were classified as asymptomatic or symptomatic based on established criteria applied to data collected by manual chart review. We examined frequency of treatment of ASB, factors associated with treatment of ASB, durations of therapy, and frequency of complications including Clostridium difficile infection, readmission and all-cause mortality within 28 days of discharge...
May 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28503324/a-5-day-antibiotic-course-for-treatment-of-intermittent-catheter-associated-urinary-tract-infection-in-patients-with-spinal-cord-injury
#7
Jean-Gabriel Previnaire, Morgane Le Berre, Elisabeth Hode, Vincent Dacquet, Hemanou Bordji, Pierre Denys, Jean-Marc Soler
INTRODUCTION: This was a retrospective monocentric study conducted at Centre Calvé, France, with the objective of evaluating the effectiveness of a 5-day course of antibiotics for symptomatic (mild urinary tract infection, UTI) or asymptomatic (aBact) bacteriuria in patients with spinal cord injury on intermittent catheterization. CASE PRESENTATION: This study was conducted from May 2013 to September 2016. Antibiotic selection always followed culture collection and analysis of antibiograms...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28487871/old-habits-die-hard-does-early-urinary-catheter-removal-affect-kidney-size-bacteriuria-and-uti-after-renal-transplantation
#8
Roghayeh Akbari, Sedigheh Rahmani Firouzi, Abazar Akbarzadeh-Pasha
Introduction: Renal transplantation is the treatment of choice in chronic renal failure patients. Objectives: The purpose of this study was to evaluate the impact of urinary catheter removal time on transplanted kidney size and incidence of asymptomatic bacteriuria and urinary tract infections (UTIs). Patients and Methods: This retrospective cohort study evaluated the clinical outcomes of 109 consecutive live donor renal transplant recipients from December 2011 to July 2014. Routine ultrasound examinations were performed on donor's kidney prior to operation and one month later...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28486744/epidemiology-and-outcome-of-antimicrobial-resistance-to-gram-negative-pathogens-in-bacteriuric-kidney-transplant-recipients
#9
Catherine Delmas-Frenette, Marc Dorais, Alexandre Tavares-Brum, Charles Frenette, Bing Yang, Samar Medani, Alain Duclos, Danielle Rouleau, Habib Mawad, Azemi Barama, Heloise Cardinal
BACKGROUND: In kidney transplant recipients, episodes of bacteriuria are often treated regardless of the presence of symptoms because of the lack of clear treatment guidelines suggesting otherwise. This practice may lead to the development of antimicrobial resistance. Our aim was to determine the incidence, determinants, and impact of antimicrobial resistance in kidney transplant recipients with gram-negative bacteriuria. METHOD: We conducted a single-center, retrospective cohort study in patients who received a kidney transplantation between January 2008 and June 2013...
May 9, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28479108/validity-of-urine-dipstick-test-to-assess-eradication-of-urinary-tract-infection-in-persons-with-spinal-cord-injury
#10
J G Previnaire, J M Soler, L Chouaki, L Pawlicki, M Le Berre, E Hode, P Denys
OBJECTIVES: To prospectively study the predictive value (PV) of urine nitrite (NIT) dipstick testing against urine cultures during antibiotic treatment for urinary tract infection (UTI), and other situations, in patients with spinal cord injury (SCI). METHODS: Inpatients with SCI on intermittent catheterisation (IC) or a Foley indwelling catheter (FC) were included. Urine specimens were collected in patients without symptoms (routine), with symptoms of UTI (suspicion), and on day 4 of a 5-day antibiotic treatment (ATB+3)...
May 4, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28476493/promoting-appropriate-urine-culture-management-to-improve-health-care-outcomes-and-the-accuracy-of-catheter-associated-urinary-tract-infections
#11
REVIEW
Robert Garcia, Eric D Spitzer
Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection...
May 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28468911/impact-of-two-step-urine-culture-ordering-in-the-emergency-department-a-time-series-analysis
#12
Amanda Stagg, Haydon Lutz, Sakshi Kirpalaney, John Justin Matelski, Adam Kaufman, Jerome Leis, Janine McCready, Jeff Powis
BACKGROUND: Despite evidence against the use of antimicrobials for asymptomatic bacteriuria (ASB), they are frequently prescribed leading to unnecessary adverse events. Prior studies have shown that reducing unnecessary urine cultures (UCs) results in decreased antimicrobial utilisation for ASB. Emergency departments (EDs) submit the largest volume of UCs, yet efforts to limit overordering in this patient setting have had limited success. METHODS: A new two-step model of care for urine collection, using a novel UC collection container, was implemented in the ED of a large community hospital...
May 3, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28457090/clinical-and-microbiological-outcomes-of-asymptomatic-bacteriuria-in-elderly-stroke-patients
#13
Efraim Aizen, Bela Shifrin, Inna Shugaev, Israel Potasman
BACKGROUND: The optimal approach to the evaluation of asymptomatic bacteruria in stroke patients is uncertain. OBJECTIVES: To compare elderly patients after an acute stroke with and without asymptomatic bacteriuria for the development of symptomatic urinary tract infections (UTI). METHODS: We prospectively monitored patients over 65 years of age admitted to our rehabilitation hospital after an acute stroke, with and without asymptomatic bacteriuria, for the development of symptomatic UTIs...
March 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28451019/prevalence-aetiology-and-antibiotic-sensitivity-profile-of-asymptomatic-bacteriuria-isolates-from-pregnant-women-in-selected-antenatal-clinic-from-nairobi-kenya
#14
Adelaide Ogutu Ayoyi, Gideon Kikuvi, Christine Bii, Samuel Kariuki
INTRODUCTION: Asymptomatic bacteriuria (ASB) is the presence of bacteria in urine without apparent symptoms of urinary tract infections. The importance of asymptomatic bacteriuria lies in the insight it provides into symptomatic infections. To determine prevalence, bacterial isolates and Antibiotic Sensitivity Profile of asymptomatic bacterial urinary tract infection in pregnant women in selected clinics in Nairobi. METHODS: This was a cross-sectional study involving women attending antenatal clinic at selected clinics of Nairobi County...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28444291/pasteurella-aerogenes-as-an-asymptomatic-bacteriuria-agent
#15
Demet Alaygut, Aynur Engin
'Asymptomatic bacteriuria' (ASB) is isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs referable to urinary infection. Catheterized specimens are less likely to be contaminated compared with voided specimens; therefore, positive cultures of catheterized specimens are more likely to reflect true bladder bacteriuria even with low colony counts. The common pathogens for ASB are Escherichia coli, Klebsiella and Streptococcus spp...
April 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28370973/a-single-center-open-label-randomized-parallel-group-study-assessing-the-relationship-between-asymptomatic-bacteriuria-and-inflammation-in-maintenance-hemodialysis-patients
#16
Ilia Beberashvili, Evgeni Golovko, Liat Golinsky, Nedal Garra, Inna Sinuani, Leonid Feldman, Oleg Gorelik, Shai Efrati, Kobi Stav
INTRODUCTION: The significance of asymptomatic bacteriuria in maintenance hemodialysis (MHD) patients remains controversial. We hypothesized that the presence of asymptomatic bacteriuria as a sole clinical manifestation of urinary tract infection (UTI) in asymptomatic MHD patient may contribute to the chronic inflammatory response. Our aim was to explore the relationship between asymptomatic bacteriuria and elevated levels of inflammatory markers in MHD patients. METHODS: A randomized open-label single center study of 114 MHD patients was conducted...
April 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28350833/a-fast-and-frugal-algorithm-to-strengthen-diagnosis-and-treatment-decisions-for-catheter-associated-bacteriuria
#17
Aanand D Naik, Felicia Skelton, Amber B Amspoker, Russell A Glasgow, Barbara W Trautner
OBJECTIVES: Guidelines for managing catheter-associated urinary tract infection (CAUTI) and asymptomatic bacteria (ASB) are poorly translated into routine care due in part to cognitive diagnostic errors. This study determines if the accuracy for CAUTI and ASB diagnosis and treatment improves after implementation of a fast and frugal algorithm compared with traditional education methods. MATERIALS AND METHODS: A pre and post-intervention with contemporaneous comparison site involving inpatient and long term care wards at two regional Veterans Affairs Systems in United States...
2017: PloS One
https://www.readbyqxmd.com/read/28345769/best-practice-policy-statement-on-urodynamic-antibiotic-prophylaxis-in-the-non-index-patient
#18
REVIEW
Anne P Cameron, Lysanne Campeau, Benjamin M Brucker, J Quentin Clemens, Gregory T Bales, Michael E Albo, Michael J Kennelly
AIMS: Antibiotic prophylaxis before urodynamic testing (UDS) is widely utilized to prevent urinary tract infection (UTI) with only limited guidance. The Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) convened a Best Practice Policy Panel to formulate recommendations on the urodynamic antibiotic prophylaxis in the non-index patient. METHODS: Recommendations are based on a literature review and the Panel's expert opinion, with all recommendations graded using the Oxford grading system...
April 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28325856/prevalence-of-undiagnosed-asymptomatic-bacteriuria-and-associated-risk-factors-during-pregnancy-a-cross-sectional-study-at-two-tertiary-centres-in-cairo-egypt
#19
Mohamed Abdel-Aziz Elzayat, Ashton Barnett-Vanes, Mohamed Farag Elmorsy Dabour, Feng Cheng
BACKGROUND: The prevalence of asymptomatic bacteriuria (ASB) during pregnancy is poorly understood in Egypt-a country with a high birth rate. OBJECTIVES: To determine the prevalence of ASB among pregnant women booking at El Hussein and Sayed Galal Hospitals in Al-Azhar University in Egypt; and to observe the relationship between ASB prevalence and risk factors such as socioeconomic level and personal hygiene. SETTING: Obstetrics and gynaecology clinics of 2 university hospitals in the capital of Egypt...
March 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28303818/biofilm-formation-capability-of-enterococcal-strains-causing-urinary-tract-infection-vis-a-vis-colonisation-and-correlation-with-enterococcal-surface-protein-gene
#20
Shubha Garg, Balvinder Mohan, Neelam Taneja
BACKGROUND: Data regarding differences in biofilm formation among urinary isolates of enterococci causing nosocomial infection versus asymptomatic colonisation is lacking. Conflicting data are available for the role of enterococcal surface protein (esp) gene in the development of enterococcal biofilms. MATERIALS AND METHODS: A total of 50 (25 each of asymptomatic bacteriuria and urinary tract infection (UTI) isolates were collected from admitted patients who had nosocomial acquisition of enterococci in urine culture (≥105 cfu/ml)...
January 2017: Indian Journal of Medical Microbiology
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