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https://www.readbyqxmd.com/read/27922910/impact-of-medicare-s-nonpayment-program-on-hospital-acquired-conditions
#1
Caroline P Thirukumaran, Laurent G Glance, Helena Temkin-Greener, Meredith B Rosenthal, Yue Li
BACKGROUND: Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inpatient days financed by Medicare] influences its response to the Program. OBJECTIVE: To determine whether the Program was associated with changes in HAC incidence, and whether this association varies across hospitals with differential Medicare patient load...
December 5, 2016: Medical Care
https://www.readbyqxmd.com/read/27919427/-lose-the-tube-a-choosing-wisely-initiative-to-reduce-catheter-associated-urinary-tract-infections-in-hospitalist-led-inpatient-units
#2
Hyung J Cho, Steve Khalil, Jashvant Poeran, Madhu Mazumdar, Nathaniel Bravo, Fran Wallach, Brian Markoff, Nathan Lee, Andrew S Dunn
We developed a multidisciplinary initiative, "Lose the Tube," focused on a Choosing Wisely recommendation to decrease catheter-associated urinary tract infection (CAUTI) rates and catheter days. Through an electronic health record catheter identification tool, daily interdisciplinary query, and clinician education, our multifaceted intervention reduced mean per-person catheter days from 3.3 to 2.9, decreased CAUTI rates from 2.85 to 0.32 per 1,000 catheter days, and reduced cost by $32,245.
December 2, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27919130/-two-cases-of-spontaneous-rupture-of-the-urinary-bladder-associated-with-radiation-cystitis-repaired-with-omentum-covering
#3
Takahito Wakamiya, Tomomi Kuramoto, Takeshi Inagaki
We experienced two cases of spontaneous rupture of the urinary bladder associated with radiation cystitis. Case 1 and Case 2 were a 45-year-old female and a 71-year-old female, respectively. Both of them were admitted to our hospital with complaints of high grade fever and severe lower abdominal pain. They had a past history of total hysterectomy followed by radiationtherapy more than10 years ago. The cystography and the subsequent computed tomography revealed spontaneous rupture of the urinary bladder. We performed the operationto repair the perforationsite with omentum covering...
October 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/27917728/comparing-catheter-associated-urinary-tract-infection-prevention-programs-between-veterans-affairs-nursing-homes-and-non-veterans-affairs-nursing-homes
#4
Lona Mody, M Todd Greene, Sanjay Saint, Jennifer Meddings, Barbara W Trautner, Heidi L Wald, Christopher Crnich, Jane Banaszak-Holl, Sara E McNamara, Beth J King, Robert Hogikyan, Barbara S Edson, Sarah L Krein
OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27916925/microbial-biofilms-in-urinary-tract-infections-and-prostatitis-etiology-pathogenicity-and-combating-strategies
#5
REVIEW
Cristina Delcaru, Ionela Alexandru, Paulina Podgoreanu, Mirela Grosu, Elisabeth Stavropoulos, Mariana Carmen Chifiriuc, Veronica Lazar
Urinary tract infections (UTIs) are one of the most important causes of morbidity and health care spending affecting persons of all ages. Bacterial biofilms play an important role in UTIs, responsible for persistent infections leading to recurrences and relapses. UTIs associated with microbial biofilms developed on catheters account for a high percentage of all nosocomial infections and are the most common source of Gram-negative bacteremia in hospitalized patients. The purpose of this mini-review is to present the role of microbial biofilms in the etiology of female UTI and different male prostatitis syndromes, their consequences, as well as the challenges for therapy...
November 30, 2016: Pathogens
https://www.readbyqxmd.com/read/27916738/a-review-of-the-recent-advances-in-antimicrobial-coatings-for-urinary-catheters
#6
REVIEW
Priyadarshini Singha, Jason Locklin, Hitesh Handa
: More than 75% of hospital-acquired or nosocomial urinary tract infections are initiated by urinary catheters, which are used during the treatment of 15-25% of hospitalized patients. Among other purposes, urinary catheters are primarily used for draining urine after surgeries and for urinary incontinence. During catheter-associated urinary tract infections, bacteria travel up to the bladder and cause infection. A major cause of catheter-associated urinary tract infection is attributed to the use of non-ideal materials in the fabrication of urinary catheters...
December 1, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27914268/anti-adhesive-antimicrobial-peptide-coating-prevents-catheter-associated-infection-in-a-mouse-urinary-infection-model
#7
Kai Yu, Joey C Y Lo, Mei Yan, Xiaoqiang Yang, Donald E Brooks, Robert E W Hancock, Dirk Lange, Jayachandran N Kizhakkedathu
Catheter-associated urinary tract infections (CAUTIs) represent one of the most common hospital acquired infections with significant economic consequences and increased patient morbidity. CAUTIs often start with pathogen adhesion and colonization on the catheter surface followed by biofilm formation. Current strategies to prevent CAUTIs are insufficiently effective and antimicrobial coatings based on antimicrobial peptides (AMPs) hold promise in curbing CAUTIs. Here we report an effective surface tethering strategy to prepare AMP coatings on polyurethane (PU), a common biomedical plastic used for catheter manufacture, by using an anti-adhesive hydrophilic polymer coating...
November 24, 2016: Biomaterials
https://www.readbyqxmd.com/read/27911468/radical-cystectomy-and-cutaneous-ureterostomy-in-4-dogs-with-trigonal-transitional-cell-carcinoma-description-of-technique-and-case-series
#8
Rafael Ricardo Huppes, Leandro Z Crivellenti, Andrigo Barboza De Nardi, Bruno Roque Lima, Cristiane Alves Cintra, Jorge Luiz Costa Castro, Christopher A Adin
OBJECTIVE: To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4). METHODS: Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed...
December 1, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27909624/for-reliable-urine-cultures-in-the-detection-of-complicated-urinary-tract-infection-do-we-use-urine-specimens-obtained-with-urethral-catheter-or-a-nephrostomy-tube
#9
Gülay Dede, Özcan Deveci, Onur Dede, Mazhar Utanğac, Mansur Dağgulli, Necmettin Penbegül, Namık Kemal Hatipoğlu
OBJECTIVE: The aim of this study was to compare the results of urine cultures obtained either from urethral, and percutaneous nephrostomy (PCN) catheters. MATERIALS AND METHODS: This study included 328 consecutive patients that underwent PCN at our institution with complicated urinary tract infections (UTIs) between July 2010 and April 2015. Results of urine cultures obtained from the urethral and nephrostomy catheters were compared. RESULTS: This study included 152 male and 176 female patients...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27906706/effects-of-cardiopulmonary-bypass-on-renal-perfusion-filtration-and-oxygenation-in-patients-undergoing-cardiac-surgery
#10
Lukas Lannemyr, Gudrun Bragadottir, Vitus Krumbholz, Bengt Redfors, Johan Sellgren, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic cardiopulmonary bypass on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen supply/demand relationship, i.e., renal oxygenation (primary outcome) in patients undergoing cardiac surgery. METHODS: Eighteen patients with a normal preoperative serum creatinine undergoing cardiac surgery procedures with normothermic cardiopulmonary bypass (2...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27904125/use-of-corticosteroids-for-urinary-tuberculosis-patients-at-risk-of-developing-ureteral-obstruction
#11
Kosuke Matsui, Akitsugu Furumoto, Kojiro Ohba, Kota Mochizuki, Takeshi Tanaka, Masahiro Takaki, Konosuke Morimoto, Koya Ariyoshi
A 77-year-old man with urinary tuberculosis developed post renal anuria two days after starting an anti-tuberculosis drug regimen. He had bilateral hydronephrosis, and his right kidney was radiologically diagnosed to be non-functioning. A transurethral catheter was placed in the left ureter. No improvement in the ureteral stricture was noted during the initial three weeks of treatment; however, the stricture did thereafter improve after the commencement of oral prednisolone. In cases of urinary tuberculosis, ureteral stricture can deteriorate and result in ureteral obstruction during anti-tuberculosis treatment...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27903130/risk-factors-and-mortality-in-the-carbapenem-resistant-klebsiella-pneumoniae-infection-case-control-study
#12
Fethiye Akgul, Ilkay Bozkurt, Mustafa Sunbul, Saban Esen, Hakan Leblebicioglu
Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been known as a nosocomial pathogen, both for the last 10 years in Turkey and for 20 years worldwide. Due to limited treatment options and high mortality rates, despite improvements in the field of medicine at the present time, CRKP is still a big threat for public health. This study was carried out between the dates of January 2010 and September 2014. Patients ≥18 who were hospitalized for at least 72 h and who also had CRKP growth were included in the study as a case group...
December 1, 2016: Pathogens and Global Health
https://www.readbyqxmd.com/read/27899416/peritoneal-dialysis-access-revision-in-children-causes-interventions-and-outcomes
#13
Dagmara Borzych-Duzalka, T Fazil Aki, Marta Azocar, Colin White, Elizabeth Harvey, Sevgi Mir, Marta Adragna, Erkin Serdaroglu, Rajiv Sinha, Charlotte Samaille, Juan Jose Vanegas, Jameela Kari, Lorena Barbosa, Arvind Bagga, Monica Galanti, Onder Yavascan, Giovanna Leozappa, Maria Szczepanska, Karel Vondrak, Kei-Chiu Tse, Franz Schaefer, Bradley A Warady
BACKGROUND AND OBJECTIVES: Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015...
November 29, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27895127/the-pathogenic-potential-of-proteus-mirabilis-is-enhanced-by-other-uropathogens-during-polymicrobial-urinary-tract-infection
#14
Chelsie E Armbruster, Sara N Smith, Alexandra O Johnson, Valerie DeOrnellas, Kathryn A Eaton, Alejandra Yep, Lona Mody, Weisheng Wu, Harry L T Mobley
Urinary catheter use is prevalent in health care settings, and polymicrobial colonization by urease-positive organisms, such as Proteus mirabilis and Providencia stuartii, commonly occurs with long-term catheterization. We previously demonstrated that coinfection with P. mirabilis and P. stuartii increased overall urease activity in vitro and disease severity in a model of urinary tract infection (UTI). In this study, we expanded these findings to a murine model of catheter-associated UTI (CAUTI), delineated the contribution of enhanced urease activity to coinfection pathogenesis, and screened for enhanced urease activity with other common CAUTI pathogens...
November 28, 2016: Infection and Immunity
https://www.readbyqxmd.com/read/27890335/device-associated-infections-in-a-paediatric-intensive-care-unit-in-pakistan
#15
A Haque, S A Ahmed, Z Rafique, Q Abbas, H Jurair, S A Ali
This study assessed the effect of implementation of active infection control and surveillance on the occurrence of device-associated infections (DAIs) in a paediatric intensive care unit (PICU) from 2012 to 2015. There were 1378 patients, equating to 4632 patient-days, on the PICU, and 29 DAI episodes, giving an incidence rate of 2.1% and an incidence density rate of 6.26 per 1000 patient-days. The rates of central-line-associated bloodstream infections, ventilator-associated pneumonia and catheter-related urinary tract infections were 7/1000 central-line-days, 1...
November 4, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27887601/protocol-for-a-prospective-randomized-study-on-neurophysiological-assessment-of-lower-urinary-tract-function-in-a-healthy-cohort
#16
Stéphanie van der Lely, Martina Stefanovic, Melanie R Schmidhalter, Marta Pittavino, Reinhard Furrer, Martina D Liechti, Martin Schubert, Thomas M Kessler, Ulrich Mehnert
BACKGROUND: Lower urinary tract symptoms are highly prevalent and a large proportion of these symptoms are known to be associated with a dysfunction of the afferent pathways. Diagnostic tools for an objective and reproducible assessment of afferent nerve function of the lower urinary tract are missing. Previous studies showed first feasibility results of sensory evoked potential recordings following electrical stimulation of the lower urinary tract in healthy subjects and patients. Nevertheless, a refinement of the methodology is necessary...
November 25, 2016: BMC Urology
https://www.readbyqxmd.com/read/27885456/-intravesical-radioimmunotherapy-of-carcinoma-in-situ-of-the-urinary-bladder-after-bcg-failure
#17
M E Autenrieth, T Horn, F Kurtz, K Nguyen, A Morgenstern, F Bruchertseifer, M Schwaiger, M Blechert, C Seidl, R Senekowitsch-Schmidtke, J E Gschwend, K Scheidhauer
BACKGROUND: In failure to respond to bacillus Calmette-Guérin (BCG) in patients with carcinoma in situ (CIS) of the urinary bladder, radical cystectomy remains the mainstay after BCG failure. OBJECTIVES: The aim of this pilot study was to evaluate tolerability and safety of the α‑emitter radioimmunoconjugate instillation in patients after BCG failure. MATERIALS AND METHODS: Nine patients were included. After emptying the bladder via a transurethral catheter, Bi-213-anti-EGFR-mAb was instilled...
November 24, 2016: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/27881213/impact-and-limitations-of-the-2015-national-health-and-safety-network-case-definition-on-catheter-associated-urinary-tract-infection-rates
#18
Ana Cecilia Bardossy, Rachna Jayaprakash, Anjali C Alangaden, Patricia Starr, Odaliz Abreu-Lanfranco, Katherine Reyes, Marcus J Zervos, George J Alangaden
Application of the new 2015 NHSN definition of catheter-associated urinary tract infection (CAUTI) in intensive care units reduced CAUTI rates by ~50%, primarily due to exclusion of candiduria. This significant reduction in CAUTI rates resulting from the changes in the definition must be considered when evaluating effectiveness of CAUTI prevention programs. Infect Control Hosp Epidemiol 2016;1-3.
November 24, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27876075/chlorhexidine-bathing-and-health-care-associated-infections-among-adult-intensive-care-patients-a-systematic-review-and-meta-analysis
#19
Steven A Frost, Mari-Cris Alogso, Lauren Metcalfe, Joan M Lynch, Leanne Hunt, Ritesh Sanghavi, Evan Alexandrou, Kenneth M Hillman
BACKGROUND: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths (Kaye and Marchaim, J Am Geriatr Soc 62(2):306-11, 2014; Roberts and Scott, Med Care 48(11):1026-35, 2010; Warren and Quadir, Crit Care Med 34(8):2084-9, 2006; Zimlichman and Henderson, JAMA Intern Med 173(22):2039-46, 2013). Importantly, infections acquired during a hospital stay have been shown to be preventable (Loveday and Wilson, J Hosp Infect 86:S1-70, 2014)...
November 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27875382/incorporation-of-leadership-rounds-in-cauti-prevention-efforts
#20
Suzanne Purvis, Gregory D Kennedy, Mary Jo Knobloch, Amy Marver, John Marx, Susan Rees, Nasia Safdar, Daniel Shirley
Leadership engagement is an important aspect of integrating best practices at the bedside. The catheter-associated urinary tract infection (CAUTI) prevention workgroup at our academic medical center implemented leadership rounding in partnership with clinical staff to increase participation in CAUTI prevention initiatives on inpatient units. There was an associated decrease in urinary catheter utilization and CAUTI rates. Implementation of leadership rounds should be considered as a part of comprehensive CAUTI prevention efforts in health care settings...
November 21, 2016: Journal of Nursing Care Quality
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