Prevalence of Hospital-Acquired Urinary Tract Infections in Urology Departments

Johansen, Truls E. Bjerklund; Çek, Mete; Naber, Kurt G.; Stratchounski, L.; Svendsen, Martin Veel; Tenke, Péter

doi:10.1016/j.eururo.2006.08.012

Cited by 103 publications

(65 citation statements)

References 11 publications

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“…In another study, from 205 analysed case histories of urosepsis, 43% resulted from urolithiasis, 25% from prostatic adenoma, 18% from urological cancer and 14% suffered other urological diseases complicated by urosepsis [5]. In patients with nosocomial UTI treated in urology departments, the prevalence of urosepsis was, on average, about 12% [6], whereas in patients with nosocomial UTI treated in other specialities the prevalence for severe sepsis was 2% and for septic shock 0·3% [7].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic challenges of urosepsis

Wagenlehner

Pilatz

Naber

et al. 2008

Eur J Clin Investigation

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Urosepsis accounts for approximately 25% of all sepsis cases and may develop from a community or nosocomial acquired urinary tract infection (UTI). The underlying UTI is almost exclusively a complicated one with involvement of parenchymatous urogenital organs (e.g. kidneys, prostate). In urosepsis, as in other types of sepsis, the severity of sepsis depends mostly upon the host response. The treatment of urosepsis comprises four major aspects: Early goal directed therapy, early optimal pharmacodynamic exposure to antimicrobials, early control of the complicating factor in the urinary tract and specific sepsis therapy. Following these prerequisites there appear two major challenges that need to be addressed:Firstly, time from admission to therapy is critical; the shorter the time to effective treatment, the higher the success rate. This aspect has to become incorporated into the organisational process. Secondly, adequate initial antibiotic therapy has to be insured. This goal implies however, a wide array of measures to ensure rational antibiotic policy. Both challenges are best targeted if an interdisciplinary approach at any level of the process is established, encompassing urologists, intensive care specialists, radiologists, microbiologists and clinical pharmacologists working tightly together at any time.

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Section: Introductionmentioning

confidence: 99%

Therapeutic challenges of urosepsis

Wagenlehner

Pilatz

Naber

et al. 2008

Eur J Clin Investigation

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“…18 Johansen et al investigated data from PEP and PEAP studies and showed that long periods of catheter use resulted in a significant linear increase in the occurrence of Candida albicans. 2 The results of our study revealed that a catheter duration exceeding three days was a risk factor for ESBL infections in both univariate (p=0,001) and multivariate analysis (p=0.019). This is probably due to the formation of bacterial biofilms developed around the catheters, which promote bacterial overgrowth.…”

Section: The Duration Of Catheter Usementioning

confidence: 63%

“…29 Likewise, Johansen et al reported that patients who had been hospitalized for any reason during the preceding six months present a significant risk for acquiring a Klebsiella sp or Pseudomonas sp as a causative pathogen. 2 The results of our study revealed that the mean duration of hospitalization is highly correlated with NAUTI in the univariate analysis, but does not represent an independent risk factor for ESBL infection in the multivariate analysis.…”

Section: Closed Drainagementioning

confidence: 69%

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Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

Bouassida¹,

Jaidane²,

Bouallègue³

et al. 2016

CUAJ

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Introduction: Our goal was to investigate the prevalence and antibiogram pattern of extended spectrum beta-lactamase (ESBL) production among uropathogens using isolates from urine samples collected at the Department of Urology in the Sahloul Hospital, Tunisia We also aimed to identify the risk factors for nosocomial urinary tract infections (UTIs) in patients who underwent transurethral resection of the prostate (TURP) and the measures for infection control. Methods: Laboratory records of a five-year period from January 2004 to December 2008 were submitted for retrospective analysis to determine the incidence of ESBL infections. A total of 276 isolates were collected. A case-control study involving comparisons between two groups of patients who underwent TURP was performed to determine the risk factors for ESBL infection. Group 1, designated case subjects, included 51 patients with nosocomial UTI after TURP. Group 2, designated control subjects, consisted of 58 randomly selected patients who underwent TURP without nosocomial UTI in the same period. Factors suspected to be implicated in the emergence of ESBL infection were compared between the two groups in order to identify risk factors for infection. A univariate regression analysis was performed, followed by a multivariate one. Results: The annual prevalence of ESBL infection ranged from 1.3-2.5%. After performing univariate and multivariate regression analysis, the main risk factors for ESBL infections were identified as: use of antibiotics the year preceding the admission, duration of catheter use, and bladder washout (p=0.012, p=0.019, and p<0.001. Conclusions: Urologists have to perform a good hemostasis, especially in endoscopic resections, in order to avoid bladder irrigation and bladder washout and to reduce the time of bladder catheterization, which is a strong risk factor of nosocomial UTIs. IntroductionHospital infections have become a growing healthcare challenge in recent decades and serious concerns have been expressed over the rise in antimicrobial resistance among pathogens causing hospital-acquired infections. Nosocomially acquired urinary tract infection (NAUTI) is one of the most common hospital-acquired infections. 2,3This infection is not already present or incubating at the time of admission, but is acquired during hospital stay. Its definition requires a 48-hour delay after admission before symptoms appear.1,4,5 NAUTI has become one of the most important quality parameters for urological surgery. The problem is further exacerbated by the emergence of drug resistance among uropathogens in the form of extended spectrum beta-lactamase (ESBL) production. In fact, the first outbreak of ESBL-producing organisms was reported in 1983 in Germany 1 and involved chromosomal-or plasmid-mediated beta-lactamases (enzymes that cleave the beta-lactam ring) that had mutated from pre-existing broad-spectrum beta-lactamases as a consequence of the extensive use of third-generation cephalosporins and aztreonam.6 Those ESBL-producing pathogens are now...

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“…Within the general population, it is a relatively rare causative pathogen in urosepsis. 1 Fungaemia secondary to Candida albicans is associated with high morbidity and mortality rates due to the fungi's polyphenic nature and ability to form virulent hyphae in patients that are immunosupressed. 2 Herein, we report an extremely unusual case of disseminated fungaemia secondary to a fungus-ball causing distal ureteric obstruction in a chronically immunosupressed patient.…”

Section: Introductionmentioning

confidence: 99%

Ureteric obstruction due to fungus-ball in a chronically immunosuppressed patient

Davis

Smyth

Mulcahy

et al. 2013

CUAJ

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E355research research AbstractCandida albicans is a fungus that can cause opportunistic urinary tract infections in immunocompromised patients. Disseminated fungaemia secondary to Candida albicans is associated with considerable mortality and therefore merits aggressive treatment. Diagnostic investigations for urosepsis and disseminated fungaemaia secondary to Candida albicans include positive urine and blood cultures. Herein, we describe an extremely unusual case of disseminated fungaemia associated with an obstructive fungusball in the distal ureter of an immunosuppressed patient. We also describe a novel application of an established endourological technique for managing this clinical scenario and discuss appropriate perioperative management strategies.

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Prevalence of Hospital-Acquired Urinary Tract Infections in Urology Departments

Cited by 103 publications

References 11 publications

Therapeutic challenges of urosepsis

Therapeutic challenges of urosepsis

Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

Ureteric obstruction due to fungus-ball in a chronically immunosuppressed patient

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