Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: a probabilistic modelling study

Dp, Smith; Pouwels, Koen B; Hopkins, Susan; Naylor, Nichola R; Robotham, Julie V.

doi:10.1016/j.jhin.2019.04.010

Cited by 45 publications

(35 citation statements)

References 37 publications

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“…Urinary tract infections (UTIs) are ranked as leading causes of healthcare-associated infections, which also account for significant morbidity and high economic costs [1, 2]. Among the pathogens causing UTIs, Escherichia coli is the most important one causing more than 75% of community-acquired UTIs and 30-50% of nosocomially-acquired UTIs [3].…”

Section: Introductionmentioning

confidence: 99%

Identification of essential oils with strong activity against stationary phase uropathogenic Escherichia coli

Xiao

Cui

Shi

et al. 2019

Preprint

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Escherichia coli is the most dominant pathogen causing urinary tract infections (UTIs), but the current most frequently prescribed antibiotics do not always effectively cure the infection due to quiescent persister bacteria. While it has been reported that some essential oils have antimicrobial activity against growing E. coli, the activity of essential oils against the non-growing stationary phase E. coli which is enriched in persisters has not been investigated. We evaluated the activity of 140 essential oils against stationary phase uropathogenic E. coli UTI89 and identified 39, 8 and 3 essential oils at 0.5%, 0.25% and 0.125% concentrations to have high activity against stationary phase E. coli. Among the top eight essential oils, Oregano showed higher activity than the known persister drug tosufloxacin. The other top seven hits included Allspice, Bandit "Thieves", Cinnamon bark, Syzygium aromaticum, Health shield, Cinnamon leaf and Clove bud. In Oregano essential oil drug combination studies with common UTI antibiotics, Oregano plus quinolone drugs (tosufloxacin, levofloxacin, ciprofloxacin) completely eradicated all stationary phase E. coli cells, partially enhanced the activity of nitrofurantoin, but had no apparent enhancement for fosfomycin, meropenem and cefdinir. Our findings may facilitate development of more effective treatments for persistent UTIs.

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Section: Introductionmentioning

confidence: 99%

Identification of essential oils with strong activity against stationary phase uropathogenic Escherichia coli

Xiao

Cui

Shi

et al. 2019

Preprint

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“…Preventing CAUTI is important for a number of reasons. Prevention of CAUTI is vital, not only because of associated morbidity, mortality Open access and increased length of stay in hospital, [2][3][4][5] but because of the added threats posed by increasing antimicrobial resistance. 36 The effect of meatal cleaning in reducing the risk of bacteriuria The meta-analysis exploring the effect of meatal cleaning in reducing the risk of bacteriuria, included studies that used antiseptics for routine meatal cleaning, for example, post catheter insertion, as well as studies using antiseptics as part of the catheter insertion process (prior to urinary catheterisation; figure 2).…”

Section: Discussionmentioning

confidence: 99%

“…They account for around 70%-80% of hospital-acquired urinary tract infections (UTIs), are associated with longer length of hospital stay and increased risk of morbidity and mortality. [2][3][4][5] In the UK, economic analyses of hospital inpatient costs estimated that CAUTIs caused over 45 000 excess bed days, 1467 deaths, and a loss of 10 471 qualityadjusted life years (QALYs). 6 The burden of CAUTIs for both patients and health services highlight the importance of reducing these infections in healthcare settings.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of meatal cleaning in the prevention of catheter-associated urinary tract infections and bacteriuria: an updated systematic review and meta-analysis

et al. 2021

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ObjectiveA systematic review on meatal cleaning prior to urinary catheterisation and post catheterisation and reduces the risk catheter-associated urinary tract infections (CAUTIs) and bacteriuria was published in 2017, with further studies undertaken since this time. The objective of this paper is to present an updated systematic review on the effectiveness of antiseptic cleaning of the meatal area for the prevention of CAUTIs and bacteriuria in patients who receive a urinary catheter.DesignSystematic review.Data sourcesElectronic databases Cochrane Library, PubMed, Embase, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Academic Search Complete were searched from 1 January 2016 and 29 February 2020.Eligibility criteriaRandomised controlled trials (RCTs) and quasi-experimental studies evaluating the use of antiseptic, antibacterial or non-medicated agents for cleaning the meatal, periurethral or perineal areas before indwelling catheter insertion or intermittent catheterisation or during routine meatal care.Data extraction and synthesisData were extracted using the Cochrane Collaboration’s data collection form for RCTs and non-RCTs. Data were extracted by one researcher and then checked for accuracy by a second researcher.ResultsA total of 18 studies were included. Some potential benefit of using antiseptics, compared with non-antiseptics for meatal cleaning to prevent bacteriuria and or CAUTI was identified (OR 0.84, 95% CI 0.69 to 1.02; p=0.071). Antiseptics (chlorhexidine or povidine-iodine) may be of value for meatal cleaning on the incidence of CAUTI, compared with comparator agents (saline, soap or antimicrobial cloths) (OR=0.65, 95% CI 0.42 to 0.99; p=0.047).ConclusionThere is emerging evidence of the role of some specific antiseptics (chlorhexidine) prior to urinary catheterisation, in reducing CAUTIs, and some potential benefit to the role of antiseptics more generally in reducing bacteriuria.PROSPERO registration numberCRD42015023741.

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“…In addition, UTIs result in a huge economic burdens to healthcare systems, leading to significant losses of income, morbidity, and restricted activity [ 1 , 3 , 5 , 10 , 15 , 16 , 17 ]. UTIs are responsible for one million emergency room visits in the USA and 100,000 hospitalizations each year [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

Palacios‐Ceña

Hernández‐Barrera

Fernández‐de‐las‐Peñas

et al. 2021

JCM

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(1) Background: To assess time trends in the incidence and in-hospital outcomes of urinary tract infection (UTI) in older people (≥65 years) in Spain (2001–2018) according to sex and to identify the factors independently associated with in-hospital mortality (IHM). (2) Methods: Using the Spanish National Hospital Database, we analyzed comorbidity, procedures, diagnosis, isolated microorganisms, and outcomes. (3) Results: We included 583,693 admissions (56.76% women). In both sexes, the incidence increased with age over time (p < 0.001). In men and women, the highest IHM was found among the oldest patients (>84 years) with values of 9.16% and 8.6%, respectively. The prevalence of bacteremia increased from 4.61% to 4.98% from 2001 to 2018 (p < 0.001) and sepsis decreased from 3.16% to 1.69% (p < 0.001). The risk of dying increased with age (>84 years) (OR 3.63; 95% CI 3.5–3.78) and with almost all comorbidities. Urinary catheter was a risk factor for women (OR 1.1; 95% CI 1.02–1.18) and protective for men (OR 0.71; 95% CI 0.66–0.76). Isolation of Staphylococcus aureus increased the risk of IHM by 40% among men (OR 1.4; 95% CI 1.28–1.53). After adjusting for confounders, IHM decreased over time. (4) Conclusions: The incidence of UTIs was higher in older patients and increased over time; however, IHM decreased during the same period. Female sex, age, comorbidities, sepsis, and a Staphylococcus aureus isolation increased risk of IHM.

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Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: a probabilistic modelling study

Cited by 45 publications

References 37 publications

Identification of essential oils with strong activity against stationary phase uropathogenic Escherichia coli

Identification of essential oils with strong activity against stationary phase uropathogenic Escherichia coli

Effectiveness of meatal cleaning in the prevention of catheter-associated urinary tract infections and bacteriuria: an updated systematic review and meta-analysis

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)

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