Factors associated with urinary tract infection in a Nursing Home

Silva, João Luis Almeida da; Fonseca, Cassiane Dezoti da; Stumm, Eniva Miladi Fernandes; Rocha, Roseanne Montargil; Silva, Myria Ribeiro da; Barbosa, Dulce Aparecida

doi:10.1590/0034-7167-2020-0813

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…As a result, they become susceptible to infection. In addition, diaper users have a high incidence of chronic cystitis [ 36 , 37 ]. In the present case, the patient was bedridden, very old, and her ADL had decreased, so she could have been easily infected.…”

Section: Discussionmentioning

confidence: 99%

Sepsis following acute pyelonephritis caused by Trueperella bernardiae: a case report and literature review

Matsuhisa¹,

Kenzaka

Kobayashi

et al. 2023

BMC Infect Dis

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Background Trueperella bernardiae is a coryneform, gram-positive bacterium that is a commensal of the skin and upper respiratory tract. It is treated as a contaminant and rarely causes infections. Blood, urine, and abscesses have been previously reported as the most common sites of infection. Infections caused by T. bernardiae are rarely reported in bedridden very old patients with reduced activities of daily living (ADL). In this report, we describe a case of sepsis due to acute pyelonephritis caused by T. bernardiae in a very old patient with impaired ADL. Case presentation A 94-year-old woman had a home visit from her local physician. She was bedridden and used diapers. On the day of admission, she presented with fever and dyspnea and was admitted with a diagnosis of sepsis associated with acute pyelonephritis. T. bernardiae was detected in blood and urine cultures; furthermore, multiple bacteria were detected in a urine culture. She was treated with ampicillin/sulbactam 3 g every 12 h on the day of admission. The fever was controlled, and inhaled oxygen 1 L/min via a nasal cannula was administered for dyspnea until hospitalization day 2. On hospitalization day 2, her fever resolved to 36 °C. Antimicrobials were de-escalated and changed to cephazolin and then to cephalexin on hospitalization days 9 and 16, respectively, and were continued until day 22. On hospitalization day 28, the urinary tract infection flared up; however, her fever resolved by hospitalization day 38 after the re-administration of antimicrobial agents. She was discharged on hospitalization day 60. Conclusions We encountered a rare case of sepsis following acute pyelonephritis caused by T. bernardiae infection. When bedridden, diaper-using, very old patients present with urinary tract infections caused by multiple bacteria, the presence of rare opportunistic organisms, such as T. bernardiae, should be considered.

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Section: Discussionmentioning

confidence: 99%

Sepsis following acute pyelonephritis caused by Trueperella bernardiae: a case report and literature review

Matsuhisa¹,

Kenzaka

Kobayashi

et al. 2023

BMC Infect Dis

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“…The relationship between all these elements can influence cases of UTI, as the continuous use of diapers in incontinent patients favors the accumulation of urine and feces, thus increasing the risk of UTI and cross-infections. 3 , 21 - 23 …”

Section: Discussionmentioning

confidence: 99%

“… 2 The risk factors are varied and can be linked to the condition of senescence itself as there is a decrease in the body’s defense mechanisms, as well as to the fact that they live in a community space that favors the transmission between residents, in addition to factors such as the unnecessary use of antibiotics, the frequent use of diuretics, incontinence, the use of diapers and dehydration. 3 Recognizing these factors and promoting actions that reduce urinary infection rates are aspects that must permeate the practices of the nursing and caregiving teams, as these are the professionals who are constantly accompanying the elderly.…”

Section: Introductionmentioning

confidence: 99%

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study

Almeida da Silva,

Ribeiro da Silva,

Ramos da Cruz Almeida

et al. 2024

Invest. Educ. Enferm.

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Objective. To analyze the effectiveness of an educational intervention among nursing professionals and caregivers to prevent urinary tract infections in institutionalized elderly people. Methods. this is a quasi-experimental study carried out with 20 people (7 nurses and 13 formal caregivers). A questionnaire was applied during the pre-intervention stage, then professional training was carried out and finally, the questionnaire was reapplied 6 months after the intervention. The prevalence profile and factors associated with urinary infections in 116 elderly people was evaluated before and after the educational interventions. Statistical analysis was performed using association and correlation tests, logistic regression model comparison and prevalence rates. Results. The average number of correct answers by the nursing professionals and caregivers after the educational intervention increased from the pre to the post-test by 52% regarding signs of urinary infection, 32% regarding its symptoms, 72.5% regarding its treatment, 40% regarding personal/behavioral and morbidity-related risk factors, 59% regarding conditional factors and 43.8% regarding its preventive measures. The team of caregivers showed a greater gain in knowledge compared to the nursing team in almost every question (p<0.05). The length of time working in elderly care showed no positive correlation with any variable (R<1; p>0.05). The prevalence of urinary tract infection in the pre-intervention period was 33.62%, and 20% in the post-intervention period. Conclusion. The educational intervention was effective in preventing urinary tract infections in the elderly. The increased knowledge acquired by nurses and caregivers was associated with a reduction in the infection rate and an improvement in the most prevalent modifiable factors for the development of this type of pathology.

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“…This finding is quite expected since this group is at higher risk of infections caused by more resistant pathogens. These risk factors, for instance, include the previous use of antibiotics, the occurrence of recurrent UTIs, previous hospital admissions, indwelling urethral catheter, and invasive urinary instrumentation 34,38,39 .…”

Section: Coagulase-positive Staphylococcimentioning

confidence: 99%

Prevalence and antimicrobial resistance profile of pathogens isolated from patients with urine tract infections admitted to a university hospital in a medium-sized Brazilian city

Negri,

Lima,

Woloszynek

et al. 2024

Rev. Inst. Med. trop. S. Paulo

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This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher's exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gramnegative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

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Factors associated with urinary tract infection in a Nursing Home

Cited by 5 publications

References 17 publications

Sepsis following acute pyelonephritis caused by Trueperella bernardiae: a case report and literature review

Sepsis following acute pyelonephritis caused by Trueperella bernardiae: a case report and literature review

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study

Prevalence and antimicrobial resistance profile of pathogens isolated from patients with urine tract infections admitted to a university hospital in a medium-sized Brazilian city

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