Pragmatic review of interventions to prevent catheter-associated urinary tract infections (CAUTIs) in adult inpatients

Gray, Jodi; Rachakonda, Akhila; Karnon, Jonathan

doi:10.1016/j.jhin.2023.03.020

Cited by 6 publications

(5 citation statements)

References 74 publications

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“…Today, CAUTI still remains a problem (1)(2)(3)(4). The source of this infection may occur during the IUC, microorganisms pass through the urinary tract from the intraluminal and extraluminal routes (6,7,14).…”

Section: Discussionmentioning

confidence: 99%

“…An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives. Journal of Human Sciences, 20 (3), 398-410. doi: 10.14687/jhs.v20i3.6395 which is recommended in the relevant guidelines and currently applied in clinical settings, can not prevent extraluminal transmission (6,19). Academic research has focused on the option of using antiseptics in daily perineal care.…”

Section: Introductionmentioning

confidence: 99%

“…An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives. Journal of Human Sciences, 20(3), 398-410. doi: 10.14687/jhs.v20i3.6395Plus 2016). Bacterial survival in CFU/mL was calculated according to the following formula 1.…”

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confidence: 99%

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An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives

Akbıyık,

Kaya,

Topaloğlu Avşar

et al. 2023

HumanSciences

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Background: Catheter-associated urinary tract infections (CAUTI) constitute a significant portion of healthcare-associated infections. Using antiseptic for routine daily perineal care of patients with IUC may reduce CAUTIs. Aim: This study aimed to examine antimicrobial photodynamic inactivation (aPDI) against clinical isolates for use in the daily perineal care of patients with IUC. In addition, it was also aimed to compare the antimicrobial activities of aPDI and 0.1% chlorhexidine gluconate. Methods: In this in-vitro study, cationic porphyrin derivatives (CPDs) were used as photosensitizers in the experiments. CPDs, named PM, PE, PN, and PL were synthesized by the researchers. A diode laser device emitting light with a wavelength of 450 nm (blue light) was used as the light source. Methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli and Klebsiella pneumoniae with multidrug-resistant (MDR) properties and Candida albicans were used. Photosensitizer (PS), aPDI, light (L), and control (C) groups in aPDI experiments; control (C) and chlorhexidine gluconate 0.1% groups were used in the chlorhexidine gluconate experiments. Survival was calculated based on CFU/mL in the control group. Results: In experiments, combinations of 25 J/cm² with 6.25 and 3.125 µM PM, PE reduced E. coli, K. pneumoniae, MRSA, and C. albicans survival in the range of 8.70 to 11.53 log₁₀. In aPDI experiments performed with 6.25 and 3.125 µM PN and PL concentrations at the same energy density, reductions in the range of 4.41 to 0.17 log₁₀ were observed in all four clinical isolates. In experiments where 1.5625 µM concentration was used, survival decreased in the range of 8.29 to 10.87 log₁₀ in PM and PE, while antimicrobial activity was limited in PN and PL. In the 0.1% chlorhexidine gluconate experiments, the survival reduction in all four clinical isolates ranged from 8.87 to 10.24 log₁₀. Conclusion: For PM and PE, a very strong aPDI was obtained in C. albicans, E.coli, K. pneumoniae, and MRSA at low concentrations and energy density. The same antimicrobial activity was found in experiments using 0.1% chlorhexidine gluconate. In this context, we would like to inform you that aPDI to be performed with a combination of 25 J/cm² at 6.25 and 3.125 µM concentrations of PM and PE has the potential to be an antiseptic in the daily perineal care of patients with IUC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives

Akbıyık,

Kaya,

Topaloğlu Avşar

et al. 2023

HumanSciences

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“…Ongoing research is essential to understanding the evolving epidemiology of CA-UTIs and developing new prevention and treatment strategies. Previous studies used multidisciplinary teams, daily catheter reviews, protocol and procedural changes, electronic order sets, catheter insertion and removal reminders, audits and feedback, and education to prevent CA-UTIs [3]. However, these interventions are systemic in nature, but lack personalization.…”

Section: Introductionmentioning

confidence: 99%

Estimating individual risk of catheter-associated urinary tract infections using explainable artificial intelligence on clinical data

Sufriyana,

Chen,

Chiu

et al. 2024

Preprint

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BackgroundCatheter-associated urinary tract infections (CA-UTIs) significantly increase clinical burdens. Identifying patients at high-risk of CA-UTIs is crucial in clinical practice. In this study, we developed and externally validated an explainable, prognostic prediction model of CA-UTIs among hospitalized individuals receiving urinary catheterization.MethodsWe applied a retrospective cohort paradigm to select data from a clinical research database covering three hospitals in Taiwan. We developed a prediction model using data from two hospitals and used the third hospital’s data for external validation. We selected predictors by a multivariate regression analysis through applying a Cox proportional-hazards model. Both statistical and computational machine learning algorithms were applied for predictive modeling: (1) ridge regression; (2) decision tree; (3) random forest (RF); (4) extreme gradient boosting; and (5) deep-insight visible neural network. We evaluated the calibration, clinical utility, and discrimination ability to choose the best model by the validation set. The Shapley additive explanation was used to assess the explainability of the best model.ResultsWe included 122,417 instances from 20-to-75-year-old subjects with multiple visits (n=26,401) and multiple orders of urine catheterization per visit (n=35,230). Fourteen predictors were selected from 20 candidate variables. The best prediction model was the RF for predicting CA-UTIs within 6 days. It detected 97.63% (95% confidence interval [CI]: 97.57%, 97.69%) CA-UTI positive, and 97.36% (95% CI: 97.29%, 97.42%) of individuals that were predicted to be CA-UTI negative were true negatives. Among those predicted to be CA-UTI positives, we expected 22.85% (95% CI: 22.79%, 22.92%) of them to truly be high-risk individuals. We also provide a web-based application and a paper-based nomogram for using the best model.ConclusionsOur prediction model was clinically accurate by detecting most CA-UTI positive cases, while most predicted negative individuals were correctly ruled out. However, future studies are needed to prospectively evaluate the implementation, validity, and reliability of this prediction model among users of the web application and nomogram, and the model’s impacts on patient outcomes.

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“…Catheter-associated UTIs (CAUTIs) account for 70-80% of all hospitalacquired UTIs, and deciding to insert a urinary catheter is the leading risk factor. [1][2][3]. Prolonged and ineffective antibiotic therapy, which is often an outcome of this problem, generates additional costs (and health risks) related to the patient's extended stay at the hospital.…”

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confidence: 99%

Bacteriophage‐based approach for treatment of urinary tract infections: a quick outlook

Grygorcewicz,

Gliźniewicz,

Jabłońska

et al. 2023

APMIS

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Urinary tract infections (UTIs) are among the most common bacterial infections affecting millions worldwide. The increasing emergence of antibiotic‐resistant bacteria has become a serious concern in managing UTIs. Therefore, there is a growing interest in using bacteriophages as an alternative or adjunct therapy for UTIs. Bacteriophages are viruses that infect and kill bacteria, making them a promising tool for treating UTIs caused by antibiotic‐resistant bacteria. This article provides a quick outlook on using bacteriophages to treat UTIs. We summarize the current understanding of the biology of bacteriophages, the challenges associated with developing phage‐based therapies, and the promising results of several case reports and clinical trials. We also highlight the potential of phage therapy as a valuable tool in the fight against antibiotic‐resistant UTIs. This quick outlook on a bacteriophage‐based approach for treating UTIs offers a timely and informative summary of the current research in this field.

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Pragmatic review of interventions to prevent catheter-associated urinary tract infections (CAUTIs) in adult inpatients

Cited by 6 publications

References 74 publications

An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives

An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives

Estimating individual risk of catheter-associated urinary tract infections using explainable artificial intelligence on clinical data

Bacteriophage‐based approach for treatment of urinary tract infections: a quick outlook

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