Prevention of urinary tract infections in patients with spinal cord injury

Salameh, Ahmad; Mohajer, Mayar Al; Daroucihe, Rabih O.

doi:10.1503/cmaj.141044

Cited by 47 publications

(30 citation statements)

References 42 publications

(56 reference statements)

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“…Although rigorous research and practice has focused on preventing UTIs for patients using a urinary catheter in various settings [14][15][16][17], having a urinary catheter was the most signi cantly associated factor for UTI related hospitalization and ED visits prediction. Notwithstanding the efforts of nurses and administrators to prevent UTI-related hospitalization or ED visits among patients with an indwelling urinary catheter (e.g., through reminding the nurses, aseptic insertion) [4,16,17], UTI-related hospitalization or ED visits remains still high in this speci c group. More rigorous research and improvement in clinical practice in this area are much needed.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Urinary Tract Infection (UTI) Among Home Health Care Patients: Analysis Using Routinely Collected Clinical Data

Woo

Song

McDonald

et al. 2020

Preprint

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Abstract Background: Urinary tract infection (UTI) is a complication often experienced during a home health care (HHC) episode, yet related hospitalization risk factors are unclear. Objectives: This study use multiple data sources to identify risk factors for UTI related hospitalization or emergency department (ED) visits among HHC patients.Method: We performed a multivariable logistic regression to identify risk factors for UTI-related hospitalization or ED visits using merged data from the Outcome and Assessment Information Set, electronic health record from a large HHC agency, and Center for Medicare and Medicaid claims. Results: Of 48,336 cases, 1,689 patients (3.5%) had a UTI-related hospitalization/ED visits. Being a female (OR = 1.31; 95% CI: 1.16–1.46), the presence of a urinary catheter (OR = 5.7; 95% CI: 4.54–7.14), treatment with general antibacterial and antiseptics (OR = 2.75; 95% CI: 1.02–7.38), dependency in instrumental activities of daily living (e.g., meal preparation [OR=1.72; 95% CI: 1.25-2.37]), and no available caregivers (OR = 1.79; 95% CI: 1.2–2.68) increased the odds of a UTI related event among HHC patients. Discussion/conclusion: We identified notable risk factors for UTI related hospitalization/ER visit, filling a knowledge gap on the currently understudied HHC population. Risk factors identified in this study can be used to proactively identify HHC patients at risk for UTI related hospitalization and target them for preventive interventions. Further research is needed in HHC to develop tailored interventions for at-risk patients.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Urinary Tract Infection (UTI) Among Home Health Care Patients: Analysis Using Routinely Collected Clinical Data

Woo

Song

McDonald

et al. 2020

Preprint

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“…5 Likely, the risk profile for UTIs among TSCI patients is a complex interplay between host factors, (such as the bladder's altered immune response as a result of different levels of neurologic bladder dysfunction), 19 the mechanism of bladder emptying (with an indwelling catheter likely conferring the highest risk), 18 the completeness and level of the SCI lesion, 20 and the use of various preventative strategies. 21 Patient counselling around signs, symptoms, management, and prevention will continue to be important for this population. Further investigation into defining patients with the largest magnitude of risk is required.…”

Section: Discussionmentioning

confidence: 99%

Urinary tract infections, urologic surgery, and renal dysfunction in a contemporary cohort of traumatic spinal cord injured patients

Welk

Liu

Winick-Ng

et al. 2016

Neurourology and Urodynamics

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“…[35][36][37] En cuanto al uso de catéteres recubiertos con plata o con antibióticos, no se han encontrado ventajas en la aparición de ITU asociada al catéter, por lo tanto, aún no existe evidencia para preferir su uso. 38,39 Catéteres Permanentes Se ha visto que los pacientes que usan catéter permanente tienen menos riesgo de hidronefrosis y mejor acomodación, si se le adicionan anticolinérgicos. 5 Con respecto a los catéteres suprapúbicos, se han realizado varias revisiones del tema, encontrando que pueden ser una alternativa para algunos pacientes que deseen más independencia, que estén más cómodos con su imagen corporal, que no toleren los cateterismos o que hayan tenido traumas uretrales o hipospadias.…”

Section: Tipo De Catéterunclassified

Infección Urinaria en Pacientes con Lesión Medular

Ospina-Galeano

Durán

2018

Urol Colomb

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ResumenLa micción es un proceso complejo, que requiere la coordinación entre el sistema nervioso central y periférico. La alteración en ése, aumenta el riesgo para que se produzcan infecciones complicadas y a largo plazo, daño renal. La alteración en el vaciado de la vejiga, obliga a que muchos de esos pacientes, realicen cateterismos intermitentes o sonda vesical permanente, aumentando el riesgo de infecciones polimicrobianas o por gérmenes multiresistentes. Algunos factores implicados en el desarrollo de las infecciones de esos pacientes, son el residuo postmiccional elevado, estasis urinario, litiasis vesical, uso de catéteres, además de las alteraciones en el sistema inmune y las capas de recubrimiento en la mucosa vesical. El diagnóstico de infección se realiza al encontrar: piuria y bacteriuria, según método de vaciado vesical, y un síntoma general que sugiera infección. Conclusión: Las infecciones urinarias en pacientes con lesión medular, deben ser tratadas de acuerdo a sensibilidades de la zona, siempre con la toma previa de un urocultivo y con un diagnóstico adecuado de infección urinaria, teniendo en cuenta las diferentes maniobras de evacuación de la vejiga. No están recomendados los tratamientos cortos ni el tratamiento de las bacteriurias asintomáticas. Una de las formas de prevenir las infecciones, está en evitar situaciones de riesgo como el estasis vesical, las presiones intravesicales elevadas y los vaciamientos incompletos. En la actualidad existen múltiples medicamentos para prevenir las infecciones urinarias, pero faltan estudios con evidencia de más peso y en pacientes con lesión medular, para que puedan ser recomendados.

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Prevention of urinary tract infections in patients with spinal cord injury

Cited by 47 publications

References 42 publications

Risk Factors for Urinary Tract Infection (UTI) Among Home Health Care Patients: Analysis Using Routinely Collected Clinical Data

Risk Factors for Urinary Tract Infection (UTI) Among Home Health Care Patients: Analysis Using Routinely Collected Clinical Data

Urinary tract infections, urologic surgery, and renal dysfunction in a contemporary cohort of traumatic spinal cord injured patients

Infección Urinaria en Pacientes con Lesión Medular

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