Technical Advances in the Prevention of Urinary Tract Infection

Desautels, Robert E.; Walter, Carl W.; Graves, Roger C.; Harrison, J. Hartwell

doi:10.1016/s0022-5347(17)64985-1

Cited by 49 publications

(11 citation statements)

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“…Thus, the nitrofurazone-matrix catheter might be expected to block the ascent in vivo of even those organisms showing small but measurable zones of inhibition in the modified disk diffusion assay described here. Certain gram-negative bacilli, notably Serratia spp., Proteus spp., and Pseudomonas spp., demonstrated reduced susceptibility to nitrofurazone (as anticipated on the basis of previous studies [6,25] The similarity of inhibition zone sizes around autoclaved versus gas-sterilized catheter segments indicates that the nitrofurazone-matrix tolerates heat sterilization without any loss of antibacterial activity. This finding provides reassurance that autoclaving, which is widely available and inexpensive, should be an acceptable method for sterilizing the nitrofurazone-matrix catheter.…”

supporting

confidence: 73%

“…Because with closed drainage systems the most common route for acquisition of infection is along the outside of the catheter (5,8), the most promising preventive measures have been those designed to block microbial migration along this pathway. However, aggressive meatal disinfection regimens have proved unhelpful or actually harmful (2,13), catheters coated with hydrophilic gels (18,21,32) or antimicrobial compounds (3,6,12,18,29) have not convincingly succeeded in blocking infection, and catheters coated with silver oxide have given encouraging results in some (15,20,31) but not all (4) clinical trials.…”

mentioning

confidence: 99%

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Activity of a nitrofurazone matrix urinary catheter against catheter-associated uropathogens

Johnson

Berggren

Conway

1993

Antimicrob Agents Chemother

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Nitrofurazone-coated urinary catheter segments inhibited 51 (75%) of 70 urinary bacterial isolates from patients with indwelling catheters. Inhibition zones correlated significantly with the nitrofurazone MIC (r2 = 0.79, P = 0.0001). All strains except the Pseudomonas spp. were inhibited by c64 ig of nitrofurazone per ml.MICs of nitrofurazone and nitrofurantoin correlated significantly (r2 = 0.93, P = 0.0001).

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supporting

confidence: 73%

mentioning

confidence: 99%

Activity of a nitrofurazone matrix urinary catheter against catheter-associated uropathogens

Johnson

Berggren

Conway

1993

Antimicrob Agents Chemother

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“…In our previous review, 2 we found evidence from one systematic review which suggested that the use of the aseptic technique has not demonstrated a reduction in the rate of CAUTI. 281 However, principles of good practice, clinical guidance 258,302 and expert opinion, 269,270,[303][304][305][306][307] together with À ndings from another systematic review, 256 agree that shortterm indwelling urethral catheters must be inserted using sterile equipment and the aseptic technique.…”

Section: What Technique Should Be Used To Insert a Catheter?mentioning

confidence: 99%

epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Loveday

Wilson

Pratt

et al. 2014

Journal of Hospital Infection

1,048

746

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National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.

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“…Catheterisation is a skilled aseptic procedure Despite evidence from one systematic review 153 which suggests that the use of aseptic technique has not demonstrated a reduction in the rate of CAUTI, principles of good practice, clinical guidance 115,134 and expert opinion [135][136][137][171][172][173][174] , together with findings from another systematic review 140 agree that urinary catheters must be inserted using sterile equipment and an aseptic technique. Expert opinion indicates that there is no advantage in using antiseptic preparations for cleansing the urethral meatus prior to catheter insertion.…”

Section: Catheter Insertionmentioning

confidence: 99%

epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

Pratt¹,

Pellowe²,

Wilson³

et al. 2007

Journal of Hospital Infection

602

478

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National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were commissioned by the Department of Health (DH) and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were published in January 2001. These guidelines describe the precautions healthcare workers should take in three areas: standard principles for preventing HCAI, which include hospital environmental hygiene, hand hygiene, the use of personal protective equipment, and the safe use and disposal of sharps; preventing infections associated with the use of short-term indwelling urethral catheters; and preventing infections associated with central venous catheters. The evidence for these guidelines was identified by multiple systematic reviews of experimental and non-experimental research and expert opinion as reflected in systematically identified professional, national and international guidelines, which were formally assessed by a validated appraisal process. In 2003, we developed complementary national guidelines for preventing HCAI in primary and community care on behalf of the National Collaborating Centre for Nursing and Supportive Care (National Institute for Healthand Clinical Excellence). A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective in preventing HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. Consequently, the DH commissioned a review of new evidence published following the last systematic reviews. We have now updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the original epic guidelines published in 2001 remain robust, relevant and appropriate but that adjustments need to be made to some guideline recommendations following a synopsis of the evidence underpinning the guidelines. These updated national guidelines (epic2) provide comprehensive recommendations for preventing HCAI in hospitals and other acute care settings based on the best currently available evidence. Because this is not always the best possible evidence, we have included a suggested agenda for further research in each section of the guidelines. National evidence-based guidelines are broad principles of best practice which need to be integrated into local practice guidelines. To monitor implementation, we have suggested key audit criteria for each section of recommendations. Clinically effective infection prevention and control practice is an essential feature of protecting patients. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiri...

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Technical Advances in the Prevention of Urinary Tract Infection

Cited by 49 publications

References 0 publications

Activity of a nitrofurazone matrix urinary catheter against catheter-associated uropathogens

Activity of a nitrofurazone matrix urinary catheter against catheter-associated uropathogens

epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

epic2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England

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