The Relationship Between Pyuria and Infection in Patients With Indwelling Urinary Catheters

Tambyah, Paul Anantharajah; Maki, Dennis G.

doi:10.1001/archinte.160.5.673

Cited by 155 publications

(89 citation statements)

References 40 publications

(43 reference statements)

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“…However, Tambyah and Maki determined that there is a poor correlation of pyuria with CAUTIs (402). WBC counts for catheterized patients are apparently skewed since pyuria can occur in the absence of infection due to irritation of the host uroepithelium caused by the catheter (402). Also, urease-producing uropathogens such as Proteus species often convert normally acidic urine into an alkaline state that can lyse WBCs, thereby reducing the WBC count during an infection (402).…”

Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

et al. 2008

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SUMMARY Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. These infections are often caused by Escherichia coli and Proteus mirabilis. Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.

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Section: Diagnosis and Treatment Of Cautismentioning

confidence: 99%

Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

et al. 2008

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“…Enterococci and coagulase-negative staphylococci are the most common Gram-positive organisms. These organisms are isolated more frequently from asymptomatic infection, and are associated with lower levels of pyuria (19,20). Candida species are also frequently isolated.…”

Section: Infecting Organismsmentioning

confidence: 99%

“…However, pyuria is also present in most patients with asymptomatic bacteriuria (9,19,29). Noninfectious causes of urinary tract inflammation in patients at risk for complicated urinary infection are also characterized by pyuria.…”

Section: Urinalysismentioning

confidence: 99%

Complicated Urinary Tract Infection in Adults

Nicolle¹

2005

Canadian Journal of Infectious Diseases and Medical Microbiolog

207

156

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OBJECTIVE: To review current knowledge relevant to complicated urinary tract infection, and to provide evidence-based recommendations for management. METHODS: The literature was reviewed through a PubMed search, and additional articles were identified by journal reference review. A draft guideline was prepared and critically reviewed by members of the Association of Medical Microbiology and Infectious Disease Canada Guidelines Committee, with modifications incorporated following the review. RESULTS: Many urological abnormalities may be associated with complicated urinary infection. There is a wide spectrum of potential infecting organisms, and isolated bacteria tend to be more resistant to antimicrobial therapy. Morbidity and infection outcomes in subjects with complicated urinary infection are principally determined by the underlying abnormality rather than the infection. Principles of management include uniform collection of a urine specimen for culture before antimicrobial therapy, characterization of the underlying genitourinary abnormality, and nontreatment of asymptomatic bacteriuria except before an invasive genitourinary procedure. The antimicrobial regimen is determined by clinical presentation, patient tolerance, renal function and known or anticipated infecting organisms. If the underlying abnormality contributing to the urinary infection cannot be corrected, then early post-treatment recurrence of infection is anticipated. CONCLUSIONS: The management of complicated urinary infection is individualized depending on patient variables and the infecting organism. Further clinical investigations are necessary to assist in determining optimal antimicrobial regimens.

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“…10 In addition an increased rate of CAUTI has been documented in patients treated in medical areas, although it was unclear if this was adjusted for duration of catheterisation, which is likely to be longer for medical patients who are generally admitted as emergencies. 39 We were unable to carry out a planned subanalysis concerning participants who were catheterised as part of their admission to a critical care area. Many of our trial participants did have part of their hospital stay on a critical care ward, particularly those undergoing neurosurgery or cardiothoracic surgery.…”

Section: Effectivenessmentioning

confidence: 99%

Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial- and antiseptic-impregnated urethral catheters (the CATHETER trial)

Pickard

Lam²,

MacLennan³

et al. 2012

Health Technol Assess

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An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTATypes of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial-and antiseptic-impregnated urethral catheters (the CATHETER trial) NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in t...

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The Relationship Between Pyuria and Infection in Patients With Indwelling Urinary Catheters

Cited by 155 publications

References 40 publications

Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

Complicated Urinary Tract Infection in Adults

Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial- and antiseptic-impregnated urethral catheters (the CATHETER trial)

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