Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients w...Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients with indwelling urinary catheter,treated in Yancheng No.1 People’s Hospital in recent two years,were recruited as research subjects.The patients were equally divided into group A and group B,with 200 patients in each group,and all received routine anti-infectives.The patients in group A(200 cases)received routine nursing.On the basis of group A,cluster nursing was implemented for patients in group B(200 cases).Results:The indwelling time of urinary catheter,the disappearance time of bladder irritation symptoms,and the probability of urinary tract infection were compared between both groups,which showed that the nursing effect of group B was better than that of group A(P<0.05).Conclusion:The implementation of cluster nursing in postoperative patients with indwelling urinary catheter can improve the deficiency of routine nursing,consolidate the treatment effect,and reduce the complication rate of urinary tract infection.展开更多
The intricate infections leading to long-term morbidity of catheterized patients are due to the presence of a covering and blocking the lumen of urinary catheters by biofilms which have increased ability of resistance...The intricate infections leading to long-term morbidity of catheterized patients are due to the presence of a covering and blocking the lumen of urinary catheters by biofilms which have increased ability of resistance to host immune system and antibiotic treatment. The biofilm mode of growth is a basic survival strategy implemented by bacteria in a wide range of settings such as environmental, industrial and clinical aquatic settings. Bacterial growth on the inner surface of the catheter with biofilm formation is frequent and may occur within days of catheter placement. This study investigated the formation of biofilm inside catheter lumen of patients from Denden hospital, Asmara, Eritrea. And also, it assessed the antimicrobial sensitivity pattern of biofilm isolates and compared it with urine isolates. Resistance to antibiotics was observed in biofilm isolates more than urine isolates. E. coli was the most frequently isolated organism in both biofilm and urine samples.展开更多
Background:A new type of silver alloy hydrogel-coated(SAH)catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent,and to block the retrograde infection pathway.However,these...Background:A new type of silver alloy hydrogel-coated(SAH)catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent,and to block the retrograde infection pathway.However,these have only been confirmed in ordinary patients.This study aims to evaluate the effectiveness of a SAH catheter for preventing urinary tract infections in critically ill patients.Methods:This was a prospective single-center,single-blind,randomized,controlled study.A total of 132 patients requiring indwelling catheterization in the intensive care unit(ICU)of the First Affiliated Hospital of the University of Science and Technology of China between October 2022 and February 2023 and who met the study inclusion/exclusion criteria were randomly divided into two groups.Patients in the SAH catheter group received a SAH catheter,while patients in the conventional catheter group received a conventional siliconized latex Foley catheter.The main outcome measure was the incidence of catheter-associated urinary tract infections(CAUTIs).Secondary outcome indicators included urine positivity for white blood cells and positive urine cultures on 3 days,7 days,10 days,and 14 days after catheterization,number of viable bacteria in the catheter biofilm on day 14,pathogenic characteristics of positive urine cultures,length of ICU stay,overall hospital stay,ICU mortality,and 28-day mortality.All the data were compared between the two groups.Results:A total of 68 patients in the conventional catheter group and 64 patients in the SAH catheter group were included in the study.On day 7 after catheter placement,the positivity rate for urinary white blood cells was significantly higher in the conventional catheter group than in the SAH catheter group(33.8%vs.15.6%,P=0.016).On day 10,the rates of positive urine cultures(27.9%vs.10.9%,P=0.014)and CAUTIs(22.1%vs.7.8%,P=0.023)were significantly higher in the conventional catheter group than in the SAH catheter group.On day 14,the numbers of viable bacteria isolated from the catheter tip([3.21±1.91]×10^(6) colony-forming units[cfu]/mL vs.[7.44±2.22]×10^(4) cfu/mL,P<0.001),balloon segment([7.30±1.99]×10^(7) cfu/mL vs.[3.48±2.38]×10^(5) cfu/mL,P<0.001),and tail section([6.41±2.07]×10^(5) cfu/mL vs.[8.50±1.46]×10^(3) cfu/mL,P<0.001)were significantly higher in the conventional catheter group than in the SAH catheter group.The most common bacteria in the urine of patients in both groups were Escherichia coli(n=13)and Pseudomonas aeruginosa(n=6),with only one case of Candida in each group.There were no significant differences between the two groups in terms of ICU hospitalization time,total hospitalization time,ICU mortality,and 28-day mortality.Conclusion:SAH catheters can effectively inhibit the formation of catheter-related bacterial biofilms in critically ill patients and reduce the incidence of CAUTIs,compared with conventional siliconized latex Foley catheters;however,regular replacement of the catheter is still necessary.展开更多
AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance...AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.展开更多
文摘Objective:This paper expounds and analyzes the effect of cluster nursing in preventing urinary tract infection in postoperative patients with indwelling urinary catheter.Methods:A total of 400 postoperative patients with indwelling urinary catheter,treated in Yancheng No.1 People’s Hospital in recent two years,were recruited as research subjects.The patients were equally divided into group A and group B,with 200 patients in each group,and all received routine anti-infectives.The patients in group A(200 cases)received routine nursing.On the basis of group A,cluster nursing was implemented for patients in group B(200 cases).Results:The indwelling time of urinary catheter,the disappearance time of bladder irritation symptoms,and the probability of urinary tract infection were compared between both groups,which showed that the nursing effect of group B was better than that of group A(P<0.05).Conclusion:The implementation of cluster nursing in postoperative patients with indwelling urinary catheter can improve the deficiency of routine nursing,consolidate the treatment effect,and reduce the complication rate of urinary tract infection.
文摘The intricate infections leading to long-term morbidity of catheterized patients are due to the presence of a covering and blocking the lumen of urinary catheters by biofilms which have increased ability of resistance to host immune system and antibiotic treatment. The biofilm mode of growth is a basic survival strategy implemented by bacteria in a wide range of settings such as environmental, industrial and clinical aquatic settings. Bacterial growth on the inner surface of the catheter with biofilm formation is frequent and may occur within days of catheter placement. This study investigated the formation of biofilm inside catheter lumen of patients from Denden hospital, Asmara, Eritrea. And also, it assessed the antimicrobial sensitivity pattern of biofilm isolates and compared it with urine isolates. Resistance to antibiotics was observed in biofilm isolates more than urine isolates. E. coli was the most frequently isolated organism in both biofilm and urine samples.
基金supported by the Anhui Provincial Key Research and Development Program(grant number:202104j07020043)the Natural Science Research Project of Colleges and Universities in Anhui Province(grant number:2022AH051264).
文摘Background:A new type of silver alloy hydrogel-coated(SAH)catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent,and to block the retrograde infection pathway.However,these have only been confirmed in ordinary patients.This study aims to evaluate the effectiveness of a SAH catheter for preventing urinary tract infections in critically ill patients.Methods:This was a prospective single-center,single-blind,randomized,controlled study.A total of 132 patients requiring indwelling catheterization in the intensive care unit(ICU)of the First Affiliated Hospital of the University of Science and Technology of China between October 2022 and February 2023 and who met the study inclusion/exclusion criteria were randomly divided into two groups.Patients in the SAH catheter group received a SAH catheter,while patients in the conventional catheter group received a conventional siliconized latex Foley catheter.The main outcome measure was the incidence of catheter-associated urinary tract infections(CAUTIs).Secondary outcome indicators included urine positivity for white blood cells and positive urine cultures on 3 days,7 days,10 days,and 14 days after catheterization,number of viable bacteria in the catheter biofilm on day 14,pathogenic characteristics of positive urine cultures,length of ICU stay,overall hospital stay,ICU mortality,and 28-day mortality.All the data were compared between the two groups.Results:A total of 68 patients in the conventional catheter group and 64 patients in the SAH catheter group were included in the study.On day 7 after catheter placement,the positivity rate for urinary white blood cells was significantly higher in the conventional catheter group than in the SAH catheter group(33.8%vs.15.6%,P=0.016).On day 10,the rates of positive urine cultures(27.9%vs.10.9%,P=0.014)and CAUTIs(22.1%vs.7.8%,P=0.023)were significantly higher in the conventional catheter group than in the SAH catheter group.On day 14,the numbers of viable bacteria isolated from the catheter tip([3.21±1.91]×10^(6) colony-forming units[cfu]/mL vs.[7.44±2.22]×10^(4) cfu/mL,P<0.001),balloon segment([7.30±1.99]×10^(7) cfu/mL vs.[3.48±2.38]×10^(5) cfu/mL,P<0.001),and tail section([6.41±2.07]×10^(5) cfu/mL vs.[8.50±1.46]×10^(3) cfu/mL,P<0.001)were significantly higher in the conventional catheter group than in the SAH catheter group.The most common bacteria in the urine of patients in both groups were Escherichia coli(n=13)and Pseudomonas aeruginosa(n=6),with only one case of Candida in each group.There were no significant differences between the two groups in terms of ICU hospitalization time,total hospitalization time,ICU mortality,and 28-day mortality.Conclusion:SAH catheters can effectively inhibit the formation of catheter-related bacterial biofilms in critically ill patients and reduce the incidence of CAUTIs,compared with conventional siliconized latex Foley catheters;however,regular replacement of the catheter is still necessary.
文摘AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.
