Objective:To explore the value of bundled nursing interventions based on empowerment theory in the care of patients with indwelling urinary catheters.Methods:Forty-two patients with indwelling urinary catheters,admitt...Objective:To explore the value of bundled nursing interventions based on empowerment theory in the care of patients with indwelling urinary catheters.Methods:Forty-two patients with indwelling urinary catheters,admitted from June 2022 to June 2023,were sampled and randomly divided using a random number table.Group A received bundled nursing care based on empowerment theory,while Group B received standard care.The differences in catheterization duration,unplanned extubation rate,emotional scores,quality of life scores,and adverse events were compared.Results:Group A had a shorter catheterization duration and a lower rate of unplanned extubation than Group B,with P<0.05.Anxiety(SAS)and depression(SDS)scores were lower in Group A than in Group B,with P<0.05,and the quality of life(SF-36)scores were higher in Group A than in Group B,with P<0.05.The adverse event rate for Group A was also lower than that for Group B,with P<0.05.Conclusion:Patients with indwelling urinary catheters who received bundled nursing care based on empowerment theory experienced improved emotional stability,optimized quality of life,fewer unplanned extubation events,and the intervention was highly effective and feasible.展开更多
Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-...Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.展开更多
Urinary tract infections (UTI) are very common in all the developed as well as developing countries in which the majority of infections are catheter associated. Catheter associated urinary tract infections (CAUTI) is ...Urinary tract infections (UTI) are very common in all the developed as well as developing countries in which the majority of infections are catheter associated. Catheter associated urinary tract infections (CAUTI) is one of the major causes of hospital acquired infections. The aim of this study is to investigate influential demographic factors responsible for contamination associated with the rate of CAUTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis, age, gender, and comparison with other studies. During the study, 22 uropathogenic species were isolated from the different segments of urinary catheter samples of the patients collected from 12 different hospitals of Amravati city, Maharashtra, India from January 2015 to 2018. Gram negative organisms were the most frequent isolates, with <i>Pseudomonas aeruginosa</i> (16.08%) being the most common followed by <i>Escherichia coli</i> (10%) and <i>Candida albicans</i> accounted for almost 11% of all the uropathogens. It was found that the majority of uropathogens were isolated from the section A (Catheter segment inside the bladder) and section E (Catheter segment connected to drainage tube) of the urinary catheter. The duration of the catheterization plays the major role in the contamination and further infection to continue. It was observed that the female catheterized patients are more prone to the contamination and infection as compared to male catheterized patient. The antibiotic sensitivity pattern indicates that MAR (Multiple Antibiotic Resistance) index was more than 0.2 for almost all the uropathogens tested concluding that there is antibiotic stress on uropathogens and rate of resistance increased rapidly. Also it was found that there was a statistically significant association between the duration of catheterization, type of disease, age of patient and type of catheter with respect to gender.展开更多
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
Objectives:Hospital-acquired catheter-associated urinary tract infections(UTIs)have been regarded as preventable adverse events,yet their risk in endoscopic skull base surgery(ESBS)has not been well described despite ...Objectives:Hospital-acquired catheter-associated urinary tract infections(UTIs)have been regarded as preventable adverse events,yet their risk in endoscopic skull base surgery(ESBS)has not been well described despite common use.We determine the incidence of UTI following ESBS and identify contributing clinical factors.Methods:Retrospective review was conducted for a cohort of 229 consecutive adult patients who underwent endoscopic endonasal surgery for treatment of any skull base pathology between July 2018 and June 2022 at a tertiary academic skull base surgery program.Postoperative UTI comprised the primary outcome.Independent variables included patient demographics,use and length of urinary catheterization,and pre-existing genitourinary conditions.Results:Nosocomial UTIs were identified in 1.3%(3/229)of patients,occurring on postoperative days 2,9,and 14,respectively;all were catheter-associated.Overall,86.0%(197/229)of patients received urinary catheters(mean duration 2.2±1.8 days).Compared to those without,patients with UTI were older(70.0±15.4 vs.52.2±16.8 years,p=0.034),had lengthier stays(94.7±126.8 vs.5.9±8.4 days,p<0.001),and had prolonged catheterizations(9.3±5.5 vs.2.1±1.5 days,p<0.001).Preoperative genitourinary conditions were also associated with UTI development,namely,chronic urinary retention/obstruction(66.7%vs.4.0%,p=0.006),urinary incontinence(66.7%vs.6.2%,p=0.013),prostate disease(100.0%vs.17.8%,p=0.035),and renal dysfunction(100.0%vs.9.7%,p=0.001).Among intraoperative cerebrospinal fluid leak patients,postoperative CSF leak incidence was not associated with catheter use versus nonuse(3.3%vs.12.5%,p=0.276).Conclusion:Although UTIs are uncommon in ESBS patients,advanced age,length of stay,duration of indwelling urinary catheterization,and comorbid genitourinary conditions may elevate risk.展开更多
Background:Urinary catheterization after vaginal prolapse surgery can cause inconvenience for patients,elevate the risk of urinary tract infections,and potentially prolong the hospitalization.In China,there is no cons...Background:Urinary catheterization after vaginal prolapse surgery can cause inconvenience for patients,elevate the risk of urinary tract infections,and potentially prolong the hospitalization.In China,there is no consensus on the optimal time to remove the urinary catheter after vaginal prolapse surgery.Thus,it will be valuable to gain insight into the nationwide catheterization management after the vaginal prolapse surgery.Methods:From March to May 2020,an online questionnaire was shared and purposive non-probabilistic sampling was used to recruit the participants.The urogynecologists currently performing vaginal prolapse surgery and involved nurses were included in this study.Results:1363 urogynecologists and 436 nurses responded and 99.5%of them reported using transurethral indwelling catheters(TIC)for post-operative bladder drainage in their practices.The duration of initial catheterization after vaginal prolapse surgery was generally 1–7 days,with a median duration of 3 days for anterior colporrhaphy(AC)and anterior&posterior colporrhaphy(APC),and 2 days for other procedures.For the same type of surgery,the median duration of catheterization varied by region.For AC,it was shorter by 1 day in West China and South China(P<0.001);for PC,it was 2 days in most regions,while 1 day in East China(P<0.05);and for APC,it was 3 days in most regions,while 4 days in Northeast China(P<0.05).No statistically significant difference was found in duration of catheterization in hospital levels.Conclusions:The findings suggested that duration of catheterization after prolapse surgery varied greatly in China,potentially resulting in unnecessary prolonging of catheterization.Well-designed studies are urgently needed to optimize catheterization management after vaginal prolapse surgery in China.展开更多
Serratia fonticola and Pantoea sp.are gram negative bacteria belonging Enterobactericeae,which were considered opportunistic pathogens and resulted in a great number of cases of nosocomial infections with serious prob...Serratia fonticola and Pantoea sp.are gram negative bacteria belonging Enterobactericeae,which were considered opportunistic pathogens and resulted in a great number of cases of nosocomial infections with serious problems of multi-drug resistance,leading to increasing morbidity and mortality rate.Recently,they were recorded as biofilm producers.There were only a few studies about the capability of these bacteria of forming biofilm.So our aim was evaluate the occurrence of Serratia fonticola and Pantoea sp.biofilm former phenotypically and genetically with the determination of their abilities to multi-drug resistance.Serratia fonticola and Pantoea sp.isolated from urine catheterized patients who were hospitalized in Iraqi hospitals.They were then examined for detection of biofilm formation phenotypically by congo red and tissue culture plate methods and genetically by detecting SmaI and EsaI genes(quarm sensing genes)in Serratia fonticola and Pantoea sp.respectively by using polymerase chain reaction method and tested for antimicrobial susceptibility by disc diffusion and VITEK2 system according to Clinical and Laboratory Standards Institute(CLSI).Serratia fonticola at 3 and Pantoea sp.at 4 isolates revealed to possess the ability of forming biofilm which contained SmaI and EsaI genes with 100%resistance to most tested antibiotics except imipenem and azithromycin.SmaI and EsaI genes are present in Serratia fonticola and Pantoea sp.respectively,and are responsible for biofilm formation and considered as indicator;biofilm formation is a strong cause of multidrug resistance in bacteria.展开更多
Staphylococcus lentus(S.lentus)is a coagulase negative gram positive cocci recognized as opportunistic pathogens and rarely forming biofilm;it has many virulence factors,but recently caused nosocomial and community in...Staphylococcus lentus(S.lentus)is a coagulase negative gram positive cocci recognized as opportunistic pathogens and rarely forming biofilm;it has many virulence factors,but recently caused nosocomial and community infections.Biofilm formation of Staphylococcus lentus may be associated with the ability to resist antibiotics which leads to increase in mortality rate due to the difficulty in eradicate infections.To evaluate the biofilm forming capacity of Staphylococcus lentus and its susceptibility to antibiotics,phenotypic and genotypic assays were used.Among 28 biofilm bacteria,Staphylococcus lentus was isolated and identified from urine catheterized patients who were hospitalized in different departments of four Iraqi hospitals(Al-Diwaniyah Teaching,Al-Hilla Teaching,Al Qassim and Al Hashimiyah Hospitals).Staphylococcus lentus was examined for detection of biofilm formation by detecting icaA gene,the intercellular adhesion gene which expressed adhesion factor to form biofilm in staphylococci by using polymerase chain reaction(PCR)method and tested for antimicrobial susceptibility by disc diffusion method and VITEK2 system according to guidelines of the Clinical&Laboratory Standards Institute(CLSI).Three isolates of Staphylococcus lentus revealed the ability to form biofilm phenotypically which contained icaA gene with 100%antibiotics resistance to penicillin,carbenicillin,gentamicin,tobramycin,oxacillin,vancomycin,clindamycin,ciprofloxacin,and 0%antibiotics resistance to azithromycin.icaA genes are present in Staphylococcus lentus and responsible for biofilm formation which is considered as the indicator;biofilm formation is a strong cause of multidrug resistance in bacteria.展开更多
Urinary catheters are essential medical devices widely used for patients requiring urinary drainage,bladder irrigation,or precise urine output monitoring.Transurethral catheters with anchoring balloons are particularl...Urinary catheters are essential medical devices widely used for patients requiring urinary drainage,bladder irrigation,or precise urine output monitoring.Transurethral catheters with anchoring balloons are particularly prevalent among hospitalized patients,facilitating continuous urinary drainage.展开更多
To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diureti...To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diuretic dosing in keeping with current recommendations for hospitalized patients, In patients with acute kidney injury, assessment of urine output is essential for diagnosis and management. The diagnosis of circulatory shock is supported by renal hypoperfusion as measured by low urine output. Indwelling urinary cathe- ters are routinely used for the ＂strict＂ monitoring of urine output, which is an accepted indication.展开更多
BACKGROUND Percutaneous nephrolithotomy(PNL)is the standard treatment for medium-sized and large kidney stones.Many potential complications of PNL may warrant hospital readmission(HR)after discharge,threatening patien...BACKGROUND Percutaneous nephrolithotomy(PNL)is the standard treatment for medium-sized and large kidney stones.Many potential complications of PNL may warrant hospital readmission(HR)after discharge,threatening patient safety and increasing the costs.AIM To estimate the rate of unplanned HR after PNL and identify its urological and nursing-related predictors.METHODS One hundred sixty-one patients were prospectively studied for HR after PNL from April 2022 to December 2022.The relevant urological and nursing-related characteristics of patients with and without unplanned HR after PNL were studied for association with HR,using univariate and multivariate analyses.Variables such as the demographic characteristics,comorbidities,laboratory and imaging characteristics,dietary status,operative time,number of kidney punctures,blood loss,urinary tract infections,and the receipt of instructions for catheter care and activities of daily living were included.A risk score was created.RESULTS The mean age of patients with HR(44.4±12.7 years)and without HR(43.9±12.6 years)was similar(P=0.847).The overall stone-free rate was 88.8%.The total complication rate was 32.3%(52 patients),and the highest grade was IIIa,according to the modified Clavein grading system,resulting in an HR rate of 22.4%.History of preoperative pyuria(P=0.001),hydronephrosis(P=0.001)and mean stone size(P=0.012),multiple renal punctures(P<0.001),double J stent(P=0.033),total operative time(P=0.001),intraoperative injury(P=0.011),postoperative urinary tract infection(P<0.001),and inadequate instructions for urethral catheter(P=0.001)and activity daily living(P=0.048)were significantly associated with HR after PNL.On multivariate analysis,only preoperative pyuria(P=0.004),intraoperative injury(P=0.001),and inadequate instructions on urethral catheter care(P=0.035)were associated with HR.The risk score of the independent predictors was 0-17;0-4(low risk),5-9(moderate risk),and 10-17(high risk).CONCLUSION The rate of unplanned HR after PNL was relatively high(22.4%).The presence of pus cells in the preoperative urine analysis,intraoperative injury,and receiving inadequate instructions on urethral catheter care were independent predictors of HR after PNL.Combined studying of the urological and nursing-related predictors may promote the implementation of enhanced recovery protocols after PNL.展开更多
Introduction: Acute postpartum urine retention is a condition whose failure to recognize it can lead to delays in diagnosis, which can worsen the prognosis, and to inappropriate management. It occurs in 0.7% to 0.9% o...Introduction: Acute postpartum urine retention is a condition whose failure to recognize it can lead to delays in diagnosis, which can worsen the prognosis, and to inappropriate management. It occurs in 0.7% to 0.9% of vaginal deliveries. Its aetiology is multifactorial. There are many risk factors. Treatment is based on intermittent evacuation catheterization. Today, there is no consensus on the management of this condition, which has received little attention in African literature. Hence the interest of this article. Clinical Case: This is a 46 years old female, G5P5 005, with no prior history of involvement, who, after a dystocic vaginal delivery (longer than 12 hours with long foetal expulsion) and at term of a female newborn weighing 3475 g, developed hypogastric pain and spontaneous failure to urinate within 24 hours of delivery. The physical examination revealed abdominal tenderness and dullness with a strong desire to urinate and a normal neurological examination. The diagnosis was postpartum urinary retention. A bladder catheter inserted through the urethra drained 1100 ml of clear urine. Management consisted of physical measures and the prescription of an alpha blocker (Alfuzosin 4 mg). Two days later, the patient urinated normally. Conclusion: Acute postpartum retention in routine practice is rare but may be underestimated. Measures need to be taken to diagnose and manage this complication and also to determine the epidemiology of this postpartum complication.展开更多
Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after su...Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after surgery(ERAS)programme.We aimed to investigate the risk factors of urinary retention(UR)after open colonic resection within the ERAS protocol and to assess the feasibility of avoiding urinary drainage during the perioperative period.Methods:A total of 110 colonic-cancer patients undergoing open elective colonic resection between July 2014 and May 2018 were enrolled in this study.All patients were treated within our ERAS protocol during the perioperative period.Data on patients’demographics,clinicopathologic characteristics,and perioperative outcomes were collected and analysed retrospectively.Results:Sixty-eight patients(61.8%)underwent surgery without any perioperative UC.Thirty patients(27.3%)received indwelling UC during the surgical procedure.Twelve(10.9%)cases developed UR after surgery necessitating UC.Although patients with intraoperative UC had a lower incidence of post-operative UR[0%(0/30)vs 15%(12/80),P=0.034],intraoperative UC was not testified as an independent protective factor inmultivariate logistic analysis.The history of prostatic diseases and the body mass index were strongly associated with post-operative UR.Six patients were diagnosed with post-operative urinary-tract infection,among whom two had intraoperative UC and four were complicated with post-operative UR requiring UC.Conclusion:Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition.Obesity and a history of prostatic diseases are significant predictors of postoperative UR.展开更多
Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms...Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms.The purple discoloration of the urine bag is often the only finding,frequently noted by caregivers.Materials and methods:This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020.A total of 46 patients with PUBS wereincluded in this study.The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested.Results:The mean age of PUBS patients was 67.4years and 67.4%were males.Most patients of PUBS(60.9%)had a urethral catheter,while there was percutaneous nephrostomy in 26.1%patients and 13%patients had a percutaneous suprapubic cystostomy catheter.Among the patients,69.65%were bedridden orin an institutionalized situation,73.9%were suffering from chronic constipation,21.7%were associated with dementia,and 47.8%were cerebrovascular accidents with hemiparesis patients.In addition,93.5%of patients presented with alkaline urine and 3 patients with acidic urine.The most common bacteria isolated in urine culture were E coli and Pseudomonas.Conclusions:Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females,but our study showed that it is more common in males.The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method.In addition,no correlation was found between the microorganisms isolated from the environment and patients'urine.展开更多
Pseudomonas oryzihabitans is uncommon pathogen,but recently there may be warning of this bacterium to be dangerous,highly virulence,and may cause increase in morbidity and mortality rate,especially if there are multi-...Pseudomonas oryzihabitans is uncommon pathogen,but recently there may be warning of this bacterium to be dangerous,highly virulence,and may cause increase in morbidity and mortality rate,especially if there are multi-drug resistance and biofilm former.Biofilm forming bacteria display resistance to antibiotics,reaching to 1000 time higher than planktonic bacteria.The aim of the current study was to detect Pseudomonas oryzihabitans as biofilm producer and determine the susceptibility to the tested antibiotics.Pseudomonas oryzihabitans was isolated from urine of catheterized patients in Iraqi hospitals and diagnosed as biofilm former phenotypically by congo red and tissue culture plate methods,and genetically by polymerase chain reaction analysis to detect lasR gene(quarm sensing gene)as biofilm indicator and determine its susceptibility to antibiotics by disc diffusion and VITEK AST method.The results revealed that Pseudomonas oryzihabitans was present at 3 isolates;all of them had lasR gene and were resistant to most tested antibiotics at 100%,except that it showed sensitivity rate reaching to 100%to imipenem.From the present study,it was concluded that Pseudomonas oryzihabitans was isolated for the first time as biofilm producer from urinary catheter which possessed lasR gene as biofilm formation indicator,and the multi-drug resistance was considered as a distinctive feature of biofilm formation bacteria.展开更多
文摘Objective:To explore the value of bundled nursing interventions based on empowerment theory in the care of patients with indwelling urinary catheters.Methods:Forty-two patients with indwelling urinary catheters,admitted from June 2022 to June 2023,were sampled and randomly divided using a random number table.Group A received bundled nursing care based on empowerment theory,while Group B received standard care.The differences in catheterization duration,unplanned extubation rate,emotional scores,quality of life scores,and adverse events were compared.Results:Group A had a shorter catheterization duration and a lower rate of unplanned extubation than Group B,with P<0.05.Anxiety(SAS)and depression(SDS)scores were lower in Group A than in Group B,with P<0.05,and the quality of life(SF-36)scores were higher in Group A than in Group B,with P<0.05.The adverse event rate for Group A was also lower than that for Group B,with P<0.05.Conclusion:Patients with indwelling urinary catheters who received bundled nursing care based on empowerment theory experienced improved emotional stability,optimized quality of life,fewer unplanned extubation events,and the intervention was highly effective and feasible.
文摘Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.
文摘Urinary tract infections (UTI) are very common in all the developed as well as developing countries in which the majority of infections are catheter associated. Catheter associated urinary tract infections (CAUTI) is one of the major causes of hospital acquired infections. The aim of this study is to investigate influential demographic factors responsible for contamination associated with the rate of CAUTI, while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis, age, gender, and comparison with other studies. During the study, 22 uropathogenic species were isolated from the different segments of urinary catheter samples of the patients collected from 12 different hospitals of Amravati city, Maharashtra, India from January 2015 to 2018. Gram negative organisms were the most frequent isolates, with <i>Pseudomonas aeruginosa</i> (16.08%) being the most common followed by <i>Escherichia coli</i> (10%) and <i>Candida albicans</i> accounted for almost 11% of all the uropathogens. It was found that the majority of uropathogens were isolated from the section A (Catheter segment inside the bladder) and section E (Catheter segment connected to drainage tube) of the urinary catheter. The duration of the catheterization plays the major role in the contamination and further infection to continue. It was observed that the female catheterized patients are more prone to the contamination and infection as compared to male catheterized patient. The antibiotic sensitivity pattern indicates that MAR (Multiple Antibiotic Resistance) index was more than 0.2 for almost all the uropathogens tested concluding that there is antibiotic stress on uropathogens and rate of resistance increased rapidly. Also it was found that there was a statistically significant association between the duration of catheterization, type of disease, age of patient and type of catheter with respect to gender.
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Objectives:Hospital-acquired catheter-associated urinary tract infections(UTIs)have been regarded as preventable adverse events,yet their risk in endoscopic skull base surgery(ESBS)has not been well described despite common use.We determine the incidence of UTI following ESBS and identify contributing clinical factors.Methods:Retrospective review was conducted for a cohort of 229 consecutive adult patients who underwent endoscopic endonasal surgery for treatment of any skull base pathology between July 2018 and June 2022 at a tertiary academic skull base surgery program.Postoperative UTI comprised the primary outcome.Independent variables included patient demographics,use and length of urinary catheterization,and pre-existing genitourinary conditions.Results:Nosocomial UTIs were identified in 1.3%(3/229)of patients,occurring on postoperative days 2,9,and 14,respectively;all were catheter-associated.Overall,86.0%(197/229)of patients received urinary catheters(mean duration 2.2±1.8 days).Compared to those without,patients with UTI were older(70.0±15.4 vs.52.2±16.8 years,p=0.034),had lengthier stays(94.7±126.8 vs.5.9±8.4 days,p<0.001),and had prolonged catheterizations(9.3±5.5 vs.2.1±1.5 days,p<0.001).Preoperative genitourinary conditions were also associated with UTI development,namely,chronic urinary retention/obstruction(66.7%vs.4.0%,p=0.006),urinary incontinence(66.7%vs.6.2%,p=0.013),prostate disease(100.0%vs.17.8%,p=0.035),and renal dysfunction(100.0%vs.9.7%,p=0.001).Among intraoperative cerebrospinal fluid leak patients,postoperative CSF leak incidence was not associated with catheter use versus nonuse(3.3%vs.12.5%,p=0.276).Conclusion:Although UTIs are uncommon in ESBS patients,advanced age,length of stay,duration of indwelling urinary catheterization,and comorbid genitourinary conditions may elevate risk.
文摘Background:Urinary catheterization after vaginal prolapse surgery can cause inconvenience for patients,elevate the risk of urinary tract infections,and potentially prolong the hospitalization.In China,there is no consensus on the optimal time to remove the urinary catheter after vaginal prolapse surgery.Thus,it will be valuable to gain insight into the nationwide catheterization management after the vaginal prolapse surgery.Methods:From March to May 2020,an online questionnaire was shared and purposive non-probabilistic sampling was used to recruit the participants.The urogynecologists currently performing vaginal prolapse surgery and involved nurses were included in this study.Results:1363 urogynecologists and 436 nurses responded and 99.5%of them reported using transurethral indwelling catheters(TIC)for post-operative bladder drainage in their practices.The duration of initial catheterization after vaginal prolapse surgery was generally 1–7 days,with a median duration of 3 days for anterior colporrhaphy(AC)and anterior&posterior colporrhaphy(APC),and 2 days for other procedures.For the same type of surgery,the median duration of catheterization varied by region.For AC,it was shorter by 1 day in West China and South China(P<0.001);for PC,it was 2 days in most regions,while 1 day in East China(P<0.05);and for APC,it was 3 days in most regions,while 4 days in Northeast China(P<0.05).No statistically significant difference was found in duration of catheterization in hospital levels.Conclusions:The findings suggested that duration of catheterization after prolapse surgery varied greatly in China,potentially resulting in unnecessary prolonging of catheterization.Well-designed studies are urgently needed to optimize catheterization management after vaginal prolapse surgery in China.
文摘Serratia fonticola and Pantoea sp.are gram negative bacteria belonging Enterobactericeae,which were considered opportunistic pathogens and resulted in a great number of cases of nosocomial infections with serious problems of multi-drug resistance,leading to increasing morbidity and mortality rate.Recently,they were recorded as biofilm producers.There were only a few studies about the capability of these bacteria of forming biofilm.So our aim was evaluate the occurrence of Serratia fonticola and Pantoea sp.biofilm former phenotypically and genetically with the determination of their abilities to multi-drug resistance.Serratia fonticola and Pantoea sp.isolated from urine catheterized patients who were hospitalized in Iraqi hospitals.They were then examined for detection of biofilm formation phenotypically by congo red and tissue culture plate methods and genetically by detecting SmaI and EsaI genes(quarm sensing genes)in Serratia fonticola and Pantoea sp.respectively by using polymerase chain reaction method and tested for antimicrobial susceptibility by disc diffusion and VITEK2 system according to Clinical and Laboratory Standards Institute(CLSI).Serratia fonticola at 3 and Pantoea sp.at 4 isolates revealed to possess the ability of forming biofilm which contained SmaI and EsaI genes with 100%resistance to most tested antibiotics except imipenem and azithromycin.SmaI and EsaI genes are present in Serratia fonticola and Pantoea sp.respectively,and are responsible for biofilm formation and considered as indicator;biofilm formation is a strong cause of multidrug resistance in bacteria.
文摘Staphylococcus lentus(S.lentus)is a coagulase negative gram positive cocci recognized as opportunistic pathogens and rarely forming biofilm;it has many virulence factors,but recently caused nosocomial and community infections.Biofilm formation of Staphylococcus lentus may be associated with the ability to resist antibiotics which leads to increase in mortality rate due to the difficulty in eradicate infections.To evaluate the biofilm forming capacity of Staphylococcus lentus and its susceptibility to antibiotics,phenotypic and genotypic assays were used.Among 28 biofilm bacteria,Staphylococcus lentus was isolated and identified from urine catheterized patients who were hospitalized in different departments of four Iraqi hospitals(Al-Diwaniyah Teaching,Al-Hilla Teaching,Al Qassim and Al Hashimiyah Hospitals).Staphylococcus lentus was examined for detection of biofilm formation by detecting icaA gene,the intercellular adhesion gene which expressed adhesion factor to form biofilm in staphylococci by using polymerase chain reaction(PCR)method and tested for antimicrobial susceptibility by disc diffusion method and VITEK2 system according to guidelines of the Clinical&Laboratory Standards Institute(CLSI).Three isolates of Staphylococcus lentus revealed the ability to form biofilm phenotypically which contained icaA gene with 100%antibiotics resistance to penicillin,carbenicillin,gentamicin,tobramycin,oxacillin,vancomycin,clindamycin,ciprofloxacin,and 0%antibiotics resistance to azithromycin.icaA genes are present in Staphylococcus lentus and responsible for biofilm formation which is considered as the indicator;biofilm formation is a strong cause of multidrug resistance in bacteria.
文摘Urinary catheters are essential medical devices widely used for patients requiring urinary drainage,bladder irrigation,or precise urine output monitoring.Transurethral catheters with anchoring balloons are particularly prevalent among hospitalized patients,facilitating continuous urinary drainage.
文摘To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diuretic dosing in keeping with current recommendations for hospitalized patients, In patients with acute kidney injury, assessment of urine output is essential for diagnosis and management. The diagnosis of circulatory shock is supported by renal hypoperfusion as measured by low urine output. Indwelling urinary cathe- ters are routinely used for the ＂strict＂ monitoring of urine output, which is an accepted indication.
文摘BACKGROUND Percutaneous nephrolithotomy(PNL)is the standard treatment for medium-sized and large kidney stones.Many potential complications of PNL may warrant hospital readmission(HR)after discharge,threatening patient safety and increasing the costs.AIM To estimate the rate of unplanned HR after PNL and identify its urological and nursing-related predictors.METHODS One hundred sixty-one patients were prospectively studied for HR after PNL from April 2022 to December 2022.The relevant urological and nursing-related characteristics of patients with and without unplanned HR after PNL were studied for association with HR,using univariate and multivariate analyses.Variables such as the demographic characteristics,comorbidities,laboratory and imaging characteristics,dietary status,operative time,number of kidney punctures,blood loss,urinary tract infections,and the receipt of instructions for catheter care and activities of daily living were included.A risk score was created.RESULTS The mean age of patients with HR(44.4±12.7 years)and without HR(43.9±12.6 years)was similar(P=0.847).The overall stone-free rate was 88.8%.The total complication rate was 32.3%(52 patients),and the highest grade was IIIa,according to the modified Clavein grading system,resulting in an HR rate of 22.4%.History of preoperative pyuria(P=0.001),hydronephrosis(P=0.001)and mean stone size(P=0.012),multiple renal punctures(P<0.001),double J stent(P=0.033),total operative time(P=0.001),intraoperative injury(P=0.011),postoperative urinary tract infection(P<0.001),and inadequate instructions for urethral catheter(P=0.001)and activity daily living(P=0.048)were significantly associated with HR after PNL.On multivariate analysis,only preoperative pyuria(P=0.004),intraoperative injury(P=0.001),and inadequate instructions on urethral catheter care(P=0.035)were associated with HR.The risk score of the independent predictors was 0-17;0-4(low risk),5-9(moderate risk),and 10-17(high risk).CONCLUSION The rate of unplanned HR after PNL was relatively high(22.4%).The presence of pus cells in the preoperative urine analysis,intraoperative injury,and receiving inadequate instructions on urethral catheter care were independent predictors of HR after PNL.Combined studying of the urological and nursing-related predictors may promote the implementation of enhanced recovery protocols after PNL.
文摘Introduction: Acute postpartum urine retention is a condition whose failure to recognize it can lead to delays in diagnosis, which can worsen the prognosis, and to inappropriate management. It occurs in 0.7% to 0.9% of vaginal deliveries. Its aetiology is multifactorial. There are many risk factors. Treatment is based on intermittent evacuation catheterization. Today, there is no consensus on the management of this condition, which has received little attention in African literature. Hence the interest of this article. Clinical Case: This is a 46 years old female, G5P5 005, with no prior history of involvement, who, after a dystocic vaginal delivery (longer than 12 hours with long foetal expulsion) and at term of a female newborn weighing 3475 g, developed hypogastric pain and spontaneous failure to urinate within 24 hours of delivery. The physical examination revealed abdominal tenderness and dullness with a strong desire to urinate and a normal neurological examination. The diagnosis was postpartum urinary retention. A bladder catheter inserted through the urethra drained 1100 ml of clear urine. Management consisted of physical measures and the prescription of an alpha blocker (Alfuzosin 4 mg). Two days later, the patient urinated normally. Conclusion: Acute postpartum retention in routine practice is rare but may be underestimated. Measures need to be taken to diagnose and manage this complication and also to determine the epidemiology of this postpartum complication.
基金supported by the China Postdoctoral Science Foundation[grant number 2018M633694]National Natural Science Foundation of China[grant number 81500417]+1 种基金Social Development Fund of Jiangsu Province[grant number BE2015687]Jiangsu Planned Projects for Postdoctoral Research Funds[grant number 1701159C].
文摘Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after surgery(ERAS)programme.We aimed to investigate the risk factors of urinary retention(UR)after open colonic resection within the ERAS protocol and to assess the feasibility of avoiding urinary drainage during the perioperative period.Methods:A total of 110 colonic-cancer patients undergoing open elective colonic resection between July 2014 and May 2018 were enrolled in this study.All patients were treated within our ERAS protocol during the perioperative period.Data on patients’demographics,clinicopathologic characteristics,and perioperative outcomes were collected and analysed retrospectively.Results:Sixty-eight patients(61.8%)underwent surgery without any perioperative UC.Thirty patients(27.3%)received indwelling UC during the surgical procedure.Twelve(10.9%)cases developed UR after surgery necessitating UC.Although patients with intraoperative UC had a lower incidence of post-operative UR[0%(0/30)vs 15%(12/80),P=0.034],intraoperative UC was not testified as an independent protective factor inmultivariate logistic analysis.The history of prostatic diseases and the body mass index were strongly associated with post-operative UR.Six patients were diagnosed with post-operative urinary-tract infection,among whom two had intraoperative UC and four were complicated with post-operative UR requiring UC.Conclusion:Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition.Obesity and a history of prostatic diseases are significant predictors of postoperative UR.
文摘Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms.The purple discoloration of the urine bag is often the only finding,frequently noted by caregivers.Materials and methods:This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020.A total of 46 patients with PUBS wereincluded in this study.The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested.Results:The mean age of PUBS patients was 67.4years and 67.4%were males.Most patients of PUBS(60.9%)had a urethral catheter,while there was percutaneous nephrostomy in 26.1%patients and 13%patients had a percutaneous suprapubic cystostomy catheter.Among the patients,69.65%were bedridden orin an institutionalized situation,73.9%were suffering from chronic constipation,21.7%were associated with dementia,and 47.8%were cerebrovascular accidents with hemiparesis patients.In addition,93.5%of patients presented with alkaline urine and 3 patients with acidic urine.The most common bacteria isolated in urine culture were E coli and Pseudomonas.Conclusions:Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females,but our study showed that it is more common in males.The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method.In addition,no correlation was found between the microorganisms isolated from the environment and patients'urine.
文摘Pseudomonas oryzihabitans is uncommon pathogen,but recently there may be warning of this bacterium to be dangerous,highly virulence,and may cause increase in morbidity and mortality rate,especially if there are multi-drug resistance and biofilm former.Biofilm forming bacteria display resistance to antibiotics,reaching to 1000 time higher than planktonic bacteria.The aim of the current study was to detect Pseudomonas oryzihabitans as biofilm producer and determine the susceptibility to the tested antibiotics.Pseudomonas oryzihabitans was isolated from urine of catheterized patients in Iraqi hospitals and diagnosed as biofilm former phenotypically by congo red and tissue culture plate methods,and genetically by polymerase chain reaction analysis to detect lasR gene(quarm sensing gene)as biofilm indicator and determine its susceptibility to antibiotics by disc diffusion and VITEK AST method.The results revealed that Pseudomonas oryzihabitans was present at 3 isolates;all of them had lasR gene and were resistant to most tested antibiotics at 100%,except that it showed sensitivity rate reaching to 100%to imipenem.From the present study,it was concluded that Pseudomonas oryzihabitans was isolated for the first time as biofilm producer from urinary catheter which possessed lasR gene as biofilm formation indicator,and the multi-drug resistance was considered as a distinctive feature of biofilm formation bacteria.
