ObjectiveTo explore the influence of evidence-based nursing care of catheterization on the incidence of urinary tract injury and urinary tract infection in patients with spinal cord injury and long-term indwelling catheters.MethodsFrom July 1st, 2017 to November 30th, 2018, 100 patients with spinal cord injury indwelling catheters in Department of Spinal Surgery were prospectively selected as the research objects. According to the admission time, patients admitted between July 2017 and February 2018 were assigned into the control group (n=50), and patients admitted between March 2018 and November 2018 were assigned into the observation group (n=50). Traditional catheter placement was used in the control group, while evidence-based catheter placement was used in the observation group. The incidences of catheter-related urethral injury and urinary tract infection after the catheterization were compared between the two groups.ResultsThere was no statistically significant difference in gender, age, diagnosis, or length of hospital stay between the two groups (P>0.05). Catheter placement was performed 57 times in the control group and 59 times in the observation group during hospitalization. After catheterization, the incidences of urethral hemorrhage and gross hematuria in the control group [22.80% (13/57) and 15.78% (9/57), respectively] were higher than those in the observation group [both were 1.69% (1/59)], with statistical differences between the two groups (P<0.05). The incidence of urinary tract infection in the control group differed from that in the observation group [42.0% (21/50) vs. 18.0% (9/50), P=0.009].ConclusionThe evidence-based urinary catheterization method for patients with spinal cord injury and long-term indwelling catheter can effectively prevent catheter-related urinary tract injury, reduce the incidence of catheter-related urinary tract infection during hospitalization, and improve the quality of clinical care.
Objective
To systematically review the efficacy of long-acting antibacterial material in the prevention of secondary urinary infection.
Methods
PubMed, The Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of long-acting antibacterial material in the prevention of secondary urinary infection from inception to November, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.
Results
A total of 16 RCTs were included. The results of meta-analysis showed that: the long-acting antibacterial material group was superior to the general intervention group in morbidity of secondary urinary infection (Peto OR=0.17, 95%CI 0.13 to 0.23, P<0.000 01), and bacterial positive rate of secondary urinary infection (Peto OR=0.15, 95%CI 0.08 to 0.27,P<0.000 01).
Conclusion
Current evidence shows that long-acting antibacterial material can effectively reduce the infection rates of secondary urinary infection. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To assess the effectiveness and safety of Shenling granule for lower urinary tract infection （damp-heat in lower-Jiao ） in comparison with Niaoganling Chongji. Methods A double-bhnd, double-dummy, randomized controlled trial was conducted. A total of 96 patients （damp-heat in lower-Jiao） were randomized to the treatment group （n =72, Shenling granule, 1 bag, rid） and the control group （n =24, Niaoganling Chongji, 1 bag, tid）. The therapeutic course for both groups was 1 week. Results ITT （intention-to-treatment） analysis showed that the total effective rates of the treatment group and the controlled group were 92.43% and 91.31% , respectively （P 〉0.05）. PP （perprotocol-population） analysis showed that they were 92.31% and 90.91% , respectively （ P 〉0.05 ）. The effective rates on Chinese medicine symptom of the treatment group and the controlled group were 93.43% and 95, 65% respectively by ITT analysis （ P 〉0.05 ） , 95.38% and 94.45% respectively by PP analysis （ P 〉0.05 ）, No significant difference between the two groups was detected. No adverse effect was found. Conclusions There is no significant difference between Shenling granule and Niaoganling Chongji in the treatment of patients with lower urinary tract infection. No adverse effect was found.
Objective
To discuss the effect of monitoring-training-planning (MTP) intervention model on the prevention and control of catheter–associated urinary tract infection (CAUTI) in Intensive Care Unit (ICU).
Methods
Patients with indwelling catheter from departments with ICU (ICU, ICU of the Department of Neurosurgery, ICU of the Department of Neurologic Medicine) between 2014 and 2015 were included in this study. Based on the inclusion criteria, target monitoring indicators were set in accordance with Hospital Infection Monitoring Norms. A total of 493 patients with indwelling catheters from January to December 2014 were subjected to target surveillance, and were used as baseline for the study. A total of 529 patients with indwelling catheters from January to December 2015 were treated with MTP intervention. The occurrence of indwelling catheter–associated urinary tract infections in the intensive care unit was compared before and after intervention.
Results
The incidence of indwelling catheter-associated urinary tract infections before and after MTP intervention were different, and the difference was statistically significant (P<0.05).
Conclusion
MTP intervention model can effectively prevent and reduce indwelling catheter-associated urinary tract infections in ICU.
ObjectiveTo investigate the species and resistance phenotypes of the pathogens causing catheter-associated urinary tract infection (CAUTI) in critically ill patients in West China Hospital of Sichuan University, and to provide the basis for the prevention and treatment of this kind of infection.
MethodsThe clinical data and findings of the laboratory examination of the patients, who were admitted to intensive care units and suffered from CAUTI in our hospital during January 2012 to December 2014, were retrospectively analyzed. The pathogens isolates from the urine specimens of the patients with CAUTI and their resistance phenotypes were analyzed.
ResultsThree hundred and seventy patients suffering from CAUTI were included in this study. Five hundred and seventeen strains of pathogens were isolated from the urine specimens of these patients, including 222 isolates (42.9%) of fungus, 181 isolates (35.0%) of gram negative bacteria, and 114 isolates (22.0%) of gram positive bacteria. In terms of species distribution, Candida albicans (105 isolates, 20.3%), C.glabrata (78 isolates, 15.1%) and C.glabrata (30 isolates, 5.8%) were the predominant fungus. Among the gram negative bacteria, Escherichia coli (81 isolates, 15.7%), Klebsiella pneumoniae (37 isolates, 7.2%), and Acinetobacter calcoaceticus-baumannii complex (23 isolates, 4.4%) were the main species. Enterococcus faecium (79 isolates, 15.3%) and E.faecalis (13 isolates, 2.5%) were the frequently isolated gram positive bacteria. Analysis of the resistance phenotype showed that the resistance rates to itraconazole, voriconazole and fluconazole of Candida spp. were above 10%. Thirty percent of the isolates of E.coli and K.pneumoniae, and 60% of the isolates of A.calcoaceticus-Baumannii complex were resistant to many of the regular antibiotics. Imipenem resistance rate of A.calcoaceticus-Baumannii complex was 60.8%. Sixty percent of the isolates of E.faecium and E.faecalis were resistant to many of the regular antibiotics. The vancomycin-resistant isolates accounted for 16.5% of E.faecium and 31.0% of E.faecalis.
ConclusionCandida species are the major pathogens for CAUTI in critically ill patients in our hospital and show the resistance to azoles. We should focus on the drug resistance of gram negative bacteria and gram positive bacteria. The rational use of antibiotics and application of effective infection control measures are important to decrease the CAUTI.
ObjectiveTo investigate the distribution and antibiotic resistance of pathogens isolated from children with primary nephrotic syndrome (PNS) complicated with urinary tract infection (UTI), so as to provide references for reasonable use of anti-infective agents in clinical practice.
MethodsA total of 218 eligible patients who hospitalized in our department between January 2009 and December 2012 were included, and the data of distribution and antibiotic resistance of pathogens were analyzed retrospectively.
ResultsIn this cohort, asymptomatic UTI in children with PNS accounted for 75.7% (165/218). And a total of 249 pathogenic strains were isolated and cultivated. The main pathogens of those subjects were G- bacilli, accounting for 64.3% (160/249), and 63.8% (102/160) of G- bacilli was Escherichia coli (E.coli); G+ cocci accounted for 31.7% (79/249), and 59.5% (47/79) of them was Enterococci faecalis; and fungi accounted for only 4.0%. Drug-susceptibility testing suggested that E.coli had a high resistance rate to hydroxyl ampicillin, cefazolin and ceftriaxone (>50%), but had lower resistance rate to cefoperazone/sulbactam and imipenem (<10%). Enterococci faecalis had a high resistance rate to rifampicin (74.6%), but had low resistance to vancomycin and linezolid (<10%).
ConclusionAsymptomatic UTI is common in children with PNS. E.coli is the major pathogen and the proportion of enterococcus infection is also not low, and these pathogens have a high antibiotic resistance and most of them are multi-resistant.
ObjectiveTo explore the nursing experience of preoperative treatment for urethral injury with ureteroscopic urethral realignment.
MethodsThe key points of the nursing experience of preoperative treatment for 58 cases of urethral injury with ureteroscopic urethral realignment were retrospectively analyzed. The patients were treated between January 2008 and December 2012.
ResultsUrethra catheterization of the 58 patients receiving the ureteroscopic urethral realignment was all successful. The catheter was extracted 4-8 weeks after the treatment, and then the urethra was dilated for two years. All patients had normal urination without any surgery complications during the 5-28-month clinical follow-up.
ConclusionUrinary tract infections can be prevented effectively under professional and meticulous preoperative treatment. The incidence of urethral stricture can be reduced greatly. The quality of the patients' life can be improved a lot.
