When one speaks of transmittable diseases one does not often think that cystitis is one of the most prevalent. Cystitis effects both genders, the young, the old and can lead to complications that can do irreparable damage to the urinary tract. The purpose of this paper is to discuss the disease of cystitis and relate the specific virulence factors of Escherichia coli to the prevalence and symptoms of cystitis. This will be accomplished by defining the disease, its etiology and the causative agent. The mode of transmission and risk factors will be discussed as well, the pathogenesis, signs and symptoms will be explained. Finally dietary and nutritional implication along with treatment and prognosis will conclude this paper.
Definition of
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Lehne (2013) continues by stating that in nosocomial caused cystitis E. coli makes up only 50 percent of UTI’s. In hospital settings more common gram negative causative agents of cystitis are Pseudomonas, Proteus or Klebsiella pneumoniae. There is also a gram positive agent named Staphylococcus saprophyticus that makes up 10 to 15 percent of nosocomial UTI’s.
Mode of Transmission
The most common mode of transmission of E. coli is through sexual activity followed by catheterization and poor post elimination hygiene. Guay (2008) states that E. coli is most often transmitted when colonized vaginal or peri-urethral area is introduced into the urinary tract through the mechanical motion of penetrative vaginal intercourse. Other modes of transmission as stated catheter insertion can impair the body’s natural immune defence systems by increasing exposure to pathogen by reducing the bladders ability to fully void and providing a route of into the bladder for the pathogen to follow.
Risk Factors
McCance (2010) and Lehne (2013) state in their texts that the greatest risk factors for bacteraemia is to be a sexually active female. Other risk factors include being a pregnant females, females with diabetes, genetically predisposed to or have an indwelling catheter for a period greater than 90 days. Madigan and Neff (2003) state that infections due to indwelling catheters make up 40% of nosocomial infections
The first and second sources of infection are most common and very important we need to know. Firstly, the skin site and the catheter hub may contaminate by the patient's endogenous skin flora and by exogenous flora which on health care workers' hands. The organisms may infect blood stream through the skin insertion site or migrate along the external surface of the catheter and migrate along the internal lumen of the catheter via the hub. The most common organisms found in CLABSIs are including coagulase-negative staphylococci, staphylococcus aureus, enterococci and Candida.
The background section reveals the purpose of the study was to conclude if the catheter was safe, effective in preventing bacteriuria and if future studies were warranted. The literature reviewed for this study included articles on the significance of the problem and articles specific to catheter materials used in manufacturing. This study also included literature about the use of silver as an antimicrobial agent. The methods section detailed the selection of the site, the population chosen for the randomized control trial and information on the catheter selection for the study. Also covered in the methods section was information on the procedures used to randomize the catheter selection and the assessment of participants. The results section of the study reveals the statistical data that lead the researchers to the final conclusions. The total number of participants that met the criteria to complete the study were divided into the test group or the control group. The results were then defined by the percentages that met certain assessment criteria or developed bacteriuria and the timeframe to bacteriuria. Each section with-in the article supports the final conclusion that the test catheter is safe, provides a decreased incidence of bacteriuria, decreased time to bacteriuria and therefor revealed a larger study of this catheter is warranted (Leuck et al., 2015).
Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection
A sample of the patients bacteria causing the urinary tract infection can only be used if a urine sample is bacteriologically viable (1 Radar). Infected urine and sterile urine are common samples used for the diagnosis of patients (1 Radar). It is important to gain further knowledge of multiple organisms’ resistance to antibiotics that cause urinary tract infections (1Radar). Escherichia coli has distinct characteristics and structures that help identify their unique properties (2 Johnson). Escherichia coli is the most common and most prevalent bacteria present in the fecal flora of the human colon (2 Johnson). Because of Escherichia coli unique ability to overcome the obstacles of a new environment, it makes easy for bacteria to spread into the urinary tract and produce a discomforting infection (2 Johnson). All research conducted lead to the belief that Escherichia coli was the Enterobacteriaceae pathogen causing the UTI in the patient. In order to confirm this prediction a set of differential tests and biochemical test must be conducted.
Esherichia coli also known as E. coli is a bacterium that lives in your gut. (1). it was founded by Theodore von Esherich in 1888. There are many people that can get the bacteria. Also there are thousands of strands of E.coli. Six E. coli O157 outbreaks were identified during 2007. Four of the outbreaks involved foodborne transmission. (Eshericha Coli). Six Minnesota cases and one Wisconsin case with the same or closely-related PFGE subtype of E. coli O157:H7, and an additional Minnesota case of Shiga-toxin producing E. coli that was not culture-confirmed, attended the Minnesota State Fair in August. All but one of the cases showed cattle or visited the cattle
This literature review essay will demonstrate a review of four different research articles and research related methodology The articles and review are based on the prevention of Catheter-associated Urinary Tract Infection (UTI). The aim of this literature review is to review publications concerning the management of Catheter-related to UTI 's including the prevention. Articles reviewed include the various precaution and preventions concerning Catheter-associated urinary tract infection (CAUTI) The article evidence summarized bellow was generated using a literature search conducted for Randomised Controlled Trials, Systemic Review or quantitative and qualitative research.
The National Patient Safety Goal NPSG 0.7.06.01 entitled “ Use proven guidelines to prevent infection of the urinary tract that are caused by catheter.” was selected (The Joint Commission, 2015). Gould et al. (2010) reported that in an acute care hospital, a urinary catheter is the most commonly used medical devices (as cited in Acker, 2014). What is a urinary catheter? Urinary catheter is a thin tube inserted into the bladder to drain urine. A collection system bag is connected to the catheter (Centers for Disease Control and Prevention, 2010). Gokula et al. (2014) asserted, short-term and long-term
One of the issues that has been addressed since the initial release of the report is the need to eliminate the occurrence of hospital-acquired infections (HIAs). As noted by Knudson (2014), current efforts to improve healthcare practices encompass new regulations and prevention efforts to eliminate, or at least reduce, HAS, including catheter-associated urinary tract infections (CAUTI). The following paper discusses current efforts in CAUTI prevention, contemporary regulations and mandates, and a quality improvement plan that can be initiated at the focus clinical site.
Urinary tract infections are one of the most hospital-acquired infections in the country. With so much technology and evidence based practice, why is this still an ongoing problem worldwide? Could it simply be the basics of hygiene or just patient negligence? The purpose of this paper is to identify multiple studies that have been done to reduce or prevent hospital associated urinary tract infections. In these articles you will find the use of different interventions that will aid in lowering the risk of these hospital acquired infections.
coli LPS alone into the bladders, leading to the occurrence of symptoms such as edema, hemorrhage, and infiltration of neutrophils into the bladder wall.
Most urinary tract infections are primarily caused by bacteria that live in the bowel region of the body. The bacterium Escherichia coli, commonly referred to as “E. coli”, causes most UTIs. The urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act as only one way valves to prevent urine from moving back up toward the kidneys. Urination is intended to wash microbes and any infectious bacteria out of the body. In males, the prostate gland produces secretions that slow down bacterial growth in the urinary tract. In both woman and men, immune defenses try to prevent infections, but despite these safety procedures put in place by the body, infections still do occur in some individuals.
This article does not provide the search strategy including a number of databases and other resources which identify key published and unpublished research. In this article, both the primary sources and the theoretical literatures are collected and appraised in order to generate the research question and to conduct knowledge-based research. In the section of the literature review, nineteen professional articles are appraised in order to provide the significance and background of the study. Saint develops the research question based on these analyses. “Catheter-associated urinary tract infections in surgical patients: A controlled study on the excess morbidity and costs” is one of the primary sources written by Givens and Wenzel who conduct and analyze this study. In addition, “Clinical and economic consequences of nosocomial catheter-related bacteriuria” is a review of a literature article which is the secondary source. Although many studies state that patient safety is a top priority and CAUTI can be controlled by the caution of health care providers, the infection rate is relatively high among other nosocomial infections. One of the reasons Saint and colleagues uncovered is unawareness and negligence by health care
Brusch says, “Once a indwelling catheter is placed, the daily incidence of bacteriuria can be between 3-10%.” Another large problem that results CAUTI’s is that at times, catheters are left in a patient longer than necessary. Prolonged use of
After microorganisms enter the patient’s body they can go to the lungs and cause pneumonia. Central line-bloodstream infections occur when microorganism enter the bloodstream by the intravenous line. Microorganisms are transfer into the blood stream by inadequate hand hygiene or improper intravenous fluid, tubing, and site care practice. Multidrug-resistant organisms can cause infections of the blood, skin, or organ systems. These infections can arise due to the overuse or misuse of antibiotics, which can result in the microorganisms becoming more resistant to antibiotic therapy. Methicillin-resistant Staphyloccocus aureus and Clostridium difficile are examples of this kind of infection. Health care employees need to know the different types of hospital acquired infections and how they are spread to be able to effectively prevent them.
Bernard, M.S., Hunter, K.F., & Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urologic Nursing 32(1)