More monitoring needed to reduce post-hospitalization urinary tract infections

June 25, 2019

CORVALLIS, Ore. - Broader monitoring of patients is needed to reduce the number of people who develop a urinary tract infection after being discharged from the hospital, new research by Oregon State University suggests.

Findings were published in the journal Infection Control & Hospital Epidemiology. The exploratory study of more than 3,000 at-risk patients showed that infection was nearly three times as likely to begin after they went home compared to when they were in the hospital.

"Every healthcare-associated infection represents an undesirable patient outcome," said Jessina McGregor, associate professor in the OSU College of Pharmacy and the study's corresponding author. "If people are still at risk for those types of infections after they leave the hospital, then healthcare-associated infection research should focus more broadly than the current definitions of surveillance definitions. We need more data to stimulate innovation for better informing patient care and preventing these types of infections."

Urinary tract infections, or UTIs, are the most common type of healthcare-associated infection, according to the National Institutes of Health. Seventy-five percent of UTIs acquired in a hospital trace to the use of a urinary catheter, a tube inserted into the bladder through the urethra to drain urine. About 20% of hospitalized patients need a catheter.

"UTI surveillance has largely focused on catheter-associated infections, and also has not focused very much on infections that onset post-discharge from the hospital," McGregor said. "But recently discharged patients are still at risk for hospital-associated UTIs, and as hospitals continue to encourage shorter hospital stays, symptoms of these infections may be more likely to show up after the patient goes home. However, data to describe the incidence of these infections is lacking, which is a barrier to better identifying which patients are most at risk."

In the group studied by Oregon State researchers, 10.6 patients per 1,000 developed a UTI while in the hospital; 29.8 per 1,000 did so within 30 days of going home. In addition to catheterization, other risk factors for healthcare-associated "community onset" UTIs - those that develop outside a hospital setting - are quadriplegia and paraplegia, prior use of certain antibiotics, and whether a patient has private insurance; those with private insurance are less likely to become infected.

"Patients who got sick after discharge had similar pathogens and antibiotic sensitivities to those who got sick while still in the hospital, which suggests that patients developing a UTI following discharge may need different treatment strategies than patients who develop UTIs that aren't associated with hospital stays," McGregor said.

The results don't say with certainty that the post-discharge infections were acquired in the hospital, but the evidence is strong enough to warrant further study, she added.
-end-
The Agency for Healthcare Research and Quality, the Oregon Clinical and Translational Research Institute, and the National Institutes of Health funded this research.

Scientists from Oregon Health & Science University, the Department of Veterans Affairs, and Doctor Evidence, a software and data company in Santa Monica, California, collaborated on the study.

Oregon State University

Related Infection Articles from Brightsurf:

Halving the risk of infection following surgery
New analysis by the University of Leeds and the University of Bern of more than 14,000 operations has found that using alcoholic chlorhexidine gluconate (CHG) halves the risk of infection in certain types of surgery when compared to the more commonly used povidone-iodine (PVI).

How plants shut the door on infection
A new study by an international team including University of Maryland scientists has discovered the key calcium channel responsible for closing plant pores as an immune response to pathogen exposure.

Sensing infection, suppressing regeneration
UIC researchers describe an enzyme that blocks the ability of blood vessel cells to self-heal.

Boost to lung immunity following infection
The strength of the immune system in response to respiratory infections is constantly changing, depending on the history of previous, unrelated infections, according to new research from the Crick.

Is infection after surgery associated with increased long-term risk of infection, death?
Whether experiencing an infection within the first 30 days after surgery is associated with an increased risk of another infection and death within one year was the focus of this observational study that included about 660,000 veterans who underwent major surgery.

Revealed: How E. coli knows how to cause the worst possible infection
The discovery could one day let doctors prevent the infection by allowing E. coli to pass harmlessly through the body.

UK study shows most patients with suspected urinary tract infection and treated with antibiotics actually lack evidence of this infection
New research presented at this week's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (April 13-16, 2019) shows that only one third of patients that enter the emergency department with suspected urinary tract infection (UTI) actually have evidence of this infection, yet almost all are treated with antibiotics, unnecessarily driving the emergence of antimicrobial resistance.

Bacteria in urine doesn't always indicate infection
Doctors should think carefully before testing patients for a urinary tract infection (UTI) to avoid over-diagnosis and unnecessary antibiotic treatment, according to updated asymptomatic bacteriuria (ASB) guidelines released by the Infectious Diseases Society of America (IDSA) and published in Clinical Infectious Diseases.

Subsidies for infection control to healthcare institutions help reduce infection levels
Researchers compared three types of infection control subsidies and found that under a limited budget, a dollar-for-dollar matching subsidy, in which policymakers match hospital spending for infection control measures, was the most effective at reducing the number of hospital-acquired infections.

Dengue virus infection may cause severe outcomes following Zika virus infection during pregnancy
This study is the first to report a possible mechanism for the enhancement of Zika virus progression during pregnancy in an animal model.

Read More: Infection News and Infection Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.