OBJECTIVES: Healthcare-associated urinary tract infections (HAUTIs) are the most frequent healthcare-associated infections in general hospitals. They are almost exclusively complicated UTIs, although complicating factors are very heterogenous. HAUTIs are mainly catheter associated. Most of them are asymptomatic and do not need antimicrobial therapy. However, cross-contamination and cross-infection may contribute to distribution of resistant uropathogens. The bacterial spectrum of HAUTI is broad, and antibiotic resistance is common. METHODS: The authors reviewed the literature from 2000 to 2010 to determine the epidemiology, prevention and best treatment strategies for HAUTI. The recommendations were summarized by determining the level of evidence and grading each recommendation. RESULTS: The treatment for HAUTI encompasses treatment for complicating factors as well as antimicrobial chemotherapy. At least in serious UTI, adequate initial antibiotic therapy results in lower mortality. Therefore, the initial antibiotic regimen must provide sufficient antibiotic coverage. This can only be achieved if the local or regional bacterial spectrum and antibiotic resistance patterns of uropathogens are followed continuously. Provisional microbiological findings, such as reports on Gram-stain or certain biochemical results, can lead to early stratification of pathogens and allow a more tailored empiric antibiotic therapy. Antibiotic therapy of HAUTI has to consider therapeutic success in the individual patient and prevention of emergence of antibiotic-resistant mutants. For both aspects, adequate drug selection and dosing are paramount. DISCUSSION: Antibiotic treatment for HAUTI should follow prudent antibiotic use to prevent emergence of antibiotic resistance.
OBJECTIVES: Healthcare-associated urinary tract infections (HAUTIs) are the most frequent healthcare-associated infections in general hospitals. They are almost exclusively complicated UTIs, although complicating factors are very heterogenous. HAUTIs are mainly catheter associated. Most of them are asymptomatic and do not need antimicrobial therapy. However, cross-contamination and cross-infection may contribute to distribution of resistant uropathogens. The bacterial spectrum of HAUTI is broad, and antibiotic resistance is common. METHODS: The authors reviewed the literature from 2000 to 2010 to determine the epidemiology, prevention and best treatment strategies for HAUTI. The recommendations were summarized by determining the level of evidence and grading each recommendation. RESULTS: The treatment for HAUTI encompasses treatment for complicating factors as well as antimicrobial chemotherapy. At least in serious UTI, adequate initial antibiotic therapy results in lower mortality. Therefore, the initial antibiotic regimen must provide sufficient antibiotic coverage. This can only be achieved if the local or regional bacterial spectrum and antibiotic resistance patterns of uropathogens are followed continuously. Provisional microbiological findings, such as reports on Gram-stain or certain biochemical results, can lead to early stratification of pathogens and allow a more tailored empiric antibiotic therapy. Antibiotic therapy of HAUTI has to consider therapeutic success in the individual patient and prevention of emergence of antibiotic-resistant mutants. For both aspects, adequate drug selection and dosing are paramount. DISCUSSION: Antibiotic treatment for HAUTI should follow prudent antibiotic use to prevent emergence of antibiotic resistance.
Authors: Nicholas Graves; Edward Tong; Anthony P Morton; Kate Halton; Merrilyn Curtis; David Lairson; Michael Whitby Journal: Am J Infect Control Date: 2007-08 Impact factor: 2.918
Authors: Truls E Bjerklund Johansen; Mete Cek; Kurt G Naber; Leonid Stratchounski; Martin V Svendsen; Peter Tenke Journal: Int J Antimicrob Agents Date: 2006-07-07 Impact factor: 5.283
Authors: G L Drusano; S L Preston; C Hardalo; R Hare; C Banfield; D Andes; O Vesga; W A Craig Journal: Antimicrob Agents Chemother Date: 2001-01 Impact factor: 5.191
Authors: Marc Leone; Jacques Albanèse; Franck Garnier; Christophe Sapin; Karine Barrau; Marie-Christine Bimar; Claude Martin Journal: Intensive Care Med Date: 2003-05-13 Impact factor: 17.440
Authors: Ibrahim Al-Habdan; Mir Sadat-Ali; James Ran Corea; Abdullah Al-Othman; Baher A Kamal; Devdas Sheena Shriyan Journal: Int Surg Date: 2003 Jul-Sep
Authors: V Spoorenberg; J M Prins; E E Stobberingh; M E J L Hulscher; S E Geerlings Journal: Eur J Clin Microbiol Infect Dis Date: 2013-07-04 Impact factor: 3.267
Authors: Latarsha Chisholm; Robert Weech-Maldonado; Alex Laberge; Feng-Chang Lin; Kathryn Hyer Journal: Health Serv Res Date: 2013-06-26 Impact factor: 3.402
Authors: Mete Cek; Zafer Tandoğdu; Florian Wagenlehner; Peter Tenke; Kurt Naber; Truls Erik Bjerklund-Johansen Journal: World J Urol Date: 2014-01-23 Impact factor: 4.226
Authors: Jennifer N Walker; Ana L Flores-Mireles; Aaron J L Lynch; Chloe Pinkner; Michael G Caparon; Scott J Hultgren; Alana Desai Journal: World J Urol Date: 2019-12-02 Impact factor: 4.226