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Healthcare Associated Infections II: Preventive Measures01:22

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
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Ureteral Access Sheath Use and Infection-Related Hospitalizations: Practice Patterns and Outcomes.

Russell E N Becker1,2, Suprita Krishna1, Andrew M Higgins3

  • 1Department of Urology, University of Michigan, Ann Arbor, Michigan.

Urology Practice
|December 15, 2025
PubMed
Summary
This summary is machine-generated.

Ureteral access sheath (UAS) use during ureteroscopy (URS) for kidney stones varies widely. This study found no significant difference in infection-related hospitalizations with or without UAS, suggesting other factors influence patient outcomes.

Keywords:
UTIinfectionsepsisureteral access sheathureteroscopy

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Area of Science:

  • Urology
  • Surgical Innovation
  • Infection Control

Background:

  • Ureteroscopy (URS) is a common procedure for treating kidney stones.
  • The use of a ureteral access sheath (UAS) during URS is debated regarding its impact on infection rates.
  • Understanding factors influencing infection-related hospitalizations is crucial for patient safety.

Purpose of the Study:

  • To compare infection-related hospitalization rates between URS with and without UAS for renal stones.
  • To identify risk factors associated with infection-related hospitalizations during URS.
  • To assess the variation in UAS usage across different surgical practices.

Main Methods:

  • Analysis of the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry.
  • Inclusion of patients undergoing single-stage unilateral URS for renal stones.
  • Multivariable logistic regression to evaluate UAS use and clinical factors on 30-day infection-related hospitalization.

Main Results:

  • A total of 6,142 patients underwent URS, with 2.5% experiencing infection-related hospitalization within 30 days.
  • UAS was used in 59% of cases, showing significant practice variation (4.1% to 99.5%).
  • Infection-related hospitalization rates were similar with (2.6%) and without (2.3%) UAS use (p=0.5).
  • Risk factors for hospitalization included higher Charlson Comorbidity Index, recurrent UTIs, larger stones, and positive preoperative urinalysis/culture.

Conclusions:

  • Ureteral access sheath use in URS for renal stones varies significantly across practices.
  • UAS use was not associated with a reduction in 30-day infection-related hospitalizations.
  • Further research on intrarenal pressure during URS is warranted to understand infection implications.