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Healthcare Associated Infections II: Preventive Measures01:22

Healthcare Associated Infections II: Preventive Measures

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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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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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Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

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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...
400
Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
530
Urinary Tract Infection I: Introduction01:26

Urinary Tract Infection I: Introduction

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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...
512
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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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...
285

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An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
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尿管アクセスシースの使用と感染関連の入院：実施状況と転帰

Russell E N Becker1, Suprita Krishna1, Andrew M Higgins2

  • 1University of Michigan, Ann Arbor, Michigan, United States.

Urology practice
|December 15, 2025
PubMed
まとめ

腎結石に対する尿管鏡検査（URS）中の尿管アクセスシース（UAS）の使用は、広く異なっている。本研究では、UASの使用有無にかかわらず、感染関連入院に有意な差は見られず、他の要因が患者の転帰に影響することを示唆している。

キーワード:
尿管アクセスシース感染敗血症尿管鏡検査尿路感染症

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Establishment and Characterization of UTI and CAUTI in a Mouse Model
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科学分野:

  • 泌尿器科学;外科的イノベーション;感染制御

背景:

  • 尿管鏡検査（URS）は、腎結石の治療に一般的に行われる手技である。;URS中の尿管アクセスシース（UAS）の使用は、感染率への影響に関して議論の余地がある。;感染関連入院に影響を与える要因を理解することは、患者の安全にとって極めて重要である。

研究 の 目的:

  • 腎結石に対するUASありとなしのURSにおける感染関連入院率を比較すること。;URS中の感染関連入院に関連する危険因子を特定すること。;異なる手術実施状況におけるUAS使用のばらつきを評価すること。

主な方法:

  • Michigan Urological Surgery Improvement Collaborative（MUSIC）レジストリの分析。;腎結石に対する単回、片側URSを受けた患者の組み入れ。;30日以内の感染関連入院に対するUASの使用および臨床的要因を評価するための多変量ロジスティック回帰。

主要な成果:

  • 合計6,142人の患者がURSを受け、2.5%が30日以内に感染関連入院を経験した。;UASは症例の59%で使用され、有意な実施状況のばらつき（4.1%から99.5%）を示した。;感染関連入院率は、UAS使用あり（2.6%）と使用なし（2.3%）で同様であった（p=0.5）。;入院の危険因子には、Charlson Comorbidity Indexが高いこと、再発性尿路感染症、結石が大きいこと、術前の尿検査/培養が陽性であることが含まれた。

結論:

  • 腎結石に対するURSにおける尿管アクセスシースの使用は、実施状況によって大きく異なる。;UASの使用は、30日以内の感染関連入院の減少とは関連がなかった。;感染への影響を理解するためには、URS中の腎内圧に関するさらなる研究が保証される。