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  1. Article ; Online: Microbial co-occurrences on catheters from long-term catheterized patients.

    Nye, Taylor M / Zou, Zongsen / Obernuefemann, Chloe L P / Pinkner, Jerome S / Lowry, Erin / Kleinschmidt, Kent / Bergeron, Karla / Klim, Aleksandra / Dodson, Karen W / Flores-Mireles, Ana L / Walker, Jennifer N / Wong, Daniel Garrett / Desai, Alana / Caparon, Michael G / Hultgren, Scott J

    Nature communications

    2024  Volume 15, Issue 1, Page(s) 61

    Abstract: Catheter-associated urinary tract infections (CAUTIs), a common cause of healthcare-associated infections, are caused by a diverse array of pathogens that are increasingly becoming antibiotic resistant. We analyze the microbial occurrences in catheter ... ...

    Abstract Catheter-associated urinary tract infections (CAUTIs), a common cause of healthcare-associated infections, are caused by a diverse array of pathogens that are increasingly becoming antibiotic resistant. We analyze the microbial occurrences in catheter and urine samples from 55 human long-term catheterized patients collected over one year. Although most of these patients were prescribed antibiotics over several collection periods, their catheter samples remain colonized by one or more bacterial species. Examination of a total of 366 catheter and urine samples identify 13 positive and 13 negative genus co-occurrences over 12 collection periods, representing associations that occur more or less frequently than expected by chance. We find that for many patients, the microbial species composition between collection periods is similar. In a subset of patients, we find that the most frequently sampled bacteria, Escherichia coli and Enterococcus faecalis, co-localize on catheter samples. Further, co-culture of paired isolates recovered from the same patients reveals that E. coli significantly augments E. faecalis growth in an artificial urine medium, where E. faecalis monoculture grows poorly. These findings suggest novel strategies to collapse polymicrobial CAUTI in long-term catheterized patients by targeting mechanisms that promote positive co-associations.
    MeSH term(s) Humans ; Escherichia coli ; Catheter-Related Infections/microbiology ; Catheters ; Urinary Tract Infections/microbiology ; Enterococcus faecalis ; Bacteria
    Language English
    Publishing date 2024-01-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-023-44095-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cost Analysis of Vaginal Anti-incontinence Procedures at a Tertiary Care Center.

    Wong, Daniel Garrett / Kim, Sandy / Christie, Alana / Rawlings, Tanner / Lemack, Gary / Zimmern, Philippe

    Urology

    2020  Volume 141, Page(s) 50–54

    Abstract: Objective: To compare the cost of 3 vaginal procedures used in the surgical management of stress urinary incontinence (SUI) at 1 tertiary institution.: Methods: The costs of autologous fascial sling (AFS), synthetic mid-urethral sling (MUS), and ... ...

    Abstract Objective: To compare the cost of 3 vaginal procedures used in the surgical management of stress urinary incontinence (SUI) at 1 tertiary institution.
    Methods: The costs of autologous fascial sling (AFS), synthetic mid-urethral sling (MUS), and anterior vaginal wall suspension (AVWS) were analyzed from a prospective long-term database, with follow-up to 5 years after these procedures. Original costing data were obtained for operating room, medical and surgical supplies, pharmacy, anesthesia supplies, and room and bed over 2 consecutive years. Included were complete cost data provided by our institution from Medicare (2012) and private payer insurance.
    Results: For the year 2013, the AVWS, AFS, and MUS had total median costs of $4513, $5721, and $3311, respectively. Total cost and all subcosts except for pharmacy costs were significantly different for each procedure. AVWS and MUS placement differed from each other regarding the cost of anesthesia and hospital stay, which was higher for AVWS. Compared to AFS, AVWS had significantly lower total costs due to decreased costs associated with operating time, hospital stay, and surgical supplies (P <.0001). At 5 years after these procedures, synthetic slings had less frequent follow-up visits. The most common revision for SUI failure was a bulking agent injection.
    Conclusion: Initial costs of vaginal SUI procedures at our institution fared favorably compared to SUI procedures reported in the contemporary US literature. Long-term costs can vary based on physician preference in follow-up routine and etiology of SUI.
    MeSH term(s) Aged ; Anesthesia/economics ; Costs and Cost Analysis ; Databases, Factual ; Economics, Pharmaceutical ; Equipment and Supplies, Hospital/economics ; Female ; Humans ; Length of Stay/economics ; Middle Aged ; Operating Rooms/economics ; Prospective Studies ; Suburethral Slings/economics ; Tertiary Care Centers ; Urinary Incontinence, Stress/economics ; Urinary Incontinence, Stress/surgery ; Urogenital Surgical Procedures/economics ; Urogenital Surgical Procedures/methods
    Language English
    Publishing date 2020-04-10
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2020.03.039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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