Non-Antibiotic Prevention of Catheter Mechanic and Septic Complications in Patients with Long-Term Indwelling Catheters: a Crossover Prospective Study Involving L-Methionine.

Bacterial antimicrobial resistance (AMR) is a major public health concern in modern society caused by bacterial changes that impair the efficacy of infection-treating drugs. Non-antibiotic techniques are critical for controlling the antimicrobial resistance concern because they provide a means of alleviating symptoms without needing antibiotics. This prospective study aims to determine whether administering L-methionine reduces mechanical and bacterial problems associated with long-term indwelling urinary catheters. The trial focused on administering only L-methionine for a three-month period to patients who had long-term bladder catheters, either indwelling or suprapubic. The catheter exchange rates were categorized according to acute urinary tract infection, macroscopic haematuria and symptomatic urinary tract infection. During the time of inclusion, catheter-related incidents were recorded. The primary incident observed was acute urine retention caused by catheter obstruction in 63.6.

Carbapenemase-producing uropathogens in real life: epidemiology and treatment at a County Emergency Hospital from Eastern Romania.

Urinary tract infections are a public health problem exacerbated by the rising concern of antibiotic resistance. Carbapenem-resistant Enterobacterales (CRE), mostly isolated from urine samples, represent an immediate public health threat, often associated with healthcare settings. This study investigated 27 cases of carbapenemase-producing organisms (CPO) detected in urinalysis over one year. There was a significant association between the presence of chronic indwelling urinary catheters and the temporary use of urinary catheters, with both groups accounting for 66.7% of all cases. We identified two modes of transmission for extended drug-resistant microorganisms: inter-hospital spread, covering wide geographical distances (involving four healthcare units across two other counties), and intra-hospital transmission (12 departments within our institution). Medium-size hospitals should thoroughly investigate their specific carbapenemase-producing strains. Their laboratories must be well-supplied to handle this situation and perform the necessary testing accurately. Treatment options should be available based on presumed susceptibility and antimicrobial susceptibility testing, with a range of antibiotics available, including novel agents such as Ceftazidime-avibactam, as well as established options like Aminoglycosides and Colistin. Adherence to rigorous catheter handling protocols, as emphasized by national and international guidelines, is essential and should be implemented consistently across all hospital departments.