Journal of Korean Academy of Nursing

Impact of Obesity on Urinary Tract Infections in Korean Adults: Secondary Data Analysis Using Community-Based Cohort Study: Seo, Seung Hee , Jeong, Ihn Sook , Lee, Eun Joo; J Korean Acad Nurs 2021;51(2):150-161. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20228

Abstract PDF: Purpose
This study investigated the incidence of urinary tract infection (UTI) in community-dwelling adults and identified the association between obesity and UTI.
Methods
The participants were 4,926 adults aged over 40 years who had no UTIs at the baseline survey of the Korean Genome Epidemiology Study. Obesity was defined according to the cirtieria of Korean Society for the Study of Obesity using body mass index (BMI) data. UTI was defined as those who had self-reported UTI or had either nitrite, or both leukocytes and blood in the urine dipstick test. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using a multivariate Cox proportional hazards regression analysis to identify the association between the obesity and UTI.
Results
The incidence proportion of UTI was 5.1%, and the incidence density per 1,000 person-years was 25.5. After controlling general characteristics, people with BMI ≥30.0 kg/m² remained 1.66 times (HR = 1.66, 95% CI = 1.06~2.60; p < .05) more likely to have UTI than those with normal weight. This trend was also present in men or people aged ≥ 60 years. Among women aged ≥ 60 years, people with BMI ≥ 30.0 kg/m² were 1.98 times (HR = 1.98, 95% CI = 1.01~3.86; p < .05) more likely to have UTI than those with normal weight.
Conclusion
The BMI ≥ 30.0 kg/m² is a risk factor of UTIs in Korean adult men over 40 years and women aged ≥ 60 years. It is necessary to emphasize the importance of obesity management to men or women aged ≥ 60 years, specifically.

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The Effects of the Rountine Meatal Care with 10% Betadine on the Reduction of Catheter-Associated Urinary Tract Infection: Phil Whan Kim, Yeong Kyeong Kim; Journal of Korean Academy of Nursing 1999;29(3):614-624. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.3.614

Abstract PDF: The purpose of this study is to determine the effectiveness of routine meatal care on the reduction of catheter-associated urinary tract infection(UTI). The study was carried out on 30 patients with foley catheters in an intensive care unit of a general hospital from September 30 to April 1, 1998, Participants were both male and female. Data were collected from each patients by urinary specimen obtained with aseptic collection technique at the 3rd and the 7th day of the experiment, after giving daily meatal care with 10% betadine for periods ranging from 1st to 7th day to the experimental group but not to the control group. The results are as follows: 1. The rate of urinary tract infection within the experimental group was 0.0%, at the 3rd day of the experiment and 20.0% at the 7th day, but that of the control group was 20.0%at the 3rd day and 7% at the 7th day. There was a significant difference in urinary tract infection rate between the two groups at the 3rd day but no significant difference at the 7th day. 2. In the control group, the rate of UTI was 0.7% for male and 13.3% for female at the 3rd day, and 6.7% for male and 40% for female at the 7th day. In the experimental group, the rate of UTI was 6.7% for male and 0.0%for female at the 3rd day and 13.3% for male and 20% for female at the 3rd day and 13.3% for male and 20% for female at the 7th day of experiment. There was a no significant difference between male and female. 3. By comparing the rate of UTI to the length of time the urinary catheter was in place, the linger the catheter was in place the more significant was the rate of UTI. 4. Microorganisms isolated in the control group were bacteria for 7 cases and fungus for 3 cases but in the experimental group, only 2 cases of bacteria were isolated.

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Risk Factors for Nosocomial Urinary Tract Infection in the Intensive Care Unit with a Positive Urine Culture and Foley Catheterization: Seong Mi Yu, Kyung Yeon Park; Journal of Korean Academy of Nursing 2007;37(7):1149-1158. Published online December 31, 2007; DOI: https://doi.org/10.4040/jkan.2007.37.7.1149

Abstract PDF: Purpose
The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture.
Method
Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis.
Result
The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were ‘age’, ‘place of catheter insertion’, ‘frequency of catheter change’, and ‘duration of catheterization’. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization.
Conclusion
Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.

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Status of Nosocomial Urinary Tract Infections in the ICU: Molecular Epidemiology of Imipenem Resistant P. aeruginosa: Seong Mi Yu, Seong Sook Jeon, In Soon Kang, Hye Gyung An; Journal of Korean Academy of Nursing 2006;36(7):1204-1214. Published online December 31, 2006; DOI: https://doi.org/10.4040/jkan.2006.36.7.1204

Abstract PDF: Purpose
This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors andtransmission route of causal IRPA through molecular epidemiology.
Method
Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA.
Result
The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection.
Conclusion
Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

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