O U R R E S E A R C H
Understanding How Urinary Catheterization Predisposes Patients to CAUTIs
Catheter-associated urinary tract infections (CAUTIs) are the most common cause of healthcare associated infection (HAI) worldwide, accounting for 40% of all HAIs with more than one million cases diagnosed annually in hospitals and nursing homes in the United States and Europe and it accounts for an annual cost of $340–370 million. Importantly, CAUTI often leads to secondary bloodstream infection with a seven day mortality rate of more than 30%. This becomes more troublesome since urinary catheters use is exceedingly common in health care facilities and it is estimated that 20-50% of all hospitalized patients receive a urinary catheter, which accounts for >30 million Foley catheters inserted annually in the United States, resulting in 1 million CAUTIs.
The presence of a urinary catheter changes the bladder environment allowing several pathogens such as Enterococcus spp., Staphylococcus aureus, Candida spp., Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and Group B Streptococcus, to colonize the bladder, something that otherwise would not occur. From these groups of bacteria, Enterococcus spp. are the leading cause of CAUTI, have emerged as a frequent cause of HAIs, and their treatment are increasingly challenging due to their intrinsic and acquired resistance to antibiotics. Currently, 30% of all enterococcal HAI isolates are resistant to vancomycin, leading the CDC to classify VRE as a serious threat, recommending monitoring and the development of new therapeutic strategies. The lab is interested in understanding how urinary catheterization-induced inflammation renders the host susceptible to microbial infection of the urinary tract and subsequent dissemination. We are also interested in deciphering key host and pathogen determinants for infection and targeting them to develop novel antibiotic-sparing therapies. |
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