CATHETER-ASSOCIATED URINARY TRACT INFECTIONS

Catheter-associated Urinary Tract Infections In Intensive Care Units

Catheter-associated Urinary Tract Infections In Intensive Care Units

Search Techniques Used

PICO for almost 40% of nosocomial infections, and according to a landmark study, between 10% and 27% of catheterized patients become bacteriuric within 5 days. Other complications include local infections (such as urethritis, periurethral abscess, epididymitis, and prostatitis), bladder fibrosis, bladder deformity, and increased risk of bladder cancer. In addition, chronic pyelonephritis, a nonbacterial tubulointerstitial nephritis found at autopsy in approximately one third of catheterized patients, is associated with increased mortality but is not clinically detectable.

Searching with a text word that can occur anywhere in the citation is useful for "new" terms or for comprehensive searching. Text word searching is effective in cancer searches for new anti-cancer drugs and for differing names of drugs that may appear in articles. Truncation can be used with text words that may have various endings, employing the specific truncation symbol specified for the search system. However, truncation should be used with caution. For example, a root word such as oncol will return citations that contain not only oncology and oncologic, but also oncolytic. Searching with text words may retrieve articles that contain the search term one or more times but are irrelevant to the search. Text words can also pose problems with spelling variations (eg, hematology or haematology) or with misspelled words.

To locate PICO terms, specific print PICO documents are available from the NLM and online through such systems as PubMed and OVID. When using the OVID system to search MEDLINE, the system defaults to searching by PICO terms and will return possible selections for choice. From those choices, a click on the highlighted terms will show the tree structure relationships. The scope note provides a brief description of how the indexers at NLM apply that term.

PICO terms are organized in a hierarchical scheme from broader to narrower subjects. A subject term relates to other terms with broader subjects above it in the tree structure and with narrower terms indented below it. When a searcher selects a term and chooses to explode that term, the original term and all the narrower related terms indented below it are included in the retrieval.

The search should be kept broad at first by not choosing the subject heading as the focus since that may make retrieval too narrow when adding additional terms for evidence-based medicine. Also, all subheadings applicable to the subject should be used initially. Whenever possible, use search terms to combine the cancer site and the histologic type of cancer (eg, lung neoplasms and non-small cell lung carcinoma). Using PICO terminology to search MEDLINE does not always produce exact results because NLM indexers sometimes lack consistency in applying PICO terms. However, PICO terms provide a good starting point for any search.

Introduction

The purpose of this review is to analyze literature concerning the diagnosis, prevention, and management of catheter-associated urinary tract infection (CAUTI) occurring in patients hospitalized in the intensive care unit ...