Reducing inappropriate urine cultures through a culture standardization program

The objective of this study was to evaluate the impact of a urine culture standardization program that included order indications and urinalysis (U/A) with reflexive culture. The program applied to all adult and pediatric inpatients at an academic medical center; emergency department and ambulatory clinic patients were excluded.MethodsThe analysis compared outcomes in the pre-implementation (January 2015-May 2016) and post-implementation (July 2016-September 2017) periods. The primary outcomes were urine culture and U/A orders per 1,000 patient days, catheter-associated urinary tract infection (CAUTI) rate per 1,000 catheter days, and urine culture contamination rate per 1,000 patient days. Catheter standardized utilization ratios (SURs) were also examined.ResultsThe intervention was associated with a significant decrease in urine culture rates by 6.9 cultures per 1,000 patient days (95% CI –4.44, –9.44; P
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research

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AbstractBackgroundThere are no consensus criteria for diagnosing upper urinary tract infections (UTI). Therefore, we conducted a study to assess whether bacterial colony counts of  ≥ 103 CFU/ml are optimal for diagnosing upper UTIs among infants.MethodsThis retrospective observational study included 673 patients (
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Abstract Infection (such as pneumonia and urinary tract infection) is one of the leading causes of death in patients with acute central nervous system (CNS) injury, which also greatly affects the patients' prognosis and quality of life. Antibiotics are commonly used for the treatment of various infections, however, available evidence demonstrate that prophylactic antibiotic treatments for CNS injury-induced infection have been unsuccessful. Effective approaches for prevention of CNS injury induced-infection remain scarce, therefore, better understanding the molecular and cellular mechanisms of infection post-CNS i...
Source: Brain Research Bulletin - Category: Neurology Authors: Tags: Brain Res Bull Source Type: research
CONCLUSIONSThis study found that implementing urine preservative tubes for specimen collection from Foley catheters improves the accuracy of urine test results. This occurred by reducing erroneous triggers of reflex cultures, falsely elevated colony counts, and fewer Foley patients requiring evaluation for CAUTI, therefore reducing the number of CAUTIs reported.
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
Abstract Diabetes mellitus (DM) is a common disease in Oman as in rest of Gulf Cooperation Council where metabolic syndrome is of high prevalence. DM is a foremost risk factor for urinary tract infections (UTIs). It is also linked to more complicated infections such as emphysematous pyelonephritis (EPN), emphysematous pyelitis (EP), renal/perirenal abscess, emphysematous cystitis, xanthogranulomatous pyelonephritis, and renal papillary necrosis. The diagnosis of these cases is frequently delayed because the clinical manifestations are generic and not different from the typical triad of upper UTI, which include fev...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Kate V. Meriwether1*, Zhenmin Lei1, Rajbir Singh2, Jeremy Gaskins3, Deslyn T. G. Hobson1 and Venkatakrishna Jala2 1Department of Obstetrics and Gynecology, University of Louisville, Louisville, KY, United States 2Department of Microbiology and Immunology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States 3Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, United States Interstitial cystitis/bladder pain syndrome (ICBPS) may be related to an altered genitourinary microbiome. Our aim was to compare the vaginal and urinary microbiomes b...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
AbstractPurpose of ReviewUrinary tract infections (UTIs), including catheter-associated UTIs, are among the most common bacterial infections in both inpatient and outpatient settings. Diagnosis of true UTI remains a clinical challenge, and excessive antimicrobial treatment of asymptomatic bacteriuria (ASB) or contaminated urine cultures is common.Recent FindingsChallenges with the appropriate diagnosis of UTIs include the lack of specific signs and symptoms, no definitive diagnostic criteria, high incidence of ASB, contamination of samples, and frequent lack of indications for ordering urine cultures. Promising interventio...
Source: Current Infectious Disease Reports - Category: Infectious Diseases Source Type: research
Screening for urinary tract infections is often performed by urinalysis (UA) which measures specific urine elements such as nitrites, white blood cells (WBC), and leukocyte esterase (LE). In our Emergency Department (ED), a positive UA, defined as positive nitrite, or>3 WBC, or positive LE, will automatically generate a urine culture to identify and quantify bacteriuria for specimens ordered as a UA with reflex to culture. Our institution's policy is that antibiotic treatment will be provided for patients with urine culture results yielding 60,000 colony-forming units (cfu) per milliliter (ml).
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Correspondence Source Type: research
Authors: Cichos KH, Lehtonen EJ, McGwin G, Ponce BA, Ghanem ES Abstract INTRODUCTION: Orthopaedic surgeons are wary of patients with neuromuscular (NM) diseases as a result of perceived poor outcomes and lack of data regarding complication risks. We determined the prevalence of patients with NM disease undergoing total joint arthroplasty (TJA) and characterized its relationship with in-hospital complications, prolonged length of stay, and total charges. METHODS: Data from the Nationwide Inpatient Sample from 2005 to 2014 was used for this retrospective cohort study to identify 8,028,435 discharges with total jo...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Urine culture is the gold standard for the diagnosis of urinary tract infection (UTI), one of the most common causes of bacterial infection. As such, urine specimens are responsible for a major share of the workload in clinical microbiology laboratories. The inclusion of metrics, such as the catheter-associated UTI (CAUTI) rate, that factor into hospital reimbursements and concerns surrounding the attrition of clinical laboratory personnel have prompted scrutiny of urine culture utilization in many organizations.
Source: Clinical Microbiology Newsletter - Category: Microbiology Authors: Source Type: news
Conclusions—Compared with nicardipine, labetalol was associated with increased in-hospital infections, but not mortality or modified Rankin Score>2. These findings do not support our hypothesis that labetalol use improves outcomes relative to nicardipine in intracerebral hemorrhage.
Source: Stroke - Category: Neurology Authors: Tags: Autonomic Nervous System, Clinical Studies, Hypertension, Quality and Outcomes, Intracranial Hemorrhage Original Contributions Source Type: research
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