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Urine Cultures among Hospitalized Veterans: Casting Too Broad a Net?

Published online by Cambridge University Press:  10 May 2016

Dimitri M. Drekonja*
Affiliation:
Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Christina Gnadt
Affiliation:
Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota
Michael A. Kuskowski
Affiliation:
Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
James R. Johnson
Affiliation:
Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota Department of Medicine, University of Minnesota, Minneapolis, Minnesota
*
Infectious Diseases (111F), Veterans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417 ([email protected])

Abstract

Since detection of asymptomatic bacteriuria among inpatients often leads to inappropriate antimicrobial treatment, we studied why urine cultures were ordered and correlates of treatment. Most cultures were obtained from patients without urinary complaints and a minority from asymptomatic patients. High-count bacteriuria, not clinical manifestations, appeared to trigger most antimicrobial use.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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References

1. Nicolle, LE, Bradley, S, Colgan, R, Rice, JC, Schaeffer, A, Hooton, TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40(5)643654.Google Scholar
2. Cope, M, Cevallos, ME, Cadle, RM, Darouiche, RO, Musher, DM, Trautner, BW. Inappropriate treatment of catheter-associated asymptomatic bacteriuria in a tertiary care hospital. Clin Infect Dis 2009;48(9)11821188.Google Scholar
3. Shaughnessy, MK, Amundson, WH, Kuskowski, MA, DeCarolis, DD, Johnson, JR, Drekonja, DM. Unnecessary antimicrobial use in patients with current or recent Clostridium difficile infection. Infect Control Hosp Epidemiol 2013;34(2)109116.Google Scholar
4. Woodford, HJ, George, J. Diagnosis and management of urinary tract infection in hospitalized older people. J Am Geriatr Soc 2009;57(1)107114.CrossRefGoogle ScholarPubMed
5. Drekonja, DM, Okoye, NC, Kuskowski, MA, Johnson, JR. Appropriateness of urinary tract infection diagnosis and treatment duration. Arch Intern Med 2010;170(5)489490.Google Scholar
6. Knoll, BM, Wright, D, Ellingson, L, et al. Reduction of inappropriate urinary catheter use at a Veterans Affairs hospital through a multifaceted quality improvement project. Clin Infect Dis 2011;52(11)12831290.Google Scholar
7. Bone, RC, Balk, RA, Cerra, FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101(6)16441655.Google Scholar
8. Lipsky, BA. Urinary tract infections in men: epidemiology, pathophysiology, diagnosis, and treatment. Ann Intern Med 1989;110(2)138150.Google Scholar
9. Hartley, S, Valley, S, Kuhn, L, et al. Inappropriate testing for urinary tract infection in hospitalized patients: an opportunity for improvement. Infect Control Hosp Epidemiol 2013;34(11): 1204-1207.Google Scholar
10. Saint, S, Wiese, J, Amory, JK, et al. Are physicians aware of which of their patients have indwelling urinary catheters? Am J Med 2000;109(6)476480.Google Scholar