Impact of restrictive urinalysis reflex to culture criteria at a large community hospital.

Autor: Caveness CF; Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, North Carolina. Electronic address: ccaveness@wakemed.org., Orvin AI; Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, North Carolina; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina., Ingram CW; Infection Control and Occupational Health, WakeMed Health and Hospitals, Raleigh, North Carolina., Bouchard JL; Department of Pharmacy, WakeMed Health and Hospitals, Raleigh, North Carolina; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina.
Jazyk: angličtina
Zdroj: Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2024 Apr; Vol. 108 (4), pp. 116183. Date of Electronic Publication: 2024 Jan 10.
DOI: 10.1016/j.diagmicrobio.2024.116183
Abstrakt: Treatment of asymptomatic bacteriuria (ASB) is a common, but often unnecessary, practice. Our objective was to determine the impact of restrictive urinalysis reflex to culture (UARC) criteria on rate of urine cultures (UC) ordered and ASB treatment. Criteria were modified from positive leukocyte esterase, positive nitrites, or white blood cells (WBC) >10 cells to only WBC >10 cells. This pre-post study evaluated UARCs ordered in the emergency department or inpatient units. The primary outcome was the proportion of reflex UCs prevented. Secondary outcomes included the frequency of repeat UARCs and stand-alone UCs, gram-negative rod (GNR) bacteremia, and ASB treatment. In the pre-intervention, there were 4761 UARCs compared to 5420 in the post-intervention; 37.9 % and 21.4 % reflexed to UCs, a 43.5 % reduction in UCs. The rate of repeat UARCs, stand-alone UCs, and GNR bacteremia in the pre- and post-interventions were similar. ASB treatment rate was numerically lower in the post-intervention.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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