دورية أكاديمية
أعرض في EDS

Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers.

التفاصيل البيبلوغرافية
العنوان: Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers.
المؤلفون: Grein JD; 1Department of Hospital Epidemiology,Cedars-Sinai Medical Center,Los Angeles,California., Kahn KL; 2David Geffen School of Medicine,Division of General Internal Medicine and Health Services Research,University of California-Los Angeles (UCLA),California., Eells SJ; 3Division of Infectious Diseases,Harbor-UCLA Medical Center,and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,Los Angeles,California., Choi SK; 6Cedars-Sinai/UCLA Multicampus Fellowship Program in Infectious Diseases,Los Angeles,California., Go-Wheeler M; 7Department of Medicine,Harbor-UCLA Medical Center,Torrance,California., Hossain T; 7Department of Medicine,Harbor-UCLA Medical Center,Torrance,California., Riva MY; 9College of Pharmacy,Western University of Health Sciences,Pomona,California., Nguyen MH; 3Division of Infectious Diseases,Harbor-UCLA Medical Center,and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,Los Angeles,California., Rekha Murthy A; 1Department of Hospital Epidemiology,Cedars-Sinai Medical Center,Los Angeles,California., Miller LG; 3Division of Infectious Diseases,Harbor-UCLA Medical Center,and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,Los Angeles,California.
المصدر: Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2016 Mar; Vol. 37 (3), pp. 319-26. Date of Electronic Publication: 2015 Nov 26.
نوع المنشور: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Cambridge University Press Country of Publication: United States NLM ID: 8804099 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-6834 (Electronic) Linking ISSN: 0899823X NLM ISO Abbreviation: Infect Control Hosp Epidemiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Jan. 2015- : Cambridge : Cambridge University Press
Original Publication: [Thorofare, N.J. ] : SLACK Inc., c1988-
مواضيع طبية MeSH: Anti-Bacterial Agents/*therapeutic use , Bacteriuria/*diagnosis , Bacteriuria/*epidemiology , Urinary Tract Infections/*drug therapy , Urinary Tract Infections/*epidemiology, Adult ; Aged ; Aged, 80 and over ; Escherichia coli/isolation & purification ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires ; Tertiary Care Centers ; United States ; Young Adult
مستخلص: Background: Antibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.
Objective: To evaluate risk factors for treatment of ASB.
Design: Retrospective observational study.
Setting: A tertiary academic hospital, county hospital, and community hospital.
Patients: Hospitalized adults with bacteriuria.
Methods: Patients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.
Results: Among 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14-0.80], P =.01), presence of leukocyte esterase (5.48 [2.35-12.79], P<.01), presence of nitrites (2.45 [1.11-5.41], P=.03), and Escherichia coli on culture (2.4 [1.2-4.7], P=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.
Conclusions: ASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.
Competing Interests: Potential conflicts of interest: All authors report no conflicts of interest relevant to this article.
References: Clin Infect Dis. 2011 Mar 1;52(5):e103-20. (PMID: 21292654)
Infect Control Hosp Epidemiol. 2013 Feb;34(2):109-16. (PMID: 23295554)
J Antimicrob Chemother. 2014 Apr;69(4):881-91. (PMID: 24324224)
Fam Med. 2005 May;37(5):360-3. (PMID: 15883903)
Clin Infect Dis. 2007 Jan 15;44(2):159-77. (PMID: 17173212)
Can J Infect Dis Med Microbiol. 2005 May;16(3):166-70. (PMID: 18159538)
Am J Infect Control. 2013 Oct;41(10):892-6. (PMID: 23541740)
Can J Infect Dis Med Microbiol. 2009 Winter;20(4):107-11. (PMID: 21119801)
J Hosp Infect. 2013 Nov;85(3):183-8. (PMID: 23998947)
MMWR Morb Mortal Wkly Rep. 2014 Mar 7;63(9):194-200. (PMID: 24598596)
PLoS One. 2015 Jul 16;10(7):e0132071. (PMID: 26182348)
Infect Control Hosp Epidemiol. 2009 Feb;30(2):193-5. (PMID: 19125678)
Infect Control Hosp Epidemiol. 2009 Jun;30(6):596-9. (PMID: 19419329)
Arch Intern Med. 2012 Jan 9;172(1):33-8. (PMID: 22232145)
Infect Dis Clin North Am. 2014 Mar;28(1):15-31. (PMID: 24484572)
Crit Care Med. 2008 Apr;36(4):1158-67. (PMID: 18379242)
Clin Infect Dis. 2007 Nov 15;45(10):1335-7. (PMID: 17968830)
Pharmacotherapy. 2014 Sep;34(9):941-60. (PMID: 24807583)
Clin Infect Dis. 2009 May 1;48(9):1182-8. (PMID: 19292664)
BMC Infect Dis. 2011 Jul 05;11:187. (PMID: 21729289)
Clin Infect Dis. 2011 Aug;53 Suppl 1:S15-22. (PMID: 21795724)
Infect Control Hosp Epidemiol. 2010 May;31(5):431-55. (PMID: 20307191)
Clin Infect Dis. 2005 Mar 1;40(5):643-54. (PMID: 15714408)
Clin Infect Dis. 2010 Mar 1;50(5):625-63. (PMID: 20175247)
Am J Infect Control. 2014 Jun;42(6):653-8. (PMID: 24713596)
معلومات مُعتمدة: UL1 TR000124 United States TR NCATS NIH HHS; UL1TR000124 United States TR NCATS NIH HHS
المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20151127 Date Completed: 20161213 Latest Revision: 20220311
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC5089900
DOI: 10.1017/ice.2015.281
PMID: 26607408
قاعدة البيانات: MEDLINE
الوصف
تدمد:1559-6834
DOI:10.1017/ice.2015.281