Kimberly C Claeys1, Natalia Blanco2, Daniel J Morgan2, Surbhi Leekha2, Kaede V Sullivan3. 1. Infectious Diseases, Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, 20 N. Pine Street, Baltimore, MD, 21201, USA. 2. Department of Epidemiology and Public Health, University of Maryland School of Medicine, 685 W. Baltimore Street, Baltimore, MD, 21201, USA. 3. Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University, 3500 N. Broad St, Philadelphia, PA, 19140, USA. kaede.ota@tuhs.temple.edu.
Abstract
PURPOSE OF REVIEW: Urinary 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 FINDINGS: Challenges 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 interventions include education and feedback, indication requirements when ordering cultures, and use of reflex culture policies that limit urine cultures. Antimicrobial and diagnostic stewardship interventions can work synergistically to decrease ordering of urine cultures without clear indication and prevent excessive antimicrobial administration in patients without clearly defined UTI.
PURPOSE OF REVIEW: Urinary 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 FINDINGS: Challenges 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 interventions include education and feedback, indication requirements when ordering cultures, and use of reflex culture policies that limit urine cultures. Antimicrobial and diagnostic stewardship interventions can work synergistically to decrease ordering of urine cultures without clear indication and prevent excessive antimicrobial administration in patients without clearly defined UTI.
Authors: Chelsea S Lynch; Andrea Appleby-Sigler; Jacqueline T Bork; Rohini Davé; Kathy Agnes; Molly Sanikop; Doris Heath; Arlene F Clark; Kimberly Claeys; Min Zhan; Daniel J Morgan Journal: Antimicrob Resist Infect Control Date: 2020-06-29 Impact factor: 4.887
Authors: Kimberly C Claeys; Min Zhan; Lisa Pineles; Alison Lydecker; Gosia Clore; Michihiko Goto; Surbhi Leekha; Darren Linkin; Charlesnika T Evans; Barbara W Trautner; Matthew B Goetz; Jonathan D Baghdadi; Eli N Perencevich; Daniel J Morgan Journal: Infect Control Hosp Epidemiol Date: 2020-08-25 Impact factor: 3.254