Preoperative Urine Cultures at a Veterans Affairs Medical Center

Drekonja, Dimitri; Zarmbinski, Breanna; Johnson, James R.

doi:10.1001/2013.jamainternmed.834

Cited by 30 publications

(23 citation statements)

References 6 publications

(1 reference statement)

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“…Drekonja et al . [ 57 ], retrospectively evaluated the use of antimicrobial treatment of ASB in 1688 patients undergoing non-urologic procedures at a single center; 25% of the patients were screened by urine culture for ASB. The authors found no difference in surgical site infection rates (20% vs .…”

Section: Antimicrobial Stewardship Opportunitiesmentioning

confidence: 99%

Antimicrobial Stewardship and Urinary Tract Infections

2014

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Urinary tract infections are the most common bacterial infections encountered in ambulatory and long-term care settings in the United States. Urine samples are the largest single category of specimens received by most microbiology laboratories and many such cultures are collected from patients who have no or questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed inappropriately in such patients. Antimicrobial use, whether appropriate or inappropriate, is associated with the selection for antimicrobial-resistant organisms colonizing or infecting the urinary tract. Infections caused by antimicrobial-resistant organisms are associated with higher rates of treatment failures, prolonged hospitalizations, increased costs and mortality. Antimicrobial stewardship consists of avoidance of antimicrobials when appropriate and, when antimicrobials are indicated, use of strategies to optimize the selection, dosing, route of administration, duration and timing of antimicrobial therapy to maximize clinical cure while limiting the unintended consequences of antimicrobial use, including toxicity and selection of resistant microorganisms. This article reviews successful antimicrobial stewardship strategies in the diagnosis and treatment of urinary tract infections.

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Section: Antimicrobial Stewardship Opportunitiesmentioning

confidence: 99%

Antimicrobial Stewardship and Urinary Tract Infections

2014

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“…Prior literature has demonstrated that preoperative urine culture testing is common, yet screening for and treatment of asymptomatic bacteriuria does not reduce prosthetic joint infections or other postoperative complications. [25][26][27] This study has several limitations. First, the study used administrative data, and it is unknown whether the urine cultures sent met clinical guidelines for testing.…”

Section: Discussionmentioning

confidence: 96%

Urine Culture on Admission Impacts Antibiotic Use and Length of Stay: A Retrospective Cohort Study

Horstman

Spiegelman

Naik

et al. 2018

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo examine the impact of urine culture testing on day 1 of admission on inpatient antibiotic use and hospital length of stay (LOS).DESIGNWe performed a retrospective cohort study using a national dataset from 2009 to 2014.SETTINGThe study used data from 230 hospitals in the United States.PARTICIPANTSAdmissions for adults 18 years and older were included in this study. Hospitalizations were matched with coarsened exact matching by facility, patient age, gender, Medicare severity-diagnosis related group (MS-DRG), and 3 measures of disease severity.METHODSA multilevel Poisson model and a multilevel linear regression model were used to determine the impact of an admission urine culture on inpatient antibiotic use and LOS.RESULTSMatching produced a cohort of 88,481 patients (n=41,070 with a culture on day 1, n=47,411 without a culture). A urine culture on admission led to an increase in days of inpatient antibiotic use (incidence rate ratio, 1.26; P<.001) and resulted in an additional 36,607 days of inpatient antibiotic treatment. Urine culture on admission resulted in a 2.1% increase in LOS (P=.004). The predicted difference in bed days of care between admissions with and without a urine culture resulted in 6,071 additional bed days of care. The impact of urine culture testing varied by admitting diagnosis.CONCLUSIONSPatients with a urine culture sent on day 1 of hospital admission receive more days of antibiotics and have a longer hospital stay than patients who do not have a urine culture. Targeted interventions may reduce the potential harms associated with low-yield urine cultures on day 1.Infect Control Hosp Epidemiol 2018;39:547-554.

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“…Drekonja ve ark. [20][21][22][23] da yaptıkları bir çalışmada, asemptomatik bakteriürisi olan hastalarda (ortopedik, kardiyotorasik ve vasküler ameliyatlarda) yapılan preoperatif tedavinin çok daha yüksek oranda cerrahi alan infeksiyonuna neden olduğunu göstermiştir.…”

Section: Gereç Ve Yöntemunclassified

Lower Respiratory Tract and Urinary System Colonization in Patients with Cardiovascular Surgery

Tanrikulu¹,

Haspolat²,

Köprülü³

et al. 2020

GKDA Derg

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Kardiyovasküler cerrahide postoperatif infeksiyonların önlenebilmesi preoperatif infeksiyonların tedavisiyle olasıdır. Ancak, klinik yakınması olmayan, tüm laboratuvar bulguları normal alt solunum yolu veya üriner sistem kolonizasyonu olan kültür (+) hastalarda üzerinde düşünce birliğine varılmış rutin klinik protokol yoktur. Çalışmamızda, klinik muayene, laboratuvar bulguları normal olan hastalardan preoperatuvar alınan trakeal/idrar kültürlerinin sonuçlarını ve üreme saptanan kolonize hastalarda bunun kliniğe yansımasını irdeledik. Böylece major risk gruplarını tanımlamayı, olası klinik sonuçları paylaşmayı amaçladık.

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Preoperative Urine Cultures at a Veterans Affairs Medical Center

Cited by 30 publications

References 6 publications

Antimicrobial Stewardship and Urinary Tract Infections

Antimicrobial Stewardship and Urinary Tract Infections

Urine Culture on Admission Impacts Antibiotic Use and Length of Stay: A Retrospective Cohort Study

Lower Respiratory Tract and Urinary System Colonization in Patients with Cardiovascular Surgery

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