Impact of Changes in Urine Culture Ordering Practice on Antimicrobial Utilization in Intensive Care Units at an Academic Medical Center

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Mohamed SargSurbhi Leekha

Abstract

OBJECTIVE To assess antimicrobial utilization before and after a change in urine culture ordering practice in adult intensive care units (ICUs) whereby urine cultures were only performed when pyuria was detected. DESIGN Quasi-experimental study SETTING A 700-bed academic medical center PATIENTS Patients admitted to any adult ICU METHODS Aggregate data for all adult ICUs were obtained for population-level antimicrobial use (days of therapy [DOT]), urine cultures performed, and bacteriuria, all measured per 1,000 patient days before the intervention (January-December 2012) and after the intervention (January-December 2013). These data were compared using interrupted time series negative binomial regression. Randomly selected patient charts from the population of adult ICU patients with orders for urine culture in the presence of indwelling or recently removed urinary catheters were reviewed for demographic, clinical, and antimicrobial use characteristics, and pre- and post-intervention data were compared. RESULTS Statistically significant reductions were observed in aggregate monthly rates of urine cultures performed and bacteriuria detected but not in DOT. At the patient level, compared with the pre-intervention group (n=250), i...Continue Reading

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Citations

Jan 6, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Abigail L CarlsonDavid K Warren
Mar 6, 2019·Current Infectious Disease Reports·Kimberly C ClaeysKaede V Sullivan
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Aug 26, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Kimberly C ClaeysDaniel J Morgan
Apr 30, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Mohamad G FakihValerie M Vaughn
Jul 1, 2020·Antimicrobial Resistance and Infection Control·Chelsea S LynchDaniel J Morgan
Dec 14, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Kaede V SullivanSurbhi Leekha
Nov 23, 2019·Current Infectious Disease Reports·Blaine KenaaSurbhi Leekha
Jul 7, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Corinne N KleinJessina C McGregor

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