No need for a urine culture in elderly hospitalized patients with a negative dipstick test result

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
Zvi ShimoniPaul Froom

Abstract

To determine the clinical utility/disutility of canceling urine cultures in elderly patients with a negative dipstick. The cohort included consecutive patients aged ≥ 65 years hospitalized in internal medicine departments with an admission urinalysis and urine culture (January 1, 2014 to December 31, 2016). We calculated the sensitivity of the dipstick (either a trace leukocyte esterase or a positive nitrite test result) to detect patients with bacteriuria, and the decrease in urine cultures resulting from cancelation in patients with a negative dipstick. We reviewed the charts of patients with a positive culture but negative dipstick to determine if they received appropriate antibiotic therapy and if the culture results had clinical utility, defined as changes in antibiotic therapy made according to culture results in a patient who did not respond to initial antibiotic therapy. The sensitivity of the dipstick for bacteriuria was 90.8% (95% CI, 89.6-92.0%). Of the 210 patients with a positive culture but negative dipstick, 132 (62.9%) had a diagnosis clearly outside the urinary tract. Thirty-five patients (16.7%) received inappropriate differential antibiotic therapy. Urine cultures did not have clinical utility and canceling u...Continue Reading

References

Jun 1, 1995·Journal of the American Geriatrics Society·M MonaneJ Avorn
Apr 1, 1996·Journal of the American Geriatrics Society·J G OuslanderS Fingold
Feb 26, 2000·American Journal of Infection Control·S Saint
Apr 20, 2001·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·L E Nicolle, UNKNOWN SHEA Long-Term-Care-Committee
Nov 1, 2002·The Lancet Infectious Diseases·Gaëtan Gavazzi, Karl-Heinz Krause
Jun 4, 2004·BMC Urology·Walter L J M DevilléLex M Bouter
Jul 5, 2007·Journal of the American Geriatrics Society·Manisha Juthani-MehtaVincent Quagliarello
Nov 18, 2008·European Journal of Internal Medicine·Z ShimoniP Froom
Dec 5, 2008·Journal of the American Geriatrics Society·Henry J Woodford, James George
Dec 17, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kevin P HighThomas T Yoshikawa
Mar 16, 2011·Archives of Internal Medicine·Porpon RotjanapanKali S Thomas
Dec 7, 2011·Nature Reviews. Urology·Barbara W Trautner
Jan 11, 2012·Archives of Internal Medicine·Eugene LinBarbara W Trautner
Sep 11, 2013·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jerome A LeisAllison McGeer
Oct 22, 2013·The Journal of Emergency Medicine·Christopher W JonesPeter H Gilligan
Feb 4, 2014·Infectious Disease Clinics of North America·Theresa Anne Rowe, Manisha Juthani-Mehta
Feb 27, 2014·JAMA : the Journal of the American Medical Association·Lona Mody, Manisha Juthani-Mehta
Dec 3, 2014·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Takanori AsakuraSatoshi Kodera
Feb 1, 2015·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·O J DyarC Pulcini
Mar 19, 2015·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Sarah HartleyScott A Flanders
Apr 16, 2015·The New England Journal of Medicine·Daniel A Leffler, J Thomas Lamont
Aug 19, 2015·JAMA Internal Medicine·Penny YinJerome A Leis
Oct 17, 2015·The American Journal of Emergency Medicine·Julian T HertzWesley H Self
Oct 18, 2015·The Urologic Clinics of North America·Keri DetweilerSophie G Fletcher
Nov 27, 2015·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jonathan D GreinLoren G Miller
May 18, 2016·BMC Infectious Diseases·Bijan MoshaverPaul Groeneveld
Jan 13, 2017·Infectious Diseases·Foppie J de BoerPaul H P Groeneveld
Jan 21, 2017·The American Journal of the Medical Sciences·Zvi ShimoniPaul Froom
Jan 26, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Molly J HorstmanBarbara W Trautner

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