Researchers at Mount Sinai Hospital in Toronto, Canada, noticed non-catheterized patients whose lab reports showed positive trace of asymptomatic bacteriuria had very little risk of developing a urinary tract infection, so they modified the way urine culture lab reports for these patients were delivered. Instead of automatically sending lab reports positive for asymptomatic bacteriuria to the physician, the test results were posted in the electronic health record with the following message:
“The majority of positive urine cultures from inpatients without an indwelling urinary catheter represent asymptomatic bacteriuria. If you strongly suspect that your patient has developed a urinary tract infection, please call the microbiology laboratory.”
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The rate of antimicrobial treatment for asymptomatic bacteriuria in non-catheterized patients fell from 48 percent pre-intervention to 12 percent post-intervention. The treatment rate for catheterized patients remained the same, at 41 percent.
Following the intervention, there were no untreated urinary tract infections or cases of sepsis in non-catheterized patients.
Researchers suggest that not reporting urine culture lab tests for non-catheterized inpatients can reduce the unnecessary antimicrobial therapy, and larger studies are needed to confirm the safety of this care model.
More Articles on Antimicrobial Stewardship:
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