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Overtreatment of Asymptomatic Bacteriuria: Identifying Targets for Improvement

Published online by Cambridge University Press:  05 January 2015

Sarah Hartley ,
Staci Valley ,
Latoya Kuhn ,
Laraine L. Washer ,
Tejal Gandhi ,
Jennifer Meddings ,
Carol Chenoweth ,
Anurag N. Malani ,
Sanjay Saint  and
Arjun Srinivasan
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Sarah Hartley*
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Staci Valley
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Latoya Kuhn
Affiliation:
Patient Safety Enhancement Program and Hospital Outcomes Program of Excellence of the Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan
Laraine L. Washer
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan Department of Infection Control and Epidemiology, University of Michigan, Ann Arbor, Michigan
Tejal Gandhi
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Jennifer Meddings
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Carol Chenoweth
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Anurag N. Malani
Affiliation:
St. Joseph Mercy Hospital, Ann Arbor, Michigan
Sanjay Saint
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan Patient Safety Enhancement Program and Hospital Outcomes Program of Excellence of the Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan
Arjun Srinivasan
Affiliation:
Healthcare Associated Infection Prevention Programs in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention, Atlanta, Georgia.
Scott A. Flanders
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
*
Address correspondence to Sarah E. Hartley, MD, Clinical Assistant Professor, University of Michigan Health System, 1500 E Medical Center Drive, SPC 5736, Ann Arbor, Michigan 48109 (hartsara@med.umich.edu).
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Abstract

Treatment of asymptomatic bacteriuria contributes to antimicrobial overuse in hospitalized patients. Indications for urine culture, treatment, and targets for improvement were evaluated in 153 patients. Drivers of antimicrobial overuse included fever with an alternative source, altered mental status, and leukocytosis, which led 435 excess days of antimicrobial therapy.

Infect Control Hosp Epidemiol 2014;00(0): 1–4

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 4 , April 2015 , pp. 470 - 473
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. Get Smart for Healthcare website. www.cdc.gov/getsmart/healthcare/index.html. Published 2014. Accessed May 11, 2014.Google Scholar
2. Gandhi, T, Flanders, SA, Markovitz, E, et al. Importance of urinary tract infection to antibiotic use among hospitalized patients. Infect Control Hosp Epidemiol 2009;30:193–195.CrossRefGoogle ScholarPubMed
3. Hartley, S, Kuhn, L, Washer, L, et al. Inappropriate testing for urinary tract infection in hospialized patients: an opportunity for improvement. Infect Control Hosp Epidemiol 2013;34:1204–1207.CrossRefGoogle Scholar
4. Nicolle, LE, Bradley, S, Colgan, R, et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643–654.CrossRefGoogle Scholar
5. Gupta, K, Hooton, TM, Naber, KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 2011;52:e103–e120.CrossRefGoogle Scholar
6. Hooton, TM, Bradley, SF, Cardenas, DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis 2010;50:625–663.CrossRefGoogle ScholarPubMed
7. [No authors listed.] The prevention and management of urinary tract infections among patients with spinal cord injuries. National Institute on Disability and Rehabilitation Research Consensus Statement. J Am Paraplegia Soc 1992;15:194–204.Google Scholar
8. Loeb, M, Bentley, DW, Bradley, S, et al. Development of minimum criteria for the intiation of antibiotics in residents of long-term-care facilities: results of a consensus conference. Infect Control Hosp Epidemiol 2001;22:120–124.CrossRefGoogle Scholar
9. Chapter 7. Catheter-Associated Urinary Tract Infection (CA-UTI) Event. In: the National Healthcare Safety Network (NHSN) Manual, edited by the CDC Division of Healthcare Quality Promotion Atlanta, GA. 2009. http://www.cdc/gov/nhsn/PDFs/pscManual_current.pdf. Published 2009. Accessed July 27, 2014.Google Scholar
10. Inouye, SK. The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients. Am J Med 1994;97:278–288.CrossRefGoogle ScholarPubMed
11. Leis, JA, Rebick, GW, Daneman, N, et al. Reducing antimicrobial therapy for asymptomatic bacteriuria among noncatheterized inpatients: a proof-of-concept study. Clin Infect Dis 2014;58:980–983.CrossRefGoogle ScholarPubMed
12. Trautner, BW, Kelly, PA, Peterson, N, et al. A hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of catheter-associated asymptomatic bacteriuria. Implement Sci 2011;6:41.CrossRefGoogle ScholarPubMed