Importance of Urinary Tract Infection to Antibiotic Use Among Hospitalized Patients

2009 ◽  
Vol 30 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Tejal Gandhi ◽  
Scott A. Flanders ◽  
Erica Markovitz ◽  
Sanjay Saint ◽  
Daniel R. Kaul
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Broad Spectrum ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Antibiotic Use ◽  
Hospitalized Patients ◽  
Broad Spectrum Antibiotics

Many patients with asymptomatic bacteriuria receive extended courses of broad-spectrum antibiotics. Antibiotic use was analyzed in patients admitted to the hospital with urinary tract infection. Strategies to optimize antibiotic use for such patients are discussed and include implementing a process whereby a urine culture is automatically performed if a urinalysis result suggests infection.

scholarly journals Evaluation of BacterioScan 216Dx in Comparison to Urinalysis as a Screening Tool for Diagnosis of Urinary Tract Infections in Children

2019 ◽  
Vol 57 (9) ◽  
Author(s):  
Ferdaus Hassan ◽  
Heather Bushnell ◽  
Connie Taggart ◽  
Caitlin Gibbs ◽  
Steve Hiraki ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Predictive Value ◽  
Screening Tool ◽  
Urine Culture ◽  
Antibiotic Use ◽  
Urine Samples ◽  
Maldi Tof ◽  
Tract Infections

ABSTRACTUrinalysis (UA) has routinely been used as a screening tool prior to urine culture set up. BacterioScan 216Dx is an FDA-cleared semiautomated system to detect bacterial growth in urine. The aim of this study was to evaluate 216Dx in comparison to UA for diagnosis of urinary tract infection (UTI) in children. Clean-catch, unpreserved urine samples from children aged <18 years were tested by 216Dx, and positive urine samples in media were processed for direct bacterial identification by matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry. Sensitivity and specificity of 216Dx and urinalysis (UA) were determined against urine culture. Of 287 urine samples obtained from children (median age, 108 months), 44.0% and 56.0% were UA positive and negative, respectively, while 216Dx detected 27% and 73% as positive and negative, respectively. Compared to culture, the overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 216Dx versus UA were 92.1% versus 97.3%, 82.7% versus 63.8%, 44.8% versus 29.1%, and 98.6% versus 99.3%, respectively. Among 216Dx true-positive (TP) samples (n= 35), 77.0% were successfully identified directly from broth by MALDI-TOF. Among urine samples that were identified as contaminated by culture (n= 127; 44%), the 216Dx detected 93 (73.0%) as negative while UA detected 69 (54.0%) as negative. Although the sensitivities of 216Dx and UA are comparable, the specificity of 216Dx was higher than that of UA. The 216Dx can be used as an alternative/adjunct screening tool to UA to rule out urinary tract infection (UTI) in children. Compared to culture, the faster turnaround time (3 hours) of 216Dx has the potential to reduce unnecessary antibiotic use and improve patient management.

scholarly journals Assessment of Rapid Dipstick Test for Diagnosis of Urinary Tract Infection in Asymptomatic Pregnant Female

2016 ◽  
Vol 5 (1) ◽  
pp. 965
Author(s):  
Ashish Khanna ◽  
Menka Khanna
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Gold Standard ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Culture Method ◽  
Premature Delivery ◽  
Dipstick Test ◽  
In Pregnancy

<strong>Background:</strong>Bacteriuria during pregnancy has been known to cause many complications like low birth weight and premature delivery.<p><strong>Objective</strong>: This study was done to evaluate the diagnostic accuracy of rapid dipstick test to predict urinary tract infection in pregnancy against the gold standard urine culture.</p><p><strong>Material&amp;Methods:</strong> A total of 200 mid stream urine samples were collected from asymptomatic pregnant females. These specimens were cultured in blood agar and MacConkey's agar by using the standard loop technique and incubated aerobically at 37°C overnight. The criterion for clinically significant bacteriuria was either a pure or predominant culture of &gt;10<sup>5</sup> colony forming units (CFU)/ml. All the specimens were also examined microscopically for pyuria and bacteriuria.</p><p><strong>Results:</strong> The prevalence of asymptomatic bacteriuria in pregnancy was 15 % in our study. The sensitivity and the specificity for leucocyte esterase were 85.7% and 74.4% and for nitrites, they were 64.2% and 72%.</p><p><strong>Conclusion:</strong> The study revealed that use of either leukocyte esterase or nitrite for screening of asymptomatic bacteriuria in pregnancy was associated with many false positive and negative results when compared with the gold standard urine culture method. By using their combination maximum negative predictive value of .98 was achieved.</p>

Infection and immunity

2018 ◽  
Author(s):  
Lesley K. Bowker ◽  
James D. Price ◽  
Ku Shah ◽  
Sarah C. Smith
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Older Patients ◽  
Recurrent Urinary Tract Infection ◽  
Asymptomatic Bacteriuria ◽  
Antibiotic Use ◽  
Varicella Zoster ◽  
Infection Treatment ◽  
Varicella Zoster Infection

This chapter provides information on the ageing immune system, an overview of infection in older people, antibiotic use in older patients, meticillin-resistant Staphylococcus aureus (MRSA), disease caused by MRSA, Clostridium difficile-associated diarrhoea, near-patient urine tests, asymptomatic bacteriuria, urinary tract infection, treatment of urinary tract infection, recurrent urinary tract infection, and varicella-zoster infection.

scholarly journals Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Clinic at the Akuapem North District of the Eastern Region of Ghana

2021 ◽  
Vol 9 (3) ◽  
pp. 24-34
Author(s):  
Aquel Rene Lopez
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Urine Culture ◽  
Multiple Pregnancy ◽  
Asymptomatic Bacteriuria ◽  
Health Care Facilities ◽  
Bivariate Analysis ◽  
Eastern Region

Asymptomatic bacteriuria is a condition in which urine culture reveals the presence of more than 105 bacteria per millilitre but without the patient showing signs and symptoms of urinary tract infection (UTI). In many of the health care facilities in Ghana, routine screening for ASB among pregnant woman is not done despite overwhelming evidence clearly demonstrating its benefits in preventing UTI and the associated adverse pregnancy outcome. It is a common problem in pregnant women, which usually results in maternal and fetal complications. The majority of the participant were in the age range of 25 years to 34 years, and all the participants had basic education. Out of the 134 sterile urine samples cultured, 11 of the participants had bacteria isolated from their urine, given a prevalence of 8.2%. Escherichia coli were 63.6%, Nitrofurantoin was 81.8% sensitive to all bacteria isolated, and Cotrimoxazole was the most resistant antibiotic with 72.7%. Factors associated with ASB in Akuapem North District were toilet facility, multiple pregnancy, and any medical condition, which were statistically significant at the bivariate analysis level. After adjusting these factors with the multiple logistics regression, only multiple pregnancy was statistically significant. The study revealed an 8.2% prevalence of ASB among pregnant women with E. coli, the predominate bacteria with 63.6%. Nitrofurantoin, 81.8% sensitive, and Cotrimoxazole was the most resistant antibiotics with 72.7%. Multiple pregnancy was associated with Asymptomatic bacteriuria among pregnant women at Akuapem North District. Keywords: Asymptomatic Bacteriuria, Pregnant Women, Urine Culture, Urinary Tract Infection.

scholarly journals Positive Urine Cultures: A Major Cause of Inappropriate Antimicrobial Use in Hospitals?

2009 ◽  
Vol 20 (4) ◽  
pp. 107-111 ◽  
Author(s):  
Samuel A Silver ◽  
Laura Baillie ◽  
Andrew E Simor
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Records ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Use ◽  
Symptomatic Urinary Tract Infection ◽  
Positive Urine ◽  
Urine Specimens

INTRODUCTION: Urine specimens are among the most common samples submitted for culture to microbiology laboratories. The objectives of the present study were to describe the indications for obtaining urine cultures in a cohort of hospitalized patients, and to determine the appropriateness of antimicrobial therapy in response to urine culture results.METHODS: The study was performed at a teaching hospital with an adjoining long-term care facility from June 1 to July 31, 2006. The medical records of nonpregnant adult patients with and without bacteriuria were reviewed. A symptomatic urinary tract infection was defined as the presence of bacteriuria in a patient with fever or urinary symptoms; asymptomatic bacteriuria was defined as bacteriuria without urinary symptoms and no infection evident at another site.RESULTS: Medical records of 335 eligible patients (64% male; mean age 68 years) were reviewed, including all 137 with bacteriuria, and 198 with negative urine cultures. In total, 51% of the urine specimens were obtained from an indwelling urinary catheter, and 28% were voided urine samples. Confusion (57%) and fever (36%) were the most common indications noted for obtaining the urine cultures. Only 34 patients (25% of those with positive urine cultures) met the criteria for a symptomatic urinary tract infection; 67 (49%) had asymptomatic bacteriuria and 36 (26%) had infection at a nonurinary site. Of those with asymptomatic bacteriuria, 64% received antimicrobial therapy for a total of 347 days. Confused patients with asymptomatic bacteriuria were more likely to be treated than were bacteriuric patients without altered mental status (OR 1.8, 95% CI 1.2 to 4.1; P=0.03).CONCLUSIONS: Urine cultures are frequently obtained from hospitalizedpatients,evenintheabsenceofurinarysymptoms.Asymptomatic bacteriuria is often treated in these patients, and accounts for a substantial burden of inappropriate antimicrobial use in hospitals. Effective strategies to improve urine culture ordering and antimicrobial utilization in hospitals need to be implemented.

scholarly journals Effect of asymptomatic bacteriuria on pregnancy outcome: a review

2021 ◽  
Vol 10 (4) ◽  
pp. 1753
Author(s):  
Nalam Neelima ◽  
Ushadevi Gopalan
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Early Detection ◽  
Gestational Age ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Upper Urinary Tract ◽  
Culture And Sensitivity ◽  
In Pregnancy

Asymptomatic bacteriuria is more common in pregnancy and if left untreated it may progress to upper urinary tract infection. Early detection and treatment of asymptomatic bacteriuria prevents further progression of the infection and thereby preventing undesirable complications to the mother and fetus. It is advisable to do Urine culture and sensitivity in all antenatal women irrespective of the gestational age and symptoms.

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