Cargando…

Urine cultures in a long-term care facility (LTCF): time for improvement

BACKGROUND: Urinary tract infections (UTIs) are the most prevalent infections in long-term care facilities (LTCFs). Numerous studies have described the problem of inadequate UTI diagnosis and treatment. We assessed the role of urine cultures in the diagnosis and treatment of UTIs in a LTCF. METHODS:...

Descripción completa

Detalles Bibliográficos
Autores principales: Haaijman, J., Stobberingh, E. E., van Buul, L. W., Hertogh, C. M. P. M., Horninge, H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149184/
https://www.ncbi.nlm.nih.gov/pubmed/30236062
http://dx.doi.org/10.1186/s12877-018-0909-x
_version_ 1783356820692140032
author Haaijman, J.
Stobberingh, E. E.
van Buul, L. W.
Hertogh, C. M. P. M.
Horninge, H.
author_facet Haaijman, J.
Stobberingh, E. E.
van Buul, L. W.
Hertogh, C. M. P. M.
Horninge, H.
author_sort Haaijman, J.
collection PubMed
description BACKGROUND: Urinary tract infections (UTIs) are the most prevalent infections in long-term care facilities (LTCFs). Numerous studies have described the problem of inadequate UTI diagnosis and treatment. We assessed the role of urine cultures in the diagnosis and treatment of UTIs in a LTCF. METHODS: In a 370-bed non-academic LTCF a retrospective assessment of antibiotic (AB) prescriptions for UTIs and urine cultures was performed from July 2014 to January 2016. The reasons why physicians, including 11 nursing home physicians and 2 junior doctors, ordered urine cultures were recorded using questionnaires. RESULTS: During the study period, 378 residents were prescribed 1672 AB courses; 803 were for UTIs. One hundred and fifty-five urine cultures were obtained from 135 residents; 66 of these cultures were performed on the same day as ABs were prescribed (8% of all prescriptions for UTI), while 89 were not. There was a discrepancy between the actions that seemed logical based on the culture results and the actions that were actually taken in 75% of the cases. In these cases, initial AB treatment was not adjusted when the isolated microorganism was resistant to the AB prescribed, the urine culture was positive and no ABs had previously been administered, or ABs were prescribed and no microorganism was isolated. The most frequent reason for ordering a urine culture was to confirm the diagnosis of a UTI. CONCLUSION: In the majority of patients, AB therapy was not adjusted when the urine culture results suggested it may be appropriate. The physicians were erroneously convinced that UTIs could be diagnosed by a positive urine culture. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0909-x) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-6149184
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-61491842018-09-26 Urine cultures in a long-term care facility (LTCF): time for improvement Haaijman, J. Stobberingh, E. E. van Buul, L. W. Hertogh, C. M. P. M. Horninge, H. BMC Geriatr Research Article BACKGROUND: Urinary tract infections (UTIs) are the most prevalent infections in long-term care facilities (LTCFs). Numerous studies have described the problem of inadequate UTI diagnosis and treatment. We assessed the role of urine cultures in the diagnosis and treatment of UTIs in a LTCF. METHODS: In a 370-bed non-academic LTCF a retrospective assessment of antibiotic (AB) prescriptions for UTIs and urine cultures was performed from July 2014 to January 2016. The reasons why physicians, including 11 nursing home physicians and 2 junior doctors, ordered urine cultures were recorded using questionnaires. RESULTS: During the study period, 378 residents were prescribed 1672 AB courses; 803 were for UTIs. One hundred and fifty-five urine cultures were obtained from 135 residents; 66 of these cultures were performed on the same day as ABs were prescribed (8% of all prescriptions for UTI), while 89 were not. There was a discrepancy between the actions that seemed logical based on the culture results and the actions that were actually taken in 75% of the cases. In these cases, initial AB treatment was not adjusted when the isolated microorganism was resistant to the AB prescribed, the urine culture was positive and no ABs had previously been administered, or ABs were prescribed and no microorganism was isolated. The most frequent reason for ordering a urine culture was to confirm the diagnosis of a UTI. CONCLUSION: In the majority of patients, AB therapy was not adjusted when the urine culture results suggested it may be appropriate. The physicians were erroneously convinced that UTIs could be diagnosed by a positive urine culture. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0909-x) contains supplementary material, which is available to authorized users. BioMed Central 2018-09-20 /pmc/articles/PMC6149184/ /pubmed/30236062 http://dx.doi.org/10.1186/s12877-018-0909-x Text en © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Haaijman, J.
Stobberingh, E. E.
van Buul, L. W.
Hertogh, C. M. P. M.
Horninge, H.
Urine cultures in a long-term care facility (LTCF): time for improvement
title Urine cultures in a long-term care facility (LTCF): time for improvement
title_full Urine cultures in a long-term care facility (LTCF): time for improvement
title_fullStr Urine cultures in a long-term care facility (LTCF): time for improvement
title_full_unstemmed Urine cultures in a long-term care facility (LTCF): time for improvement
title_short Urine cultures in a long-term care facility (LTCF): time for improvement
title_sort urine cultures in a long-term care facility (ltcf): time for improvement
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149184/
https://www.ncbi.nlm.nih.gov/pubmed/30236062
http://dx.doi.org/10.1186/s12877-018-0909-x
work_keys_str_mv AT haaijmanj urineculturesinalongtermcarefacilityltcftimeforimprovement
AT stobberinghee urineculturesinalongtermcarefacilityltcftimeforimprovement
AT vanbuullw urineculturesinalongtermcarefacilityltcftimeforimprovement
AT hertoghcmpm urineculturesinalongtermcarefacilityltcftimeforimprovement
AT horningeh urineculturesinalongtermcarefacilityltcftimeforimprovement