Cargando…
Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing
OBJECTIVES: To inform point-of-care test (POCT) development, we quantified the primary care demand for laboratory microbiology tests by describing their frequencies overall, frequencies of positives, most common organisms identified, temporal trends in testing and patterns of cotesting on the same a...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611454/ https://www.ncbi.nlm.nih.gov/pubmed/34815274 http://dx.doi.org/10.1136/bmjopen-2020-048527 |
_version_ | 1784603299756900352 |
---|---|
author | Ordóñez-Mena, JM Fanshawe, Thomas R Foster, Dona Andersson, Monique Oakley, Sarah Stoesser, Nicole Walker, A. Sarah Hayward, Gail |
author_facet | Ordóñez-Mena, JM Fanshawe, Thomas R Foster, Dona Andersson, Monique Oakley, Sarah Stoesser, Nicole Walker, A. Sarah Hayward, Gail |
author_sort | Ordóñez-Mena, JM |
collection | PubMed |
description | OBJECTIVES: To inform point-of-care test (POCT) development, we quantified the primary care demand for laboratory microbiology tests by describing their frequencies overall, frequencies of positives, most common organisms identified, temporal trends in testing and patterns of cotesting on the same and subsequent dates. DESIGN: Retrospective cohort study. SETTING: Primary care practices in Oxfordshire. PARTICIPANTS: 393 905 patients (65% female; 49% aged 18–49). PRIMARY AND SECONDARY OUTCOME MEASURES: The frequencies of all microbiology tests requested between 2008 and 2018 were quantified. Patterns of cotesting were investigated with heat maps. All analyses were done overall, by sex and age categories. RESULTS: 1 596 752 microbiology tests were requested. Urine culture±microscopy was the most common of all tests (n=673 612, 42%), was mainly requested without other tests and was the most common test requested in follow-up within 7 and 14 days. Of all urine cultures, 180 047 (27%) were positive and 172 651 (26%) showed mixed growth, and Escherichia coli was the most prevalent organism (132 277, 73% of positive urine cultures). Antenatal urine cultures and blood tests in pregnancy (hepatitis B, HIV and syphilis) formed a common test combination, consistent with their use in antenatal screening. CONCLUSIONS: The greatest burden of microbiology testing in primary care is attributable to urine culture ± microscopy; genital and routine antenatal urine and blood testing are also significant contributors. Further research should focus on the feasibility and impact of POCTs for these specimen types. |
format | Online Article Text |
id | pubmed-8611454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-86114542021-12-10 Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing Ordóñez-Mena, JM Fanshawe, Thomas R Foster, Dona Andersson, Monique Oakley, Sarah Stoesser, Nicole Walker, A. Sarah Hayward, Gail BMJ Open Diagnostics OBJECTIVES: To inform point-of-care test (POCT) development, we quantified the primary care demand for laboratory microbiology tests by describing their frequencies overall, frequencies of positives, most common organisms identified, temporal trends in testing and patterns of cotesting on the same and subsequent dates. DESIGN: Retrospective cohort study. SETTING: Primary care practices in Oxfordshire. PARTICIPANTS: 393 905 patients (65% female; 49% aged 18–49). PRIMARY AND SECONDARY OUTCOME MEASURES: The frequencies of all microbiology tests requested between 2008 and 2018 were quantified. Patterns of cotesting were investigated with heat maps. All analyses were done overall, by sex and age categories. RESULTS: 1 596 752 microbiology tests were requested. Urine culture±microscopy was the most common of all tests (n=673 612, 42%), was mainly requested without other tests and was the most common test requested in follow-up within 7 and 14 days. Of all urine cultures, 180 047 (27%) were positive and 172 651 (26%) showed mixed growth, and Escherichia coli was the most prevalent organism (132 277, 73% of positive urine cultures). Antenatal urine cultures and blood tests in pregnancy (hepatitis B, HIV and syphilis) formed a common test combination, consistent with their use in antenatal screening. CONCLUSIONS: The greatest burden of microbiology testing in primary care is attributable to urine culture ± microscopy; genital and routine antenatal urine and blood testing are also significant contributors. Further research should focus on the feasibility and impact of POCTs for these specimen types. BMJ Publishing Group 2021-11-23 /pmc/articles/PMC8611454/ /pubmed/34815274 http://dx.doi.org/10.1136/bmjopen-2020-048527 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Diagnostics Ordóñez-Mena, JM Fanshawe, Thomas R Foster, Dona Andersson, Monique Oakley, Sarah Stoesser, Nicole Walker, A. Sarah Hayward, Gail Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
title | Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
title_full | Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
title_fullStr | Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
title_full_unstemmed | Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
title_short | Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
title_sort | frequencies and patterns of microbiology test requests from primary care in oxfordshire, uk, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing |
topic | Diagnostics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611454/ https://www.ncbi.nlm.nih.gov/pubmed/34815274 http://dx.doi.org/10.1136/bmjopen-2020-048527 |
work_keys_str_mv | AT ordonezmenajm frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT fanshawethomasr frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT fosterdona frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT anderssonmonique frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT oakleysarah frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT stoessernicole frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT walkerasarah frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting AT haywardgail frequenciesandpatternsofmicrobiologytestrequestsfromprimarycareinoxfordshireuk20082018aretrospectivecohortstudyofelectronichealthrecordstoinformpointofcaretesting |