Abstract:
OBJECTIVE:To assess the safety, sustainability, and effectiveness of a laboratory intervention to reduce processing of midstream urine (MSU) cultures. DESIGN:Prospective observational cohort. SETTING:Medical and surgical inpatients in a tertiary-care hospital. PARTICIPANTS:The study included 1,678 adult inpatients with an order for MSU culture. METHODS:From 2013 to 2019, ordered MSU cultures were not processed unless the laboratory was called. Patients were interviewed on days 0 and 4; from 2017 to 2019, day-30 follow-up was added. Primary outcome was serious adverse events due to not processing MSU cultures. Secondary outcomes were nonserious adverse events due to not processing MSU cultures, rates of MSU cultures submitted, proportion of MSU cultures processed, proportion of patients prescribed urinary tract infection (UTI)-directed antibiotics, and laboratory workload. RESULTS:Among 912 and 459 patients followed to days 4 and 30, respectively, no serious adverse events attributable to not processing MSU cultures were identified. However, 6 patients (0.66%) had prolonged urinary symptoms potentially associated with not processing MSU cultures. We estimated that 4 patients missed having empiric antibiotics stopped in response to negative MSU cultures, and 99 antibiotic courses for asymptomatic bacteriuria (ASB) and 8 antibiotic-associated adverse events were avoided. The rate of submitted MSU samples and proportion of patients receiving empiric UTI-directed antibiotics did not change. The proportion of MSU cultures processed declined from 59% to 49% (P < .0001), and total laboratory workload was reduced by 185 hours. CONCLUSIONS:De-adopting the processing of MSU cultures from medical and surgical inpatient units is safe and sustainable, and it reduces antibiotic prescriptions for ASB at a cost of prolonged urinary symptoms in a small proportion of patients.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Mozafarihashjin M,Leis JA,Maze Dit Mieusement L,McCreight L,Poutanen S,Shrivastava A,So J,Soong C,van Horne L,Wong L,McGeer Adoi
10.1017/ice.2020.385subject
Has Abstractpub_date
2021-01-01 00:00:00pages
43-50issue
1eissn
0899-823Xissn
1559-6834pii
S0899823X20003852journal_volume
42pub_type
杂志文章abstract::The effectiveness and efficiency of 17 housekeepers in terminal cleaning 292 hospital rooms was evaluated through adenosine triphosphate detection. A subgroup of housekeepers was identified who were significantly more effective and efficient than their coworkers. These optimum outliers may be used in performance impro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676431
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Better understand the incidence, risk factors, and outcomes of peripheral venous catheter (PVC)-related Staphylococcus aureus bacteremia. DESIGN:Retrospective study of PVC-related S. aureus bacteremias in adult patients from July 2005 through March 2008. A point-prevalence survey was performed January 9, 200...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/660099
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of, and risk factors for, infections associated with intra-arterial catheters used for cancer chemotherapy. METHODS:Between September 1992 and September 1995, we conducted a surveillance study of all 807 intra-arterial catheters placed for chemotherapy at our center. The insertion ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647890
更新日期:1998-09-01 00:00:00
abstract::During the last quarter century, numerous reports have indicated that antimicrobial resistance commonly is encountered in long-term-care facilities (LTCFs). Gram-negative uropathogens resistant to penicillin, cephalosporin, aminoglycoside, or fluoroquinolone antibiotics and methicillin-resistant Staphylococcus aureus ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647257
更新日期:1996-02-01 00:00:00
abstract::Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%). Most CRE...
journal_title:Infection control and hospital epidemiology
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doi:10.1017/ice.2018.236
更新日期:2018-12-01 00:00:00
abstract::We employed a questionnaire to survey 334 registered nurses regarding their knowledge, perceptions and vaccine acceptance for Hepatitis B virus (HBV) infections. The study population was those persons working in areas considered at high-risk for contracting HBV. The nurses were asked to provide information regarding b...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646135
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:To study the relationship between serum high-density lipoprotein cholesterol (HDL-C), total serum cholesterol, and nosocomial infection in patients undergoing general surgery. DESIGN:Prospective cohort study, with an extended follow-up to 1 month after hospital discharge. SETTING:The general surgery service...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647494
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:Multidrug-resistant Enterobacteriaceae pose a serious infection control challenge and have emerged as a public health threat. We examined national trends in the proportion of Klebsiella pneumoniae isolates resistant to carbapenems (CRKP) and third-generation cephalosporins (G3CRKP). DESIGN AND SETTING:Retros...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/669523
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:The quality of environmental hygiene in hospitals is under increasing scrutiny from both healthcare providers and consumers because the prevalence of serious infections due to multidrug-resistant pathogens has reached alarming levels. On the basis of the results from a small number of hospitals, we undertook ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/524329
更新日期:2008-01-01 00:00:00
abstract::To ascertain the microbiology of skin abscesses, emergency department records were reviewed to identify patients with debrided skin abscesses. Methicillin-resistant Staphylococcus aureus was isolated from 255 (67.6%) of 377 culture samples from episodes in the adult cohort and from 145 (79.7%) of 182 culture samples f...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/516799
更新日期:2007-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503335
更新日期:2006-05-01 00:00:00
abstract::We assessed the rate of recovery of fluoroquinolone-resistant and fluoroquinolone-susceptible Escherichia coli isolates from culture of frozen perirectal swab samples compared with the results for culture of the same specimen before freezing. Recovery rates for these 2 classes of E. coli were 91% and 83%, respectively...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/529590
更新日期:2008-04-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2017-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.212
更新日期:2015-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/528815
更新日期:2008-03-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
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更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To describe factors associated with a rectal swab or stool sample positive for norovirus, rotavirus, or adenovirus. DESIGN:Retrospective study. SETTING:Charleston Area Medical Center, a regional academic medical center in Charleston, West Virginia. METHODS:Rectal swab or stool samples were obtained from pa...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/654004
更新日期:2010-08-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671274
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To determine the appropriateness of antibiotic prophylaxis regimens for major surgery in Korea. DESIGN:Retrospective study using a written survey for each patient who underwent arthroplasty, colon surgery, or hysterectomy. SETTING:Six tertiary hospitals in Seoul and Gyeonggi Province. PATIENTS:From each ho...
journal_title:Infection control and hospital epidemiology
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doi:10.1086/519180
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abstract:OBJECTIVE:To describe the epidemiology and spread of methicillin-resistant Staphylococcus aureus (MRSA) in three tertiary-care centers in Ottawa, Ontario, Canada, where MRSA is encountered infrequently. DESIGN:Retrospective review over a 6-year period, from January 1, 1990, through December 31, 1995. SETTING:Three te...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647838
更新日期:1998-06-01 00:00:00
abstract::Quality assurance is rapidly encroaching on the fields of epidemiology and infection control. If we are to lead this most recent revolution in medical care, we must ensure that our approach is structured, that we reassess our goals and methods regularly and that we achieve the maximal benefit from the resources we con...
journal_title:Infection control and hospital epidemiology
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doi:10.1086/646164
更新日期:1990-05-01 00:00:00
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更新日期:2004-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
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journal_title:Infection control and hospital epidemiology
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更新日期:2010-11-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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更新日期:2018-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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更新日期:2019-03-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/646867
更新日期:1994-02-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501744
更新日期:2000-03-01 00:00:00