Urine Culture Stewardship – Avoiding Screening and Treatment of Asymptomatic Bacteriuria

Posted on Dec 2, 2020 in Announcements | 0 comments

Urine Culture Stewardship – Avoiding Screening and Treatment of Asymptomatic Bacteriuria 

Urine culture stewardship aims to ensure that urine cultures are only performed when appropriate indications are present to prevent unnecessary collection and treatment of asymptomatic bacteriuria.

The IDSA (Infectious Diseases Society of America) recommends against screening and treating asymptomatic bacteriuria in most cases, with the exception of pregnant women and those undergoing urological procedures associated with mucosal trauma. In elderly patients with cognitive impairment presenting with confusion without systemic signs of infection, assessment for other causes and careful observation rather than antimicrobial therapy is strongly recommended. There is a lack of evidence that treatment is beneficial in this population, with greater risk of adverse outcomes from antimicrobial therapy, including increased resistance, C. difficile infection, and adverse drug effects.

By implementing Urine Culture Stewardship, hospitals can decrease the total number of urine cultures ordered, the number of inappropriate asymptomatic bacteriuria treatments, and costs related to overtreatment without increasing patient adverse events.

References:

Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP).

Nicolle LE et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis, 2019: 68(10):e83-110. 

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