ArticleOpen forum infectious diseases2019
Knowledge and Practices of Physicians and Nurses Related to Urine Cultures in Catheterized Patients: An Assessment of Adherence to IDSA Guidelines.
Article in Open forum infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Knowledge, attitudes and practices concerning catheter-associated urinary tract infection amongst healthcare workers: a mixed methods systematic review.Nursing open · 2023Pooled it
- Impact of an Educational Leaflet About Asymptomatic Bacteriuria and Urinary Tract Infection on Antibiotic Preferences Among US Adults ≥65 Years: An Online Randomized Controlled Survey Experiment.Open forum infectious diseases · 2025Article
- Improving urine culture appropriateness and reducing unnecessary testing through education and feedback in a hospital setting.BMC infectious diseases · 2025Article
- Impact of discontinuing automatic reflex urine culture after urinalysis: a diagnostic and antibiotic stewardship initiative.Frontiers in cellular and infection microbiology · 2025Article
- Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria.JAMA network open · 2024Article
- Fever and infections in surgical intensive care: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document.Trauma surgery & acute care open · 2024Article
- Provider & nursing perspectives on the "panculture": opportunities for innovative diagnostic stewardship interventions.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Inpatient clinicians' approach to diagnosis of urinary tract infections in older adults using the COM-B model: a qualitative assessment.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Using clinical decision support to improve urine testing and antibiotic utilization.Infection control and hospital epidemiology · 2023Article
- Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update.Infection control and hospital epidemiology · 2023Article
- Optimizing reflex urine cultures: Using a population-specific approach to diagnostic stewardship.Infection control and hospital epidemiology · 2023Article
- Using the COM-B model to identify barriers to and facilitators of evidence-based nurse urine-culture practices.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Blood culture utilization practices among febrile and/or hypothermic inpatients.BMC infectious diseases · 2022Article
- Quality Improvement Interventions and Implementation Strategies for Urine Culture Stewardship in the Acute Care Setting: Advances and Challenges.Current infectious disease reports · 2021Article
- Organizational readiness assessment in acute and long-term care has important implications for antibiotic stewardship for asymptomatic bacteriuria.American journal of infection control · 2020Article
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundA positive urine culture often drives initiation of antimicrobials even in the absence of symptoms. Our objectives were to evaluate the knowledge and practice patterns related to ordering urine cultures in patients with indwelling urinary catheters.
methodsWe performed chart reviews of catheter-associated urinary tract infections (CAUTIs) at our academic health care system between October 1, 2015, and September 30, 2017, to assess practice patterns related to the assessment of potential CAUTIs. Following this, we surveyed physicians and nurses about indications for ordering urine cultures in catheterized patients between January 11, 2018, and April 17, 2018. The accuracy of these indications was assessed based on Infectious Diseases Society of America CAUTI and asymptomatic bacteriuria guidelines.
resultsOn chart review, we identified 184 CAUTIs in 2 years. In 159 episodes (86%), urine cultures were ordered inappropriately. In 114 episodes (62%), CAUTI criteria were met by "pan-culturing" rather than symptom-directed testing. Twenty cases (11%) experienced partial or delayed management of other infections, drug adverse events, and Clostridioides difficile infections (CDIs). On our survey, we received 405 responses, for a response rate of 45.3%. Mean scores varied by occupation and level of training. Nurses were more likely than physicians to consider change in appearance (61% vs 23%; P < .05) and odor (74% vs 42%; P < .05) of urine as indications to order urine cultures.
conclusionsOur data reveal specific knowledge gaps among physicians and nurses related to ordering urine cultures in catheterized patients. The practice of pan-culturing and inappropriate urine culture orders may contribute to overdiagnosis of surveillance CAUTIs, delay in diagnosis of alternative infections, and excess CDIs.
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