Evidence map›Paper›PMID 31466935›Full record

ArticleJournal of the American Medical Directors Association2020

Trends in Collection of Microbiological Cultures Across Veterans Affairs Community Living Centers in the United States Over 8 Years.

Haley J Appaneal, Aisling R Caffrey, Maria-Stephanie A Hughes, Vrishali V Lopes, Robin L P Jump, Kerry L LaPlante, David M Dosa

Abstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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  6. Are Antibiograms Ready for Prime Time in the Nursing Home?Journal of the American Medical Directors Association · 2020
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Haley J AppanealInfectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI; Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI; College of Pharmacy, University of Rhode Island, Kingston, RI; Brown University School of Public Health, Providence, RI.
Aisling R CaffreyInfectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI; Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI; College of Pharmacy, University of Rhode Island, Kingston, RI; Brown University School of Public Health, Providence, RI.
Maria-Stephanie A HughesInfectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI; Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI; College of Pharmacy, University of Rhode Island, Kingston, RI.
Vrishali V LopesInfectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI.
Robin L P JumpGeriatric Research Education and Clinical Center (GRECC) and the Specialty Care Center of Innovation at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; Division of Infectious Diseases and HIV Medicine, Department of Medicine and Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH.
Kerry L LaPlanteInfectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI; Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI; College of Pharmacy, University of Rhode Island, Kingston, RI; Warren Alpert Medical School of Brown University, Providence, RI.
David M DosaInfectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI; Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI; College of Pharmacy, University of Rhode Island, Kingston, RI; Brown University School of Public Health, Providence, RI; Warren Alpert Medical School of Brown University, Providence, RI. Electronic address: david.dosa@va.gov.

Funding

Improving Antimicrobial Stewardship in Veterans Affairs (VA) Community Living CentersI01HX001894 · VA · PROVIDENCE VA MEDICAL CENTER · PI DOSA, DAVID M., MD, MPH · 2018 to 2020
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Development of a Stewardship Intervention for CLC Pharmacists to Improve UTI TreatmentsIK2HX002247 · VA · PROVIDENCE VA MEDICAL CENTER · PI APPANEAL, HALEY J · 2018 to 2022
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HSRD VA I01 HX001894HSRD VA IK2 HX002247
6 · The paper itself

Abstract

objectivesTo describe and evaluate changes in the collection of microbiological cultures across Veterans Affairs (VA) Community Living Centers (CLCs) nationally.

designDescriptive study.

setting146 VA CLCs.

participantsWe identified both positive and negative microbiological cultures collected during VA CLC admissions from January 2010 through December 2017. MEASURES: We measured the average annual percentage change (AAPC) in the rate of cultures collected per 1000 bed days and per admission, overall and stratified by culture type (ie, urine, blood, skin and soft tissue, and respiratory tract). AAPCs were also calculated for the proportion and rate of positive cultures collected, overall and stratified by culture type and organism (ie, Escherichia coli, Proteus mirabilis, Staphylococcus aureus, Enterococcus spp, Pseudomonas aeruginosa, Klebsiella spp, Enterobacter spp, Morganella morganii, Citrobacter spp, Serratia marcescens, and Streptococcus pneumoniae). Joinpoint regression software was used to assess trends and estimate AAPCs and 95% confidence intervals (CIs).

resultsOver 8 years, 355,329 cultures were collected. The rate of cultures collected per 1000 bed days of care decreased significantly by 6.0% per year (95% CI -8.7%, -3.2%). The proportion of positive cultures decreased by 0.9% (95% CI -1.4%, -0.4%). The most common culture types were urine (48.4%), followed by blood (27.7%). The rate of cultures collected per 1000 bed days of care decreased per year by 6.3% for urine, 5.0% for blood, 4.4% for skin and soft tissue, and 4.9% for respiratory tract. In 2010, S aureus was the most common organism identified, and in all subsequent years E coli was the most common. CONCLUSION AND IMPLICATIONS: We identified a significant reduction in the number of cultures collected over time among VA CLCs. Our findings may be explained by decreases in the collection of unnecessary cultures in VA CLCs nationally due to increased antibiotic stewardship efforts targeting unnecessary culturing and antibiotic treatment.

Indexed as

Residential FacilitiesUnited States Department of Veterans AffairsEscherichia coliHumansMicrobiological TechniquesStaphylococcusUnited StatesCommunity Living CentersLong-term care facilitiesmicrobiologic culture collection trendsVeterans Affairs

Identifiers

PMID31466935
PMCPMC7233461

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.