ArticleInfection control and hospital epidemiology2026
Improving urine testing stewardship with a technology-leveraged urine testing guideline.
Article in Infection control and hospital epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
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Abstract
backgroundUnnecessary urine cultures contribute to inappropriate antibiotic use, antimicrobial resistance, and
methodsThis prospective quality improvement study was conducted at a 740-bed tertiary care hospital. The BPA triggered when urinalysis with reflex to culture (UACC) was ordered for patients admitted ≥48 hours, guiding clinicians through an algorithm-based ordering workflow. Monthly rates of UACC and pan-culturing were compared between a 12-month pre-intervention period and a 12-month post-intervention period using interrupted time series (ITS) and Mood's median two-sample test. Gram-negative rod (GNR) bacteremia rates were monitored for safety.
resultsUrine testing decreased from 6.45 to 4.41 tests per 1,000 patient-days (31.6% reduction;
conclusionsAn EMR-integrated, algorithm-based BPA coincided with sustained lower urine testing and pan-culturing rates without adverse safety signals within the context of existing downward trends. Ongoing monitoring is needed to sustain adoption and appropriate use.
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