Urine culture testing in community nursing homes: Gateway to antibiotic overprescribing

Infection Control and Hospital Epidemiology

Volumn 38, Issue 5, 2017, Pages 524-531

  Sloane, Philip D ^a,b   Kistler, Christine E ^a,b   Reed, David ^b   Weber, David J ^a,c   Ward, Kimberly ^b   Zimmerman, Sheryl ^b  

^a UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF NORTH CAROLINA   (United States)

^c University of North Carolina at Chapel Hill   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT; CEFTRIAXONE; CIPROFLOXACIN; COTRIMOXAZOLE; LEVOFLOXACIN; NITROFURANTOIN; ANTIINFECTIVE AGENT;

ACUTE DISEASE; ANTIBIOTIC SENSITIVITY; ANTIBIOTIC THERAPY; ARTICLE; ASYMPTOMATIC BACTERIURIA; BACTERIAL COUNT; CLINICAL AUDIT; COMMUNITY HEALTH NURSING; DYSURIA; HUMAN; INAPPROPRIATE PRESCRIBING; MAJOR CLINICAL STUDY; MENTAL DISEASE; NORTH CAROLINA; NURSING HOME; NURSING HOME PATIENT; OBSERVATIONAL STUDY; URINE COLOR; URINE CULTURE; URINE ODOR; URINE SEDIMENT; BACTERIURIA; DECISION MAKING; DRUG UTILIZATION; HEALTH SERVICE; MICROBIOLOGY; STATISTICS AND NUMERICAL DATA; URINALYSIS; URINARY TRACT INFECTIONS; URINE;

ANTI-BACTERIAL AGENTS; BACTERIURIA; COLONY COUNT, MICROBIAL; DECISION MAKING; DRUG UTILIZATION; HUMANS; INAPPROPRIATE PRESCRIBING; MEDICAL AUDIT; MEDICAL OVERUSE; NORTH CAROLINA; NURSING HOMES; URINALYSIS; URINARY TRACT INFECTIONS; URINE;

EID: 85017581066     PISSN: 0899823X     EISSN: 15596834     Source Type: Journal    
DOI: 10.1017/ice.2016.326     Document Type: Article

References (37)

1. Medicare and Medicaid programs: reform of requirements for long-term care facilities. Office of the Federal Register website. https://www.federalregister.gov/documents/2016/10/04/2016-23503/medicare-and-medicaid-programs-reformof-requirements-for-longterm- care-facilities. Published 2016. Accessed November 7, 2016.
2. The core elements of antibiotic stewardship in nursing homes. Centers for Disease Control and Prevention website. http://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html. Published 2015. Accessed August 9, 2016.
3. Daneman N, Gruneir A, Bronskill SE, et al. Prolonged antibiotic treatment in long-term care: role of the prescriber. JAMA Intern Med 2013;173:673-682.
4. Zimmerman S, Sloane P, Bertrand R, et al. Successfully reducing antibiotic prescribing in nursing homes. J Am Geriatr Soc 2014;62:907-912.
5. Eikelenboom-Boskamp A, Cox-Claessens J, Boom-Poels P, Drabbe M, Koopmans R, Voss A. Three-year prevalence of healthcare-associated infections in Dutch nursing homes. J Hosp Infect 2011;78:59-62.
6. Nace D, Drinka P, Crnich C. Clinical uncertainties in the approach to long term care residents with possible urinary tract infection. J Am Med Dir Assoc 2014;15:133-139.
7. The national action plan to prevent health care-associated infections: road map to elimination; Chapter 8: Long-term care facilities. US Department of Health and Human Services website. http://health.gov/hcq/pdfs/hai-action-plan-ltcf.pdf. Published 2013. Accessed August 9, 2016.
8. Trautner B, Grigoryan L. Approach to a positive urine culture in a patient without urinary symptoms. Infect Dis Clin North Am 2014;28:15-31.
9. Phillips C, Adepoju O, Stone N, et al. Asymptomatic bacteriuria, antibiotic use, and suspected urinary tract infections in four nursing homes. BMC Geriatr 2012;12:73.
10. Nicolle L, Bradley S, Colgan R, Rice J, Schaeffer A, Hooton T. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643-654.
11. Cai T, Nesi G, Mazzoli S, et al. Asymptomatic bacteriuria treatment is associated with a higher prevalence of antibiotic resistant strains in women with urinary tract infections. Clin Infect Dis 2015;61:1655-1661.
12. Eke-Usim AC, Rogers MA, Gibson KE, Crnich C, Mody L. Targeted infection prevention study team. Constitutional symptoms trigger diagnostic testing before antibiotic prescribing in high-risk nursing home residents. J Am Geriatr Soc 2016;64: 1975-1980.
13. High K, Bradley S, Gravenstein S, et al. Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. J Am Geriatr Soc 2009;57:375-394.
14. Loeb M, Bentley D, Bradley S, et al. Development of minimum criteria for the initiation of antibiotics in residents of long-termcare facilities: results of a consensus conference. Infect Control Hosp Epidemiol 2001;22:120-124.
15. Loeb M, Brazil K, Lohfeld L, et al. Optimizing antibiotics in residents of nursing homes: protocol of a randomized trial. BMC Health Serv Res 2002;2:17.
16. Genao L, Buhr G. Urinary tract infections in older adults residing in long-term care facilities. Ann Long Term Care 2012;20: 33-38.
17. Stone N, Ashraf M, Calder J, et al. Surveillance definitions of infections in long-term care facilities: revisiting the McGeer criteria. Infect Control Hosp Epidemiol 2012;33:965-977.
18. Sloane PD, Kistler C, Mitchell CM, et al. Role of body temperature in diagnosing bacterial infection in nursing home residents. J Am Geriatr Soc 2014;62:135-140.
19. Fever temperatures: accuracy and comparison-topic overview. WebMD website. http://www.webmd.com/children/tc/fevertemperatures- accuracy-and-comparison-topic-overview. Published 2015. Accessed December 1, 2015.
20. Nursing Home Compare. US Government Medicare website. https://www.medicare.gov/NursingHomeCompare/search.html. Accessed August 31, 2015.
21. Rafii F, Sutherland J, Cerniglia C. Effects of treatment with antimicrobial agents on the human colonic microflora. Therapeut Clin Risk Manag 2008;4:1343-1358.
22. Loeb M, Brazil K, Lohfeld L, et al. Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial. BMJ 2005;331: 669-670.
23. Boscia J, Abrutyn E, Kaye D. Asymptomatic bacteriuria in elderly persons: treat or do not treat? Ann Intern Med 1987;106: 764-766.
24. Wagenlehner F, Naber K, Weidner W. Asymptomatic bacteriuria in elderly patients: significance and implications for treatment. Drugs Aging 2005;22:801-807.
25. Inouye S. Delirium in older persons. N Engl J Med 2006; 354:1157-1165.
26. Borsje P, Wetzels R, Lucassen P, Pot A, Koopmans R. The course of neuropsychiatric symptoms in community-dwelling patients with dementia: a systematic review. Int Psychogeriatr 2015;27: 385-405.
27. Balogun S, Philbrick J. Delirium, a symptom of UTI in the elderly: fact or fable? A systematic review. Canad Geriatr J 2013; 17:22-26.
28. Juthani-Mehta M, Quagliarello V, Perrelli E, Towle V, Van Ness P, Tinetti M. Clinical features to identify urinary tract infection in nursing home residents: a cohort study. J Am Geriatr Soc 2009;57:963-970.
29. Midthun S, Paur R, Lindseth G. Urinary tract infections. Does the smell really tell? J Gerontol Nurs 2004;30:4-9.
30. Vaisman A, Gold W, Leis J. A 78-year-old woman with lethargy and a positive urine culture. CMAJ 2013;185:679-680.
31. Pandey S, Kim H, Choi S, Sa I, Oh S. Major odorants released as urinary volatiles by urinary incontinent patients. Sensors (Basel) 2013;13:8523-8533.
32. Nicolle L, Bradley S, Colgan R, Rice J, Schaeffer A, Hooton T. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643-654.
33. Wald H. Challenging the "Culture of Culturing": the case for less testing and more clinical assessment. JAMA Intern Med 2016;176:587-588.
34. Pettersson E, Vernby A, Mölstad S, Lundborg CS. Can a multifaceted educational intervention targeting both nurses and physicians change the prescribing of antibiotics to nursing home residents? A cluster randomized controlled trial. J Antimicrob Chemother 2011;66:2659-2666.
35. Trautner BW, Grigoryan L, Petersen NJ, Hysong S, Cadena J, Patterson JE, Naik AD. Effectiveness of an antimicrobial stewardship approach for urinary catheter-associated asymptomatic bacteriuria. JAMA Intern Med 2015;175:1120-1127.
36. Zabarsky TF, Sethi AK, Donskey CJ. Sustained reduction in inappropriate treatment of asymptomatic bacteriuria in a longterm care facility through an educational intervention. Am J Infect Control 2008;36:476-480.
37. Juthani-MehtaM, Datunashvili A, TinettiM. Tests for urinary tract infection in nursing home residents. JAMA 2014;312:1687-1688.