Asymptomatic bacteriuria is the presence of bacteria in the urine of a patient, who does not have symptoms of urinary tract infection (UTI). This is a common finding especially among women, elderly persons, and patients with urinary catheters. Guidelines strongly recommend not to screen for or treat asymptomatic bacteriuria with antimicrobials, except for specific patients at risk of developing a complicated UTI.
Conditions
Interventions
A multifaceted de-implementation strategy.
Sponsors
Amsterdam UMC, location AMC
Eligibility
Inclusion criteria
Inclusion criteria: Our target size is at least 420 patients. Patients =18 years old who had urine tests (culture and/or urinalysis), that were obtained during presentation at the emergency department will be screened for eligibility.
Exclusion criteria
Exclusion criteria: - Negative urinalysis and negative urine cultures - Patients with symptomatic UTI - Patients with an alternate site of infection for which they receive antimicrobial treatment - Patients with ASB and risk factors, defined as pregnant women, patients prior to planned invasive urologic procedures associated with mucosal trauma (including transurethral surgery of the prostate or bladder, ureteroscopy including lithotripsy, and percutaneous stone surgery), and high-risk neutropenia (defined as absolute neutrophil count <500 cells/µl).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The percentage of patients with ASB without risk factors or other alternative site of infections who are treated with antimicrobials. | — |
Secondary
| Measure | Time frame |
|---|---|
| The duration of antimicrobial treatment for ASB, the number of urine cultures per 1000 patients at the emergency department, the number of urinalysis (dipsticks and microscopic analysis), incorrect treatment of patients with urine cultures that are in daily practice considered positive with a quantitative count of bacteria =10^3 CFU/ml, and the percentage of patients treated with antimicrobials for a positive urinalysis without symptoms or risk factors as stated above. In addition, the total number of urine cultures ordered in the hospital will be assessed explorative. Furthermore, the indications for the negative urine cultures will be assessed explorative during the baseline period. | — |
Contacts
Public ContactTessa van Horrik
Amsterdam UMC, University of Amsterdam, Internal Medicine, Infectious Diseases, Amsterdam, The Netherlands
Outcome results
None listed