{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:12:48Z","timestamp":1762866768585},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2015,11,26]],"date-time":"2015-11-26T00:00:00Z","timestamp":1448496000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec id=\"S0899823X15002810_abs1\" sec-type=\"general\"><jats:title>BACKGROUND<\/jats:title><jats:p>Antibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs2\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To evaluate risk factors for treatment of ASB.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs3\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Retrospective observational study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs4\" sec-type=\"general\"><jats:title>SETTING<\/jats:title><jats:p>A tertiary academic hospital, county hospital, and community hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs5\" sec-type=\"general\"><jats:title>PATIENTS<\/jats:title><jats:p>Hospitalized adults with bacteriuria.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs6\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Patients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs7\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>Among 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62\/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, <jats:italic>P<\/jats:italic>&lt;.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14\u20130.80], <jats:italic>P<\/jats:italic> =.01), presence of leukocyte esterase (5.48 [2.35\u201312.79], <jats:italic>P<\/jats:italic>&lt;.01), presence of nitrites (2.45 [1.11\u20135.41], <jats:italic>P<\/jats:italic>=.03), and <jats:italic>Escherichia coli<\/jats:italic> on culture (2.4 [1.2\u20134.7], <jats:italic>P<\/jats:italic>=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002810_abs8\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>ASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.<\/jats:p><jats:p><jats:italic>Infect. Control Hosp. Epidemiol.<\/jats:italic> 2016;37(3):319\u2013326<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2015.281","type":"journal-article","created":{"date-parts":[[2015,11,26]],"date-time":"2015-11-26T10:23:39Z","timestamp":1448533419000},"page":"319-326","source":"Crossref","is-referenced-by-count":35,"title":["Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers"],"prefix":"10.1017","volume":"37","author":[{"given":"Jonathan D.","family":"Grein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine L.","family":"Kahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha J.","family":"Eells","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong K.","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Go-Wheeler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanzib","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya Y.","family":"Riva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan H.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Rekha Murthy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loren G.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,11,26]]},"reference":[{"key":"S0899823X15002810_ref6","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1437"},{"key":"S0899823X15002810_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2013.07.007"},{"key":"S0899823X15002810_ref23","doi-asserted-by":"publisher","DOI":"10.1086\/651706"},{"key":"S0899823X15002810_ref4","doi-asserted-by":"publisher","DOI":"10.1086\/427507"},{"key":"S0899823X15002810_ref2","first-page":"194","article-title":"Vital signs: improving antibiotic use among hospitalized patients","volume":"63","author":"Fridkin","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X15002810_ref25","first-page":"360","article-title":"Understanding interobserver agreement: the kappa statistic","volume":"37","author":"Viera","year":"2005","journal-title":"Fam Med"},{"key":"S0899823X15002810_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2013.01.020"},{"key":"S0899823X15002810_ref16","doi-asserted-by":"publisher","DOI":"10.1086\/522183"},{"key":"S0899823X15002810_ref26","doi-asserted-by":"publisher","DOI":"10.1086\/597514"},{"key":"S0899823X15002810_ref9","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1155\/2009\/702545","article-title":"Positive urine cultures: a major cause of inappropriate antimicrobial use in hospitals?","volume":"20","author":"Silver","year":"2009","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"S0899823X15002810_ref18","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181692af9"},{"key":"S0899823X15002810_ref10","doi-asserted-by":"publisher","DOI":"10.1086\/597403"},{"key":"S0899823X15002810_ref8","doi-asserted-by":"publisher","DOI":"10.1086\/669089"},{"key":"S0899823X15002810_ref1","unstructured":"Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. CDC website. http:\/\/www.cdc.gov\/drugresistance\/threat-report-2013\/index.html. Accessed June 23, 2014."},{"key":"S0899823X15002810_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir364"},{"key":"S0899823X15002810_ref5","doi-asserted-by":"publisher","DOI":"10.1086\/650482"},{"key":"S0899823X15002810_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-187"},{"key":"S0899823X15002810_ref15","unstructured":"Choosing Wisely website. www.choosingwisely.org. Accessed October 2, 2015."},{"key":"S0899823X15002810_ref3","doi-asserted-by":"publisher","DOI":"10.1086\/593951"},{"key":"S0899823X15002810_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.02.003"},{"key":"S0899823X15002810_ref28","doi-asserted-by":"publisher","DOI":"10.1086\/510393"},{"key":"S0899823X15002810_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt477"},{"key":"S0899823X15002810_ref17","unstructured":"Catheter-associated urinary tract infection (CAUTI) event. National Healthcare Safety Network website. http:\/\/www.cdc.gov\/nhsn\/acute-care-hospital\/CAUTI\/index.html. Accessed August 30, 2013."},{"key":"S0899823X15002810_ref12","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.565"},{"key":"S0899823X15002810_ref11","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1155\/2005\/868179","article-title":"An evaluation of the management of asymptomatic catheter-associated bacteriuria and candiduria at the Ottawa Hospital","volume":"16","author":"Dalen","year":"2005","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"S0899823X15002810_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq257"},{"key":"S0899823X15002810_ref13","doi-asserted-by":"crossref","first-page":"e0132071","DOI":"10.1371\/journal.pone.0132071","article-title":"A controlled quasi-experimental study of an educational intervention to reduce the unnecessary use of antimicrobials for asymptomatic bacteriuria","volume":"10","author":"Ifran","year":"2015","journal-title":"PLOS ONE"},{"key":"S0899823X15002810_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.09.005"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X15002810","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T22:00:53Z","timestamp":1555711253000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X15002810\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,26]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["S0899823X15002810"],"URL":"https:\/\/doi.org\/10.1017\/ice.2015.281","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,26]]}}}