{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:47:47Z","timestamp":1791964067343,"version":"4.3.4"},"reference-count":10,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"abstract":"Abstract<\/jats:title>\n \n Objective:<\/jats:title>\n To evaluate the impact of removing the \u201cother\u201d free text special indication from an inpatient urinalysis (UA)-driven reflex urine culture UTI panel on urine culture utilization and special indication designation.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Single-center interrupted time series analysis using segmented regression to assess changes in urine culture ordering before and after intervention.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Tertiary academic medical center inpatient units, July 1, 2022\u2013October 31, 2025.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n All hospitalized adults with UTI panels during the study period. Urine culture orders from emergency and ambulatory settings were excluded.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n Removal of the \u201cother\u201d free text special indication from the UTI panel in February 2024. A new \u201cdeceased donor\u201d special indication was added to maintain compliance with local organ procurement regulations.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 39,218 UTI panels, 11,923 cultures were performed. Postintervention urine cultures decreased by 2.09 per 1,000 patient days (PD) (\n P<\/jats:italic>\n <.05), with a significant postintervention downward trend of 0.15 cultures per 1,000 PD per month (\n P<\/jats:italic>\n <.05). Special indication designation decreased immediately by 2.17 special indications per 1,000 PD (\n P<\/jats:italic>\n <.05) with a reversal of the preintervention upward trend (\n P<\/jats:italic>\n <.05). Designation for neutropenia increased by 0.74 indications per 1,000 PD immediately postintervention (\n P<\/jats:italic>\n <.05); renal\/pancreas transplant and pregnancy indications remained stable or declined. No compensatory increase in total urine cultures was observed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Removing the \u201cother\u201d free text option in a UTI panel led to a sustained reduction in overall urine culture ordering and low-value special indication designations. Modifying electronic order set architecture represents a feasible diagnostic stewardship strategy to reduce unnecessary testing and potential overtreatment of asymptomatic bacteriuria while preserving pathways for high-risk populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ice.2026.10596","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:17:59Z","timestamp":1791962279000},"page":"1-6","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["No \u201cother\u201d way: modification of urinalysis-driven reflex urine culture protocol to reduce inpatient urine cultures"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7222-8245","authenticated-orcid":false,"given":"Mackenzie Rae","family":"Keintz","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00thqtb16","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0504-753X","authenticated-orcid":false,"given":"Jasmine R","family":"Marcelin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00thqtb16","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1635-6365","authenticated-orcid":false,"given":"Elizabeth","family":"Lyden","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8946-8272","authenticated-orcid":false,"given":"Mark E","family":"Rupp","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00thqtb16","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9928-4546","authenticated-orcid":false,"given":"Trevor C.","family":"Van Schooneveld","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00thqtb16","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"S0899823X26105960_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.09.1471"},{"key":"S0899823X26105960_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2022.315"},{"key":"S0899823X26105960_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ696"},{"key":"S0899823X26105960_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz021"},{"key":"S0899823X26105960_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2025.10130"},{"key":"S0899823X26105960_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2025.2"},{"key":"S0899823X26105960_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.400"},{"key":"S0899823X26105960_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis534"},{"key":"S0899823X26105960_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf018"},{"key":"S0899823X26105960_ref9","first-page":"1","article-title":"Not everyone is special: evaluation of indication in a urinalysis-driven reflex urine culture protocol at an academic medical center","volume":"2026","author":"Keintz","journal-title":"Infect Control Hosp Epidemiol"}],"container-title":["Infection Control & Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105960","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:18:00Z","timestamp":1791962280000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26105960\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":10,"alternative-id":["S0899823X26105960"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10596","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}