{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:05:28Z","timestamp":1791525928036,"version":"4.3.4"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The Infectious Diseases Society of America (IDSA) recommends against screening for and\/or treating asymptomatic bacteriuria (ASB). This study aims to evaluate the inappropriate use of antibiotics in ASB before and after Antimicrobial Stewardship Program (ASP) implementation and advance towards its appropriate use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>We performed a retrospective study of patients diagnosed with ASB from 2016 to 2019 at a tertiary hospital in Saudi Arabia. This study included hospitalized patients \u2265 18\u2009years old who had a positive urine culture with no documented signs or symptoms of urinary tract infection We excluded pregnant women, solid organ transplant patients, patient on active chemotherapy, and patients about to undergo urological surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 716 patients with a positive urine culture were screened. Among these, we identified 109 patients with ASB who were included in our study. The rate of inappropriate antibiotic use was 95% during the study period. The implementation of the ASP Program was associated with a significant reduction in the use of carbapenems (<jats:italic>P<\/jats:italic>\u2009=\u20090.04) and an increase in the use of cephalosporins (<jats:italic>P<\/jats:italic>\u2009=\u20090.01). However, overprescribing antimicrobial agents was a concern in both eras. Approximately 90% of the microorganisms identified were gram-negative bacteria. Of those, 38.7% were multidrug-resistant strains.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The urine culture order in ASB is considered relatively small number; however, it showed a high rate of the inappropriate use of antibiotics when there is an order of urine culture in both era. ASP ought to focus on targeting the ordering physician, promoting awareness and\/or organizational interventions that appear to reduce the incidence of overtreatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06460-6","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T09:03:39Z","timestamp":1629882219000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of asymptomatic bacteruria management before and after antimicrobial stewardship program implementation: retrospective study"],"prefix":"10.1186","volume":"21","author":[{"given":"Ahlam","family":"Alghamdi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Almajid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raneem","family":"Alalawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Alganame","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shorooq","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghaida","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman","family":"Alharthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isra","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"issue":"10","key":"6460_CR1","doi-asserted-by":"publisher","first-page":"E83","DOI":"10.1093\/cid\/ciy1121","volume":"68","author":"LE Nicolle","year":"2019","unstructured":"Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):E83\u201375. https:\/\/doi.org\/10.1093\/cid\/ciy1121.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"6460_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-015-1044-3","volume":"15","author":"MJ Lee","year":"2015","unstructured":"Lee MJ, Kim M, Kim NH, Kim CJ, Song KH, Choe PG, et al. Why is asymptomatic bacteriuria overtreated?: a tertiary care institutional survey of resident physicians. BMC Infect Dis. 2015;15(1):1\u20137. https:\/\/doi.org\/10.1186\/s12879-015-1044-3.","journal-title":"BMC Infect Dis"},{"issue":"2","key":"6460_CR3","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/pathogens5020038","volume":"5","author":"LE Nicolle","year":"2016","unstructured":"Nicolle LE. The paradigm shift to non-treatment of asymptomatic bacteriuria. Pathogens. 2016;5(2):2\u20137. https:\/\/doi.org\/10.3390\/pathogens5020038.","journal-title":"Pathogens"},{"issue":"11","key":"6460_CR4","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1001\/jamainternmed.2019.2871","volume":"179","author":"LA Petty","year":"2019","unstructured":"Petty LA, Vaughn VM, Flanders SA, Malani AN, Conlon A, Kaye KS, et al. Risk factors and outcomes associated with treatment of asymptomatic bacteriuria in hospitalized patients. JAMA Intern Med. 2019;179(11):1519\u201327. https:\/\/doi.org\/10.1001\/jamainternmed.2019.2871.","journal-title":"JAMA Intern Med"},{"issue":"11","key":"6460_CR5","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1093\/cid\/civ696","volume":"61","author":"T Cai","year":"2015","unstructured":"Cai T, Nesi G, Mazzoli S, Meacci F, Lanzafame P, Caciagli P, 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(11):1655\u201361. https:\/\/doi.org\/10.1093\/cid\/civ696.","journal-title":"Clin Infect Dis"},{"issue":"4","key":"6460_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ofid\/ofx207","volume":"4","author":"ME Flokas","year":"2017","unstructured":"Flokas ME, Andreatos N, Alevizakos M, Kalbasi A, Onur P, Mylonakis E. Inappropriate Management of Asymptomatic Patients with Positive Urine Cultures: a systematic review and meta-analysis. Open Forum Infect Dis. 2017;4(4):1\u201310. https:\/\/doi.org\/10.1093\/ofid\/ofx207.","journal-title":"Open Forum Infect Dis"},{"issue":"12","key":"6460_CR7","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1016\/j.ajic.2019.06.005","volume":"47","author":"JA Ramos-Castaneda","year":"2019","unstructured":"Ramos-Castaneda JA, Ruano-Ravina A, Salinas DF, Osorio-Manrique J, Segura-Cardona AM, Lemos-Luengas EV. Factors associated with multidrug-resistant bacteria in a cohort of patients with asymptomatic bacteriuria who underwent urological surgery. Am J Infect Control. 2019;47(12):1479\u201383. https:\/\/doi.org\/10.1016\/j.ajic.2019.06.005.","journal-title":"Am J Infect Control"},{"issue":"2","key":"6460_CR8","doi-asserted-by":"publisher","first-page":"17814","DOI":"10.3402\/jchimp.v2i2.17814","volume":"2","author":"F Chowdhury","year":"2012","unstructured":"Chowdhury F, Sarkar K, Branche A, Kim J, Dwek P, Nangit A, et al. Preventing the inappropriate treatment of asymptomatic bacteriuria at a community teaching hospital. J Commun Hosp Intern Med Perspect. 2012;2(2):17814. https:\/\/doi.org\/10.3402\/jchimp.v2i2.17814.","journal-title":"J Commun Hosp Intern Med Perspect"},{"issue":"10","key":"6460_CR9","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1086\/522183","volume":"45","author":"PA Gross","year":"2007","unstructured":"Gross PA, Patel B. Reducing antibiotic overuse: a call for a National Performance Measure for not treating asymptomatic bacteriuria. Clin Infect Dis. 2007;45(10):1335\u20137. https:\/\/doi.org\/10.1086\/522183.","journal-title":"Clin Infect Dis"},{"issue":"2","key":"6460_CR10","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1097\/MOU.0000000000000368","volume":"27","author":"T Cai","year":"2017","unstructured":"Cai T, Koves B, Johansen TEB. Asymptomatic bacteriuria, to screen or not to screen - and when to treat? Curr Opin Urol. 2017;27(2):107\u201311. https:\/\/doi.org\/10.1097\/MOU.0000000000000368.","journal-title":"Curr Opin Urol"},{"issue":"9","key":"6460_CR11","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1086\/597403","volume":"48","author":"M Cope","year":"2009","unstructured":"Cope M, Cevallos ME, Cadle RM, Darouiche RO, Musher DM, Trautner BW. Inappropriate treatment of catheter-associated asymptomatic bacteriuria in a tertiary care hospital. Clin Infect Dis. 2009;48(9):1182\u20138. https:\/\/doi.org\/10.1086\/597403.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"6460_CR12","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1093\/cid\/cis534","volume":"55","author":"T Cai","year":"2012","unstructured":"Cai T, Mazzoli S, Mondaini N, Meacci F, Nesi G, D\u2019Elia C, et al. The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: to treat or not to treat? Clin Infect Dis. 2012;55(6):771\u20137. https:\/\/doi.org\/10.1093\/cid\/cis534.","journal-title":"Clin Infect Dis"},{"key":"6460_CR13","volume-title":"StatPearls","author":"MF Crader","year":"2020","unstructured":"Crader MF, Leslie SW. Bacteruria. In: StatPearls. Treasure Island: StatPearls Publishing; 2020. [Updated 2019 Nov 7]. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482276\/."},{"issue":"2","key":"6460_CR14","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1086\/674848","volume":"35","author":"D Kelley","year":"2014","unstructured":"Kelley D, Aaronson P, Poon E, McCarter YS, Bato B, Jankowski CA. Evaluation of an antimicrobial stewardship approach to minimize overuse of antibiotics in patients with asymptomatic bacteriuria. Infect Contr Hosp Epidemiol. 2014;35(2):193\u20135. https:\/\/doi.org\/10.1086\/674848.","journal-title":"Infect Contr Hosp Epidemiol"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06460-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06460-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06460-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T09:03:48Z","timestamp":1629882228000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06460-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,25]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6460"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06460-6","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,25]]},"assertion":[{"value":"22 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by Security Forces Hospital Institutional Review Board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"869"}}