Automatic urine cultures from catheter-obtained samples—time to implement a practice change to improve value Article Swipe
Inbal Kestenbom
,
Neta Cohen
,
Gidon Test
,
Aaron Campigotto
,
Michelle Science
,
Olivia Ostrow
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/pch/pxae021
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/pch/pxae021
Objectives Urine cultures are often automatically obtained after urinary catheterization in young children, even in the absence of pyuria, to test for urinary tract infections (UTIs). Although this practice conflicts with some newer guidelines, it is frequently followed in busy emergency departments (EDs) to minimize the need for a repeat invasive procedure. To assess the implications of this longstanding practice, we aimed to describe the frequency and characteristics of children with normal urinalysis (UA) and positive urine culture obtained via catheterization, and to describe their clinical course. Methods A single center, retrospective cohort study was performed for otherwise healthy children aged 6 to 24 months, presenting to a Pediatric ED between January and June 2019 who underwent UTI testing via a urine catheterization. The point-of-care (POC) UA and urine culture results along with any follow-up phone call documentation were reviewed and analyzed using descriptive statistics. Results Of the 818 urine cultures obtained via catheterization during the 6-month study period, 131 (16%) cultures were reported as positive. Of these positive cultures, 14 (10.7%) of the patients meeting inclusion criteria had a normal POC UA. In follow-up phone calls after the ED visit, the majority of these 14 patients were asymptomatic without any antibiotic treatment and 3 (2.3%) patients were still febrile and classified as a potentially missed UTI. Conclusions The routine practice of sending urine cultures from all catheterized urine samples in children 6 to 24 months, regardless of POC UA results, rarely detect missed UTIs. In alignment with more recent practice guidelines, this practice should be reconsidered in low-risk children seen in EDs to improve overall care quality and resource utilization.
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Metadata
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All OpenAlex metadata
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https://doi.org/10.1093/pch/pxae021Digital Object Identifier
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Automatic urine cultures from catheter-obtained samples—time to implement a practice change to improve valueWork title
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articleOpenAlex work type
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enPrimary language
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2024Year of publication
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2024-05-29Full publication date if available
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Inbal Kestenbom, Neta Cohen, Gidon Test, Aaron Campigotto, Michelle Science, Olivia OstrowList of authors in order
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https://doi.org/10.1093/pch/pxae021Publisher landing page
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YesWhether a free full text is available
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greenOpen access status per OpenAlex
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https://www.ncbi.nlm.nih.gov/pmc/articles/11885880Direct OA link when available
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Value (mathematics), Urine, Computer science, Medicine, Internal medicine, Machine learningTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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| referenced_works | https://openalex.org/W2029614344, https://openalex.org/W2115839337, https://openalex.org/W2050712556, https://openalex.org/W2258778080, https://openalex.org/W3184192997, https://openalex.org/W2783849924, https://openalex.org/W2095918352, https://openalex.org/W4283654113, https://openalex.org/W1487226181, https://openalex.org/W1983677547, https://openalex.org/W4241897282, https://openalex.org/W3186284083, https://openalex.org/W2157669393, https://openalex.org/W2132172265, https://openalex.org/W2159300537, https://openalex.org/W1546019407, https://openalex.org/W2051563393, https://openalex.org/W1994810881, https://openalex.org/W3017652810, https://openalex.org/W2038621589, https://openalex.org/W2605984098, https://openalex.org/W2079580282, https://openalex.org/W3129632162, https://openalex.org/W2039253292, https://openalex.org/W2470978812, https://openalex.org/W4210268382 |
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