Assessing the possibility of implementing a sieving protocol to improve diagnostic stewardship in urinalysis.

Objectives: Urinary tract infection (UTI) is a highly prevalent cause of bacterial infection and urologic disease. Asymptomatic bacteriuria is common and presents without pyuria (<10 WBC x106/L). Sieving protocol uses defined clinical details for samples without pyuria to indicated that they must be...

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Publicado en:New Zealand Journal of Medical Laboratory Science Vol. 77; no. 2; pp. 94 - 96
Autores principales: Dixon, Nia, De Ruyter, Annie, Cahill, Catherine
Formato: abstract research Journal Article
Publicado: New Zealand Institute of Medical Laboratory Science Jul2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2023
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      pub: New Zealand Institute of Medical Laboratory Science
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        atl: Assessing the possibility of implementing a sieving protocol to improve diagnostic stewardship in urinalysis.
      aug:
        au:
          Dixon, Nia
          De Ruyter, Annie
          Cahill, Catherine
        affil: University of Otago, Dunedin
      sug:
        subj:
          Urinalysis
          Program Implementation
          Protocols
          Antimicrobial Stewardship
          Quality Improvement
          Human
          Retrospective Design
          Cell Culture Techniques
          Culture Media
          Data Analysis Software
          Descriptive Statistics
          Confidence Intervals
      ab: Objectives: Urinary tract infection (UTI) is a highly prevalent cause of bacterial infection and urologic disease. Asymptomatic bacteriuria is common and presents without pyuria (<10 WBC x106/L). Sieving protocol uses defined clinical details for samples without pyuria to indicated that they must be cultured. This retrospective study was conducted to assess the possibility of implementing a sieving protocol for urinalysis in the Invercargill laboratory to improve diagnostic and antibiotic stewardship. Methods: A total of 236 urines were analysed between 29th June and 6th July, 2022, and of these, 83 samples had <10 WBC x106/L. A variety of collection techniques including voided midstream urine, catheter urine etc. were accepted for this study. Manual urine microscopy was performed on each specimen and all were cultured onto Blood/Chromogenic Orientation Agar. Any significant growth was analysed by a Senior Scientist, recorded and the causative agent identified. Clinical details that would meet the culture criteria were also recorded. Microsoft excel was used for data analysis and other statistical calculations. Results: Of the 83 urine specimens with <10 WBC x106/L, 11% had significant growth. 34% of urines met the culture criteria and, of the 66% that did not, 11% had significant growth. The margin of error for <10 WBC x106/L urine samples that did not meet the culture criteria but had significant growth was ± 5.5% (95% confidence interval) and for total urine specimens received, it was ± 2%. Conclusion: Implementing the sieving protocol for urinalysis in the Invercargill laboratory will improve diagnostic and antibiotic stewardship, be more cost effective, reduce the harm of over interpreting and over reporting urine cultures and generally enhance patient care.
      pubtype: Academic Journal
      doctype:
        abstract
        research
        Journal Article
      ougenre: Article
    language: English
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