Urine Culture and Urinalysis Utilization Practices in United States Acute Care Hospitals Between 2017 and 2020.

Details

• Alternative Title:
  Infection Control and Hospital Epidemiology, 2026, v. 47, no. 1: Urine Culture and Urinalysis Utilization Practices in United States Acute Care Hospitals Between 2017 and 2020.
• Journal Article:
  Infection Control and Hospital Epidemiology
• Personal Author:
  Asonganyi, Nyawung L. ; Kazakova, Sophia V. ; Hatfield, Kelly M. ; Baggs, James ; Fridkin, Scott K. ; Reddy, Sujan C. ; Lutgring, Joseph Daniel
• Description:
  Inappropriate urine cultures (UCs) are common and lead to inappropriate antimicrobial use. Urinalyses (UAs) have been increasingly incorporated into diagnostic stewardship interventions, but the impact of these interventions nationally has not been assessed. We describe UA and UC utilization practices using a nationwide dataset of patients admitted to acute care hospitals.
  
  Design, Setting and Participants: We performed a retrospective cohort study of index UCs and their associated UAs performed for adult patients (age ≥ 18 years) admitted in U.S. acute care hospitals, participating in the PINC AI™ Healthcare Database (PHD) from January 1, 2017, through December 31, 2020. A positive UA was defined as >10 leukocytes per high power field, positive leukocyte esterase, or positive nitrite.
  
  The overall rate of UCs in this study was 124.7 per 1000 discharges and annual UC rates decreased from 2017 (129.2) to 2020 (120.0). The proportion of UCs that had a positive UA increased from 60.5% in 2017 to 68.1% in 2020; UCs without a UA decreased from 19.3% to 10.5%, and UCs with a negative UA did not significantly change (20.2% to 21.5%). A multivariate multinomial logistic regression model identified male sex, age <65, and a diagnosis of cancer to be predictors of having a UC with a negative UA or no UA.
  
  UC utilization decreased over the study period. The proportion of UCs with a positive UA increased. This may suggest a positive impact of diagnostic stewardship practices at the national level although further progress is needed.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Male
  • Female
  • Retrospective Studies
  • Urinalysis
  • Middle Aged
  • Aged
  • Adult
  • Urinary Tract Infections
  • Aged, 80 and over
  More +
• Source:
  Infection Control and Hospital Epidemiology, 2026, v. 47, no. 1
• DOI:
  https://doi.org/10.1017/ice.2025.10260
• ISSN:
  0899-823X ; 1559-6834
• Pubmed ID:
  41131934
• Pubmed Central ID:
  PMC12624373
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U54 CK000601/CK/NCEZID CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  71-79 (17 pdf pages)
• Volume:
  47
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/262114/cdc_262114_DS1.pdf
• File Type:
  [PDF - 364.53 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b7954684995e765258ba49b7d0719739974c8853d7fac5b62ca351a743c4f910fe03597a48a69f51e96c8a627bc8863744eb188e8515577319273caac69f6ca9