Urine cultures are often positive in the absence of a urinary tract infection (UTI). Pyuria is generally considered necessary to diagnose a UTI. Urine cultures are often positive in the absence of UTI leading to unnecessary antibiotics. Quasi-experimental pre-post study of all patient urine cultures ordered in a VA acute care hospital, emergency department (ED), and two long-term care (LTC) facilities from August 2016 to August 2018. Urine cultures performed per 100 days were compared pre- (August 2016 to July 2017) versus post-intervention (August 2017 to August 2018) using interrupted time series negative binomial regression. We examined whether reflexing to urine culture only if a urinalysis (UA) found greater than 10 WBC/hpf decreased urine culturing. In acute-care, reflex culturing resulted in a 39% time series regression analysis adjusted decrease in the rate of cultures performed (pre-intervention, 3.6 cultures/100 days vs. Post-intervention, 1.8 cultures/100 days, p < 0.001). Pre-intervention, 29% (4/14) of Catheter-associated UTI (CAUTI) would not have been reported if reflex culturing was employed. In the ED, reflex culturing was associated with a 38% (p = 0.0015) regression analysis adjusted decrease in cultures, from 5.4/100 visits to 3.3/100 visits. In LTC, there was a small absolute, but regression analysis adjusted increase of 89% (p = 0.0018) in rates from (0.4/100 days to 0.5/100 days). In acute care and ED, urine reflex culturing decreased the number of urine cultures performed. A small absolute increase was seen between pre-post time periods in LTC. Reflex testing generally decreases cultures and may lead to more accurate diagnoses of CAUTI.

中文翻译：

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尿反射培养对急性和长期护理中培养和感染率的影响。

在没有尿路感染（UTI）的情况下，尿液培养物通常是阳性的。通常认为脓尿是诊断UTI所必需的。在没有UTI的情况下，尿培养物通常是阳性的，从而导致不必要的抗生素。2016年8月至2018年8月在VA急诊医院，急诊科（ED）和两个长期护理（LTC）设施中订购的所有患者尿液培养物的准实验性事前研究。使用中断时间序列负二项式回归比较干预前（2016年8月至2017年7月）与干预后（2017年8月至2018年8月）。我们仅在尿液分析（UA）发现大于10 WBC / hpf的情况下，才对尿培养进行反思，以减少尿培养。在急诊中 反射培养导致39％的时间序列回归分析，调整后的执行培养速率降低（干预前为3.6个培养/ 100天，干预后为1.8个培养/ 100天，p <0.001）。干预前，如果采用反射培养，则尚无29％（4/14）的导管相关性UTI（CAUTI）报告。在ED中，反射培养与38％（p = 0.0015）回归分析相关，调整后的文化减少量从5.4 / 100次降低到3.3 / 100次。在LTC中，绝对值很小，但是回归分析将费率从（0.4 / 100天）增加到（0.5 / 100天）增加了89％（p = 0.0018）。在急诊和急诊中，尿反射培养减少了进行的尿培养次数。在LTC的前后时间段之间，看到了绝对的小幅增长。