| Title |
Why is asymptomatic bacteriuria overtreated?: A tertiary care institutional survey of resident physicians
|
|---|---|
| Published in |
BMC Infectious Diseases, July 2015
|
| DOI | 10.1186/s12879-015-1044-3 |
| Pubmed ID | |
| Authors |
Myung Jin Lee, Moonsuk Kim, Nak-Hyun Kim, Chung-Jong Kim, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang Won Park, Nam Joong Kim, Myoung-don Oh, Hong Bin Kim |
| Abstract |
Asymptomatic bacteriuria (ABU) is common and often leads to unnecessary antimicrobial use. Reducing antibiotic overuse for ABU is therefore an important issue for antimicrobial stewardship. We performed this study to investigate the appropriateness of ABU management and to evaluate physicians' knowledge and practice regarding ABU. We reviewed all urine cultures of ≥10(5) cfu/mL of bacteria among inpatients in a 900-bed hospital in 2011. Each episode of bacteriuria was classified into ABU or urinary tract infection (UTI). ABU was defined as a positive urine culture (≥10(5) cfu/mL) without symptoms or signs suggesting UTI. In October 2012 a cross-sectional survey of resident physicians was undertaken using an anonymous, self-administered questionnaire. We identified 219 ABU cases among 1167 positive urine cultures, of which 70 (32.0 %) were inappropriately treated. Female gender, old age, pyuria, hematuria, and positive nitrite on urinalysis were associated with inappropriate ABU treatment in a multivariate analysis (P < 0.05). The response rate to the survey was 74.2 % (95/128). The mean knowledge score was 37.3 %, and 33.7 % of respondents were able to distinguish ABU from UTI, but less than half knew the indications for treating ABU. Even after ABU was correctly diagnosed, concerns about postoperative infections (38.6 %), UTI (9.1 %), and abnormal urinalysis (29.5 %) prevented proper management. About half of the respondents reported to prescribing antibiotics for ABU despite knowing they were not indicated. About one third of ABUs were inappropriately managed. Lack of knowledge and discrepancies between knowledge and practice, contributed to antimicrobial overuse for ABU. Our findings highlight the importance of developing interventions, including education, audit and feedback, to tackle the problem of inappropriate treatment of ABU. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Korea, Democratic People's Republic of | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 127 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Unknown | 126 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 18 | 14% |
| Student > Master | 15 | 12% |
| Student > Ph. D. Student | 14 | 11% |
| Researcher | 12 | 9% |
| Student > Bachelor | 11 | 9% |
| Other | 31 | 24% |
| Unknown | 26 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 55 | 43% |
| Immunology and Microbiology | 9 | 7% |
| Agricultural and Biological Sciences | 6 | 5% |
| Nursing and Health Professions | 6 | 5% |
| Social Sciences | 5 | 4% |
| Other | 17 | 13% |
| Unknown | 29 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 July 2015.
All research outputs
#15,340,815
of 22,818,766 outputs
Outputs from BMC Infectious Diseases
#4,465
of 7,676 outputs
Outputs of similar age
#153,617
of 262,962 outputs
Outputs of similar age from BMC Infectious Diseases
#97
of 148 outputs
Altmetric has tracked 22,818,766 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,676 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 33rd percentile – i.e., 33% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 262,962 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 148 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.