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Urinalysis orders and yield among General Medicine patients: a single-centre's experience in New Zealand.
Shahid, Khurram; Alamri, Yassar; Scowcroft, Hannah; Dixon, Liane; Creighton, Julie; Isenman, Heather; Metcalf, Sarah; Chambers, Steve.
Afiliación
  • Shahid K; Canterbury District Health Board, Christchurch.
  • Alamri Y; New Zealand Brain Research Institute; Canterbury District Health Board, Christchurch.
  • Scowcroft H; Canterbury District Health Board, Christchurch.
  • Dixon L; Canterbury District Health Board, Christchurch.
  • Creighton J; Canterbury Health Laboratories, Christchurch.
  • Isenman H; Canterbury District Health Board, Christchurch.
  • Metcalf S; Christchurch Hospital, Infectious Diseases, Christchurch.
  • Chambers S; University of Otago Christchurch Department of Pathology, Christchurch.
N Z Med J ; 132(1488): 21-27, 2019 01 18.
Article en En | MEDLINE | ID: mdl-31851658
BACKGROUND: Urinalysis performed by dipstick testing is an aid to diagnosing urinary tract infections (UTI), and a tool in selecting patients who require urine culture and antibiotic treatment. Previous studies have demonstrated that UTI, especially in the elderly, are over-diagnosed and over-treated. We sought to study the pattern and yield of urinalysis and urine culture at our service in a tertiary institution. METHODS: A convenience sampling method was utilised to prospectively collect clinical data, through a pre-designed pro forma, from patients admitted to the General Medicine service at Christchurch Hospital between March and June 2016. RESULTS: The study included 395 patients, with a median age of 76 (range 15-100 years). The presence of urinary tract symptoms was documented in 94 patients (24%) and a non-specific syndrome of elevated temperature, confusion or subjective feverishness in 69 (17%). In symptomatic patients, 121 (74%) had a dipstick performed and 104 (86%) urine samples cultured. In the remaining patients, 181 (78%) had a dipstick performed and 81 (35%) had a urine sample sent for culture. CONCLUSIONS: We found a large number of urine dipsticks is being ordered unnecessarily in asymptomatic patients. A more useful test is urine microscopy and culture that is done on symptomatic patients only following careful clinical evaluation. Performing 'routine' urinalysis in patients presenting a wide variety of symptoms may lead to unnecessary urine cultures and treatment of asymptomatic bacteriuria. Efforts to reduce unnecessary tests and antibiotic treatment are a vital component of diagnostic stewardship programmes.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Urinálisis / Medicina General Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: N Z Med J Año: 2019 Tipo del documento: Article Pais de publicación: Nueva Zelanda
Buscar en Google
Añadir a Mi BVS
Imprimir
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PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Urinálisis / Medicina General Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: N Z Med J Año: 2019 Tipo del documento: Article Pais de publicación: Nueva Zelanda