TABLE 1.
Demographic, Clinical, and Urine Culture Characteristics of Random Samples of Adult ICU Patients with Orders for Urine Cultures, Pre- and Post-Implementation of a Reflex Urine Culture Protocol
| Characteristic | Pre-intervention, (n = 250) | Post-intervention (n = 250) | P Value |
|---|---|---|---|
| Age, y, mean (SD) | 57.4 (18) | 57.7 (17) | .85 |
| Sex, No. (% male) | 161 (64) | 139 (56) | .04 |
| Charlson comorbidity index, mean (SD) | 2.55 (2.1) | 2.42 (2.5) | .48 |
| ICU type, No. (%) | |||
| Medical | 63 (25) | 51 (20) | .09 |
| Cardiac | 15 (6) | 13 (5) | |
| Cardiac surgical | 30 (12) | 24 (10) | |
| Trauma | 66 (26) | 93 (37) | |
| Surgical | 41 (16) | 28 (11) | |
| Neurocare | 35 (14) | 41 (16) | |
| Hospital length of stay, d, mean (SD) | 24.4 (22.7) | 21.7 (17.5) | .13 |
| ICU length of stay, d, mean (SD) | 16.2 (15.2) | 15.3 (12.3) | .49 |
| Duration of catheterization, d, mean (SD) | 14.9 (15.4) | 12.6 (12.4) | .06 |
| On any antibiotic at index urine culture, No. (%) | 116 (46) | 127 (51) | .32 |
| Type of index urine culture, No. (%) | |||
| Regular | 250 (100) | 74 (30) | <.001 |
| Reflex | 0 (0) | 176 (70) | |
| WBC/hpf of index urinalysis, No. (%) | |||
| Not sent | 29 (12) | 20 (8) | .29 |
| ≤10 per hpf | 138 (55) | 152 (61) | |
| >10 per hpf | 83 (33) | 78 (31) | <.001 |
| Result of index urine culture | |||
| Negative | 173 (69) | 70 (28) | |
| Positive | 77 (31) | 40 (16) | |
| Not applicable, culture not performed | 0 (0) | 140 (56) | |
| Another urine culture performed | 178 (71) | 131 (52) | <.001 |
| No. of urine cultures per patient,a mean (SD) | 2.6 (3.3) | 1.0 (1.5) | <.001 |
| Any blood culture performed, No. (%) | 226 (90) | 227 (91) | .88 |
| No. of blood cultures per patient,a mean (SD) | 3.5 (3.4) | 3.2 (3.3) | .45 |
NOTE. ICU, Intensive care unit; hpf, high power field; SD, standard deviation; IQR, interquartile range.
a
No. of cultures per patient were for the entire hospital stay.