Table 1.
Demographics of Hospitalized Patients Presenting to the Emergency Department Ultimately Identified as Having Asymptomatic Bacteriuria, N = 2461
| Characteristic | N (%) |
|---|---|
| Age, median [IQR] | 78 [67–87] |
| Women | 1818 (73.9%) |
| Length of stay [IQR] | 5 [3–6] |
| Comorbiditiesa | |
| Moderate to severe chronic kidney disease | 942 (38.3%) |
| Diabetes | 1013 (41.2%) |
| Hemodialysis | 35 (1.4%) |
| Liver disease | 138 (5.6%) |
| Congestive heart failure | 619 (25.2%) |
| Cerebrovascular disease | 646 (26.2%) |
| History of cancer | 510 (20.7%) |
| Spinal cord injury | 50 (2.0%) |
| Immunosuppressedb | 71 (2.9%) |
| Dementia | 622 (25.3%) |
| Urinary Catheter | |
| Indwelling | 353 (14.3%) |
| Otherc | 67 (2.7%) |
| Urinalysis | |
| Urinalysis obtained | 2421 (98.4%) |
| Urinalysis Result | |
| Abnormal urinalysisd | 2313 (94.0%) |
| Positive LE and/or >5 WBC/hpf | 2264 (92.0%) |
| Positive nitrite | 966 (39.3%) |
| Documentation of reason for culturee | 1830 (74.4%) |
| Abnormal urinalysis | 543 (22.1%) |
| Altered mental status | 223 (9.1%) |
| Nausea, vomiting, abdominal pain | 199 (8.1%) |
| Changes in urine characteristics | 173 (7.0%) |
| Urine Pathogens | |
| Escherichia coli, n (%) | 1180 (47.9%) |
| Klebsiella spp, n (%) | 383 (15.6%) |
| Enterococcus spp, n (%) | 259 (10.5%) |
| Proteus spp, n (%) | 162 (6.6%) |
| Pseudomonas aeruginosa, n (%) | 108 (4.4%) |
| Enterobacter spp, n (%) | 77 (3.1%) |
| Citrobacter spp, n (%) | 69 (2.8%) |
| ≥2 bacteria | 394 (16.0%) |
| Treatment | |
| Received antibiotics | 1830 (74.4%) |
| First treatment by EM | 1253 (52.0%) |
| First treatment by inpatient clinician | 577 (23.4%) |
| Duration of therapy for those treated, median [IQR] N = 1744 | 6 [3–9] |
| Antibiotics on day 1 of treatmentf | |
| Ceftriaxone | 1418 (78.2%) |
| Fluoroquinoloneg | 153 (8.4%) |
| Antibiotics at Dischargeg | |
| Fluoroquinoloneg | 290 (30.2%) |
| Cephalexin | 263 (27.4%) |
| Trimethoprim/sulfamethoxazole | 92 (9.6%) |
| Cefuroxime | 77 (7.7%) |
| Nitrofurantoin | 52 (5.4%) |
| Amoxicillin | 48 (5.0%) |
Abbreviations: EM, emergency medicine clinician; IQR, interquartile range; LE, leukocyte esterase; N, number; WBC/hpf, white blood cells per high-power field.
aComorbidities are not mutually exclusive.
bDefined as human immunodeficiency virus positive with CD4 count greater than 200 cells/mm3, at least 30 days of prednisone 10 mg/day or more (or equivalent corticosteroid dose), on biologic agents (eg, tumor necrosis factor inhibitors), received chemotherapy in last 30 days, or congenital or acquired immunodeficiency.
cDefined as condom catheters, intermittent straight catheterization.
dDefined as presence of LE or >5 WBC/hpf and/or presence of nitrites.
eListed if greater than 5% of indications documented.
fListed if greater than 5% of total antibiotics prescribed to patients.
gLevofloxacin or ciprofloxacin.