Fernández-García Silvia, Monfà Ramon, Jiménez Cristina Miranda, Giner-Soriano Maria, Gómez Frederic, Moragas Ana
Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain; Universitat de Girona, Girona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.
Aten Primaria. 2025 Jan 11;57(7):103208. doi: 10.1016/j.aprim.2024.103208.
Studies evaluating urine culture requests in our country have highlighted a high rate of requests that fall outside the indications specified in clinical guidelines. We evaluated the current degree of inadequacy in the request of urine cultures and how this influences the therapeutic decisions of general practitioners.
Cross-sectional descriptive study.
Three primary care centres in Tarragona area.
Urine culture requests from the adult population≥18 years old, received at the Microbiology Service of the reference hospital in 2022. All requests were made in primary care settings.
The collected variables included sociodemographic data, urinary tract infection (UTI) symptoms at the time of the urine culture request, comorbidities, reason for the request (including diagnosis), type of urine culture, therapeutic approach before and after receiving the result, and the urine culture result.
A total of 461 urine cultures were reviewed: 152 men (mean age 64.1 years) and 309 women (mean age 57 years). Of the urine cultures analyzed, 17.4% were for cystitis (22% in women), 2.4% for pyelonephritis, 1.3% for complicated UTIs, and 1.5% for asymptomatic bacteriuria. In 10.6%, they were for recurrent UTIs; in 9.6%, post-treatment. In 55.5% of cases, general practitioners continued without antibiotic treatment, regardless of urine culture results. The reason to request was unknown in 18.9%. Antibiotic changes occurred in 5.6%.
There is still a high rate of urine culture over-requesting in primary care, with 20% of cultures being ordered for otherwise uncomplicated UTIs. While the methodology of the project does not allow for causal analysis, it provides a detailed description of clinical practices in primary care.
评估我国尿液培养检查申请情况的研究表明，超出临床指南规定指征的申请率很高。我们评估了当前尿液培养检查申请的不适当程度，以及这如何影响全科医生的治疗决策。
横断面描述性研究。
塔拉戈纳地区的三个初级保健中心。
2022年在参考医院微生物科收到的来自≥18岁成年人群的尿液培养检查申请。所有申请均在初级保健机构提出。
收集的变量包括社会人口统计学数据、尿液培养检查申请时的尿路感染（UTI）症状、合并症、申请原因（包括诊断）、尿液培养类型、收到结果前后的治疗方法以及尿液培养结果。
共审查了461份尿液培养检查申请：152名男性（平均年龄64.1岁）和309名女性（平均年龄57岁）。在分析的尿液培养检查申请中，膀胱炎占17.4%（女性为22%），肾盂肾炎占2.4%，复杂性UTI占1.3%，无症状菌尿占1.5%。10.6%是复发性UTI的申请；9.6%是治疗后的申请。在55.5%的病例中，无论尿液培养结果如何，全科医生都继续不使用抗生素治疗。18.9%的申请原因不明。抗生素更换率为5.6%。
初级保健中尿液培养检查申请过度的比率仍然很高，20%的培养检查是针对原本不复杂的UTI进行的。虽然该项目的方法不允许进行因果分析，但它详细描述了初级保健中的临床实践。
