Olson Jared, Anella Vincent, Webb Brandon J, Pavia Andrew T, Thorell Emily A, Hersh Adam L, Waters Dustin
Division of Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Department of Pharmacy, Primary Children's Hospital, Salt Lake City, UT, USA.
Antimicrob Steward Healthc Epidemiol. 2025 Jul 17;5(1):e157. doi: 10.1017/ash.2025.10067. eCollection 2025.
bacteriuria (SABU) may represent bacteremia in a subset of patients. We describe the impact of a microbiology alert recommending follow-up blood cultures (FUBC) for patients with SABU in a large integrated health system.
We conducted a quasi-experimental implementation study in adult ambulatory patients with documented SABU. We excluded patients with confirmed SAB up to 14 days prior to index SABU culture and with blood cultures obtained on the day of SABU. The primary outcome was rate of FUBC (collected between 1 and 5 days of SABU) among all cases of SABU. Secondary outcomes included percentage of patients with early SAB (collected between 1 and 5 days of SABU). We used interrupted time series analysis to compare rates of FUBC pre vs postintervention.
A total of 2 540 patients were identified; 1 213 (48%) were male. By the end of the postintervention period, the rate of FUBC (20.6%) had increased by 6.3 percentage points ( = .005) compared to the counterfactual (14.2%) had no intervention taken place (44.5% relative increase). Early SAB detection due to FUBC increased from .6% preintervention to 2.0% postintervention ( = .004).
The microbiology alert initiative increased FUBC in patients with SABU by 44%, but the overall rate of FUBC remained low. The intervention increased early SAB detection. Risk-targeted strategies are needed to optimize FUBC collection in patients with SABU.
菌尿症（SABU）在部分患者中可能代表菌血症。我们描述了一项微生物学警报对大型综合医疗系统中患有SABU的患者推荐进行后续血培养（FUBC）的影响。
我们对有记录的成年门诊SABU患者进行了一项准实验性实施研究。我们排除了在索引SABU培养前14天内确诊为SAB的患者以及在SABU当天进行血培养的患者。主要结局是所有SABU病例中FUBC的发生率（在SABU的1至5天内采集）。次要结局包括早期SAB患者的百分比（在SABU的1至5天内采集）。我们使用中断时间序列分析来比较干预前后FUBC的发生率。
共确定了2540例患者；其中1213例（48%）为男性。到干预后期结束时，与未进行干预的反事实情况（14.2%）相比，FUBC的发生率（20.6%）增加了6.3个百分点（P = 0.005）（相对增加44.5%）。由于FUBC导致的早期SAB检测率从干预前的0.6%增加到干预后的2.0%（P = 0.004）。
微生物学警报倡议使SABU患者的FUBC增加了44%，但FUBC的总体发生率仍然较低。该干预措施增加了早期SAB的检测。需要采用风险靶向策略来优化SABU患者的FUBC采集。
