Modified Reporting of Positive Urine Cultures Collected From Long Term Care

Study Overview
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Brief Summary
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Asymptomatic bacteriuria (AB) is a condition in which bacteria are detected in urine culture without urinary symptoms. The inappropriate use of antibiotic treatment for AB selects bacterial flora to express resistance mutations. Reducing inappropriate antibiotic use for AB is difficult, since the microbiology laboratory cannot distinguish patients with AB. The investigators study will use a restricted laboratory report requesting the physician to call the laboratory for culture results. The restricted report may reduce the rate of inappropriate treatment of AB.

Detailed Description
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Positive urine cultures during the study period will be randomized to restricted microbiology laboratory reporting or standard microbiology laboratory reporting. Physician or patient consent will not be collected. Patient records will be assessed by the investigator to determine if patients have AB or urinary tract infection. Physician antibiotic treatment decision in both groups will be collected.

Official Title
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Modified Reporting of Positive Urine Cultures Collected From Long Term Care, a Randomized Controlled Trial

Conditions
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Urinary Tract Infections, Asymptomatic Bacteriuria

Intervention / Treatment
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* Behavioral: Modified Report


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Consecutive positive urine cultures collected from patients admitted to Long term care facilities will be included. All methods of urine collection will be included (midstream, in-and-out catheterization, indwelling catheter). Exclusion Criteria: Positive urine cultures not collected from Long term care facility patients Pregnancy Antibiotic treatment at the time of collection Patients known to have blood neutrophils <1.0 within 7 days of urine collection
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Modified Reporting<br>Microbiology laboratory will report Positive urine cultures may represent asymptomatic bacteriuria or urinary tract infection. If urinary tract infection is suspected clinically, please call 777-xxxx (researcher mobile phone) for identification and susceptibility results | Behavioral: Modified Report<br>* An abbreviated version of the microbiology report indicating that growth is present and the physician should call the lab for further details if clinically important.<br>* Other names: Restricted Report;|
| No Intervention: Standard Reporting<br>Microbiology laboratory will report identification and susceptibility results | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of asymptomatic bacteriuria treated with antibiotics and urinary tract infection treated with antibiotics | Appropriate treatment | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adverse events | Bacteremia or death | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Long term care, Urine culture