Developing a user-friendly report for electronically assisted surveillance of catheter-associated urinary tract infection.

Catheter-associated urinary tract infection (CAUTI) surveillance is labor intensive, generally involving manual medical record review. We developed a prototype automated report through iterative design. Surveys and qualitative interviews were administered to key stakeholders to assess the report design.

Survey finds improvement in cognitive biases that drive overtreatment of asymptomatic bacteriuria after a successful antimicrobial stewardship intervention.

Background: Lack of guideline knowledge and cognitive biases are barriers that drive overtreatment of catheter-associated asymptomatic bacteriuria (ASB). We explored whether providers' knowledge and attitudes toward management of ASB differed before and after a multifaceted guidelines implementation intervention, reported elsewhere.

Methods: We surveyed providers' knowledge of guidelines, cognitive-behavioral constructs, and self-reported familiarity with the relevant Infectious Diseases Society of America guidelines.

Decreased microbiota diversity associated with urinary tract infection in a trial of bacterial interference.

Background: Patients with long-term indwelling catheters are at high risk of catheter-associated urinary tract infection (CAUTI). We hypothesized that colonizing the bladder with a benign Escherichia coli strain (E. coli HU2117, a derivative of E.

Overtreatment of asymptomatic bacteriuria: identifying provider barriers to evidence-based care.

Background: Inappropriate use of antibiotics to treat asymptomatic bacteriuria (ASB) is a significant contributor to antibiotic overuse in hospitalized patients despite evidence-based guidelines on ASB management. We surveyed whether accurate knowledge of how to manage catheter-associated urine cultures was associated with level of training, familiarity with ASB guidelines, and various cognitive-behavioral constructs.

Methods: We used a survey to measure respondents' knowledge of how to manage catheter-associated bacteriuria, familiarity with the content of the relevant Infectious Diseases Society of America guidelines, and cognitive-behavioral constructs.

Quality gaps in documenting urinary catheter use and infectious outcomes.

Objective: To describe the frequency of use of all types of urinary catheters, including but not limited to indwelling catheters, as well as positive cultures associated with the various types. We also determined the accuracy of catheter-days reporting at our institution.

Design: Prospective, observational trial based on patient-level review of the electronic medical record.

Overtreatment of enterococcal bacteriuria.

Background: The purposes of this study were to investigate the clinical outcomes of enterococcal bacteriuria and to determine whether current management is adherent to Infectious Diseases Society of America guidelines.

Methods: We conducted a retrospective medical record review of patients from 2 academic teaching hospitals for 3 months (September 1 through November 30, 2009). Patients were classified as having urinary tract infection (UTI) or asymptomatic bacteriuria (ABU) by applying the guidelines.