1161. Frequency of Urine Cultures, their Positivity, and CAUTI: Analysis of a Large Health System

Abstract

Abstract Background Hospitalized patients with bacteriuria are often identified based on positive urine cultures during the workup of urinary tract infection (UTI). However, the frequency of obtaining urine cultures varies between hospitals and may affect the detection of asymptomatic bacteriuria and symptomatic UTI. Methods We evaluated the frequency of urine cultures, their positivity and any association to CAUTI in the inpatient setting (excluding emergency department) of 53 hospitals during 2017 and 2018. Total inpatient urine cultures, positive urine cultures and positive urine cultures identified >2 days post-admission were normalized to patient-days. In addition, the rates of positive urine cultures >2 days post-admission were compared per institution to the corresponding CAUTI SIR. We compared small (75,000 patient-days per year). Results A total of 238,451 urine cultures were obtained in 53 hospitals over a period of 2 years with bacteriuria detected in 97,138 (40.74%). Hospitals varied in how often urine cultures were obtained, the % of positive urine cultures, and positive urine cultures per 10,000 patient-days (table). Medium size hospitals had significantly higher number of cultures per 10,000 compared with large hospitals (mean difference= 191; P = 0.006), while % positives were significantly lower (mean difference= -8.4; P = 0.02). There was no significant association between the rate of positive urine cultures >2 days after admission and CAUTI SIR (figure). Conclusion Our findings underscore the importance of addressing appropriate urine culturing as part of the infection workup in the hospital setting. A lower detection of bacteriuria after 2 days of admission did not necessarily result in a reduction of CAUTI, reflecting the importance of working on a better identification of patients likely to have a urinary tract infection. Disclosures All authors: No reported disclosures.