- Urine culture susceptibility can accurately predict blood culture susceptibility in patients with bacteremic urinary tract infection (UTI) when pathogen isolate is the same.
- Earlier, targeted treatment might reduce broad-spectrum antibiotic exposure.
Why this matters
- Use urine culture susceptibility results to select/streamline antibiotic therapy in hospitalized patients with bacteremic UTI when same pathogen is isolated in blood cultures, and susceptibility results pending.
- 428 patients with bacteremic UTI with matching urine-blood culture pairs.
- 98.5% (4734/4807) urine/blood concordant antimicrobial susceptibility test results included.
- Urine culture predictability for blood culture susceptibility: 0.99 (95% CI, 0.98-0.99) sensitivity, 0.98 (95% CI, 0.97-0.99) specificity, and 0.99 (95% CI, 0.99-1.00) and 0.95 (95% CI, 0.93-0.96) positive and negative predictive value, respectively.
- Time from specimen receipt to susceptibility results for urine and blood cultures (based on 15 consecutive Escherichia coli isolate culture pairs) was 46.0 and 61.7 hours, respectively (time difference: 15.7 hours; 95% CI, 8.7-22.7, P<.001>
- Retrospective chart review evaluating value of urine culture susceptibility for predicting blood culture results in patients with bacteremic UTI.
- Funding: None disclosed.
- Limited to patients with presumed UTI source.
- Future technology might attenuate time advantage.