Bacteremic UTI: urine culture susceptibility predicts blood culture results

  • Lam PW & al.
  • Antimicrob Agents Chemother
  • 15 Oct 2018

  • curated by Liz Scherer
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.


  • 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.

Key results

  • 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>

Study design

  • 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.
  • Nongeneralizable.
  • Future technology might attenuate time advantage.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.