Antibiotic screening of urine culture a useful quality audit

Abstract number: P640

Interpretation of urine cultures depends on various factors. Antibiotic history is an important factor that affects the performance of urine cultures in the laboratory. We decided to test the urine specimens for antibiotics and compare it with the request forms sent to our laboratory. The technique, incidence, implications, involved in processing of specimens with incomplete antibiotic history received in the laboratory are discussed. This internal audit practice stresses the need for quality requests which play a major role in the clinical interpretation of culture specimens.

Material and Method: Detection of antibacterial substance in the urine. We modified the Urine Antibacterial Substance Assay (UABA), a technique described by Sombrero L et al by using two Muller Hinton agars each inoculated with a lawn culture of standard strains of Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923.

Results: A total of 14680 consecutive urine specimens for culture and sensitivity received in the laboratory during the study period from 1st July 2008–30th June 2009 were tested with the UABA assay. 2494 (16.99%) samples yielded positive cultures. 388 (2.64%) samples were positive for UABA of which 165 (42.53%) were received from the out patient departments (OPD) and 223 (57.5%) from the wards. Of the positive samples of UABA 222 (57.22%) had antibiotic history written on the requisition form and 208 (93.7%) of the samples reported no growth. Compliance to writing antibiotic history in the wards 183 (82.1%) was higher than OPD's 39 (23.64%). 115 (29.6%) of the positive UABA had pus cells >5/HPF.

Conclusion: A periodic internal audit of antibiotic assay in urine cultures provides baseline data permitting blind assessment of areas of culture based clinical diagnostic work that are not readily amenable to other quality assurance methods. It raises awareness to the importance of quality and patient safety issues involved with history taking using an evidence-based protocol and aids in the review of validating physicians' compliance with an established protocol. Reaudit interventional strategies can be planned, as part of a continuous quality improvement program to affect change in physicians' practices when there is a drop from established benchmark. This can lead to overall quality improvement in the process of care and save valuable financial resources.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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