Houston Health Department
Asymptomatic Bacteriuria — A Community Case Study
The Houston Health Department has made it a priority to address antibiotic resistance and stewardship by working collaboratively with members of the healthcare community.
In conjunction with infectious diseases experts from the Houston Health Department, the Antimicrobial Stewardship Executive Committee formed a joint learning collaborative in 2017-2018 to work on an asymptomatic bacteriuria stewardship project.
Asymptomatic Bacteriuria (ASB) is one of the most common reasons for inappropriate antibiotic use in hospitalized patients. Treatment itself may be associated with subsequent antimicrobial resistance, adverse drug effects, and cost.
The goal of the project was to engage with healthcare professionals across facilities within the Houston area to work collaboratively to help reduce unnecessary testing and treatment of ASB. The project was guided by Dr. Barbara Trautner as the subject matter expert who provided case-based feedback and intervention tools which include the “Kicking UTI” algorithm.
Participating facilities included:
|Susan Loughlin, PharmD, BCPS||TIRR – Memorial Hermann|
|Ardath Mitchell, PharmD, BCPS, RN||Memorial Hermann — Katy Hospital|
|Shimeka Edwards, PharmD||Memorial Hermann Rehabilitation Hospital — Katy|
|Christy Su, PharmD, BCPS||Memorial Hermann Greater Heights|
|Punit J. Shah, PharmD, BCPS||Houston Methodist Sugarland|
|Nancy N. Vuong, PharmD, MBIOT, BCPS||Memorial Hermann Memorial City Medical Center|
|Chris Huls, PharmD, BCPS||Houston Methodist West|
|Shivani Patel, PharmD, BCPS||Memorial Hermann Southwest Hospital|
Pre-project ASB treatment rates were 61% and post-project ASB treatment rates were 24% (for three of the sites), representing a 37% decrease in ASB treatment. In addition, two health systems that participated in the study utilized the information obtained from the project to work with their laboratory departments to change testing practices by increasing the threshold of urine white blood cells required in the sample before reflex to testing for the presence of bacteria.