Skip to main content

Table 3 Description of bacteriuria cases diagnosed by long-term care providers and signs/symptoms endorsed

From: Development and validation of an algorithm to recalibrate mental models and reduce diagnostic errors associated with catheter-associated bacteriuria

Case

Culture results

Diagnosis based on guideline criteria

Comments

Guideline-consistent diagnoses (%)

Guideline-concordant signs/symptoms endorsed (Number of clinicians)

Guidelines-discordant signs/symptoms endorsed (Number of clinicians)

1

>105 CFU/mL Klebsiella Pneumoniae

CA-ABU

Systemic leukocytosis, receiving systemic corticosteroids

6 (60%)

Urinary symptoms incorrectly identified as present (1)

Pyuria (5)

Lack of fever (6)

Leukocytosis (7)

 

Elderly/frail patient (5)

 

Weakness (3)

 

Organism number (1)

2

<104 CFU/mL gram positive organisms

CA-UTI

Fever of 103.3 degrees, and no other source identified

4 (40%)

Lack of urinary symptoms (2)

Pyuria (3)

 

Leukocytosis (4)

Fever (6)

Organism type (3)

Delirium (3)

Elderly/frail patient (5)

Hematuria (3)

Isolated Organisms (3)

3

>105 CFU/mL E. coli; and >103 - <105 CFU/mL Klebsiella oxytoca

CA-ABU

Leg weakness, no symptoms of urinary tract infection

1 (10%)

 

Pyuria (3)

Leukocytosis (7)

Organism type (6)

Elderly/frail patient (5)

Weakness (6)

Patient fall (5)

History of UTIs (3)

4

>105 CFU/mL Candida albicans

CA-ABU

No symptoms of urinary tract infection

10 (100%)

Presence of respiratory symptoms [alternate cause] (4)

Lack of leukocytosis/mild Leukocytosis (3)

Lack of fever (3)

Organism type (6)

Intact mental status (2)

Elderly/frail patient [likely to colonized candida] (3)

No urinary symptoms (2)

 

Total

  

21 (53%)

 

Leukocytosis, pyuria, frailty cited by 3-7 respondents in every case

  1. CA-ABU= catheter associated asymptomatic bacteriuria, CA-UTI catheter associated urinary tract infection.