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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.
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