@article{mbs:/content/journal/acmi/10.1099/acmi.0.000224, author = "Duncan, Donald Brody and Vincent, Yasmeen Marbaniang and Main, Cheryl", title = "Purposeful microbiology comment added to urine cultures with Staphylococcus aureus increases orders for follow-up blood cultures", journal= "Access Microbiology", year = "2021", volume = "3", number = "4", pages = "", doi = "https://doi.org/10.1099/acmi.0.000224", url = "https://www.microbiologyresearch.org/content/journal/acmi/10.1099/acmi.0.000224", publisher = "Microbiology Society", issn = "2516-8290", type = "Journal Article", keywords = "blood culture", keywords = "comment", keywords = "urine", keywords = "bacteriuria", keywords = "Staphylococcus aureus", eid = "000224", abstract = " Introduction. Patients with Staphylococcus aureus bacteriuria (SABU) often have underlying invasive disease, including S. aureus bacteremia (SAB). It has been proposed that most patients with SABU should have a blood culture done to rule out SAB. A preliminary audit suggested that our local hospitals had a low rate of follow-up blood culture orders for patients with SABU. In response to this, our microbiology laboratory changed the comment appended to urine cultures with growth of S. aureus to make a more assertive link between SABU and SAB and to recommend follow-up blood cultures. Aim. We designed a retrospective quasi-experimental study to see if the change in microbiology comment wording had an effect on clinician behaviour. We hypothesized that this simple comment change to make a more assertive link between SABU and SAB would lead to an increase in follow-up blood culture orders. Methodology. We used microbiology records to identify adult patients with urine cultures positive for Staphylococcus aureus at three acute-care hospitals in Hamilton, Ontario, Canada, for 1 year pre- and post-intervention. We recorded urine and blood culture results, timing, patient demographics, and in-hospital mortality. Results. A total of 243 adult patients with urine cultures with S. aureus were identified for inclusion. The primary outcome was met, as there was a significant increase in blood culture orders between the pre-intervention and post-intervention groups (66.9 % vs 80.4 %). This difference was mainly driven by an increase for emergency department and urgent care patients (30.6 % vs 63.6 %). The inpatient group had a high baseline rate of blood culture orders that did not change significantly (80.0 % vs 84.7 %). There was no significant change in detection of SAB (23.5 % vs 32.7 %) or inpatient mortality (18.0 % vs 24.7 %). Conclusion. Our study shows that a simple, purposeful comment appended to urine cultures with S. aureus leads to a significant increase in follow-up blood culture orders.", }