Resumo

LOPEZ, JAIME ALBERTO et al. Increment in positive urine cultures in a fourth level attention hospital. Infect. [online]. 2006, vol.10, n.1, pp.15-21. ISSN 0123-9392.

Goal: To determine if the implementation of educative and administrative interventions with respect to the use of screening tests increases the proportion of positive urocultures, in comparison with the absence of using these interventions. Design: The study is a prospective, analytical study. Place: Hospital Pablo Tobón Uribe, Medellín, Colombia. Population: 25.766 urocultures obtained from 1998 to 2005. Methods: some educative and administrative actions were taken to increase the positivity of the requestes urocultures. All data from ordered urocultures were registered. The ordered Gram stains in hospitalized patients and patients who attended the emergency unit that were hospitalized, the positive urocultures of the recommended ones, those requested directly by the medical practitioners, and services. Results: Gram stain percentage without centrifugation for uroculture in hospitalized patients increased from 0.7% in 1998 to 32.1% in 2005 ( p = 0.000). Urocultures were positive in 79.4% of the cases when they were done by laboratory recommendation, whereas positivity of directly requested cultures was of 27.9% ( p = 0.000). The total percentage of positive urocultures in 1998 for hospitalized patients was 29.7%, and in 1999-2005 was 40.3% ( c² = 74.95; p = 0.000), period when the microbiology laboratory intervened actively. Positive urocultures from requested for adult and pediatric emergency patients increased from 34% and 15% in 1998 to 66% and 30% in 2005, respectively; in other hospitalization services the percentage increased from 26% to 40%. Conclusions: The percentage of positive urocultures may increase if the knowledge derived from the study of the corresponding screening tests is applied to the clinical practice.

Palavras-chave : urine; diagnosis; cystitis; laboratory techniques and procedures; bacteriuria; routine diagnostic tests; pyelonephritis.