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Research Letter
Less Is More
April 29, 2019

Association of Increased Colony-Count Threshold for Urinary Pathogens in Hospitalized Patients With Antimicrobial Treatment

Author Affiliations
  • 1Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
  • 2Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 3Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 4Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
JAMA Intern Med. 2019;179(7):990-992. doi:10.1001/jamainternmed.2019.0188

Treatment of asymptomatic bacteriuria and candiduria (ASB/C) remains a leading reason for unnecessary antimicrobial use among hospitalized patients, yet the optimal colony-count threshold for identifying and reporting growth from inpatient urine cultures (UCs) is unknown.1-3 Two prior studies suggest that UC growth from hospitalized patients with low colony counts of organisms (104 to 105 CFU [colony-forming units]/mL) was infrequently associated with urinary tract infection (UTI) but generated substantial antimicrobial prescribing for ASB/C.2,3

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