Acceptability of Proposed Stewardship Interventions to Reduce Preoperative Screening and Treatment of Asymptomatic Bacteriuria

Kimberly C Dukes; Kalpana Gupta; Julia Friberg Walhof; Madisen E Brown; Judith Strymish; Dan Suh; William J O'Brien; Jeffrey Chan; Brice Beck; Vanessa Au; Heather Schacht Reisinger; Marin L Schweizer

doi:10.1016/j.ajic.2025.08.005

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Acceptability of Proposed Stewardship Interventions to Reduce Preoperative Screening and Treatment of Asymptomatic Bacteriuria

Journal article

Peer reviewed

Acceptability of Proposed Stewardship Interventions to Reduce Preoperative Screening and Treatment of Asymptomatic Bacteriuria

Kimberly C Dukes, Kalpana Gupta, Julia Friberg Walhof, Madisen E Brown, Judith Strymish, Dan Suh, William J O'Brien, Jeffrey Chan, Brice Beck, Vanessa Au, …

American journal of infection control, Vol.53(11), pp.1131-1136

11/2025

DOI: 10.1016/j.ajic.2025.08.005

PMID: 40803553

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Abstract

The IDSA Clinical Practice guidelines do not recommend screening patients for asymptomatic bacteriuria (ASB) before non-urological surgeries. We conducted semi-structured interviews at 5 Veterans Affairs hospitals about the acceptability of 4 prospectively identified potential interventions to de-implement routine preoperative urine testing for ASB: substitution of another infection prevention intervention, lab restrictions on ordering urine tests, audit and feedback on guideline concordance, and interactive workshops. We coded responses as acceptable, not acceptable, or possibly acceptable, and noted recommendations for modifications. We interviewed 35 clinicians. Clinicians expressed concerns about de-implementing routine urine testing for specific procedures and specialties. Some actively sought to identify and treat ASB. Interviewees found audit and feedback and substitution of different infection-control practices most acceptable. Interviewees suggested changes to make interventions more acceptable or feasible and identified new potential interventions. Understanding clinical decision-making about preoperative urine screening and treatment can help design effective interventions to facilitate guideline concordance and support antibiotic stewardship. Interventions to optimize preoperative urine screening and treatment may require tailoring for surgical specialties and should address clinical concerns about intervention feasibility. Developing a suite of interventions could allow sites to choose intervention(s) that would work for them.

de-implementation

Stewardship

urine testing

Asymptomatic Bacteriuria

Details

Title: Subtitle: Acceptability of Proposed Stewardship Interventions to Reduce Preoperative Screening and Treatment of Asymptomatic Bacteriuria
Creators: Kimberly C Dukes - University of Iowa
Kalpana Gupta - VA Boston Healthcare System
Julia Friberg Walhof - University of Iowa, Internal Medicine
Madisen E Brown - VA Boston Healthcare System
Judith Strymish - VA Boston Healthcare System
Dan Suh - Iowa City VA Health Care System
William J O'Brien - VA Boston Healthcare System
Jeffrey Chan - VA Boston Healthcare System
Brice Beck - Iowa City VA Health Care System
Vanessa Au - Iowa City VA Health Care System
Heather Schacht Reisinger - University of Iowa
Marin L Schweizer - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: American journal of infection control, Vol.53(11), pp.1131-1136
DOI: 10.1016/j.ajic.2025.08.005
PMID: 40803553
NLM abbreviation: Am J Infect Control
ISSN: 0196-6553
eISSN: 1527-3296
Publisher: MOSBY-ELSEVIER
Language: English
Electronic publication date: 08/11/2025
Date published: 11/2025
Academic Unit: Epidemiology; Center for Social Science Innovation; General Internal Medicine; Community and Behavioral Health; Internal Medicine
Record Identifier: 9984946840702771

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