Mohammad Ourani, a USF College of Public Health (COPH) DrPH candidate concentrating in public health and clinical laboratory science and practice, is lead author of the article “Evaluation of Evidence-Based Urinalysis Reflex to Culture Criteria: Impact on Reducing Antimicrobial Usage.” The article, co-authored by the COPH’s Dr. Jill Roberts and others, was published in the International Journal of Infectious Diseases in October.

“Urinalysis reflex criteria ​is a tool used to screen urine to predict positive cultures,” says Ourani, director of laboratory services at PIH Health in Whittier, Calif. “The purpose of implementing this criterion is to reduce unnecessary urine cultures and to prevent the inappropriate use of antibiotics.”

According to the Centers for Disease Control and Prevention (CDC), antimicrobial resistance (which occurs when germs become impervious to the drugs designed to kill them) is one of the “biggest public health challenges of our time.” The CDC reports that every year in the US, 2.8 million people get an antibiotic-resistant infection and more than 38,000 of them will die. 

Ourani and his fellow researchers note that urinary tract infections are one of the leading human infections that require antibiotic treatment, and, thus, can be big contributors to antibiotic misuse. They also note that many labs rely on outdated urinalysis techniques, which have a high false-positive rate.

“When evidence-based urinalysis reflex criteria was used, it significantly decreased the number of urine cultures performed,” said Ourani, “and that significantly decreased the number of patients inappropriately treated with antibiotics.”

In fact, say Ourani and his fellow researchers, the number of patients inappropriately treated with antibiotics could potentially go from 45.1 percent to just 9 percent.

The bottom line?

“This article showed that applying evidence-based reflex criteria in a clinical laboratory setting can improve diagnostics tests, provide quality of test results and decrease the inappropriate use of antibiotics,” explained Ourani. “And that, consequently, leads to improved patient outcomes.”

Story by Donna Campisano, USF College of Public Health