Journal article Open Access
Brown, Kevin Antoine;
Daneman, Nick;
Schwartz, Kevin L.;
Langford, Bradley;
McGeer, Allison;
Quirk, Jacquelyn;
Diong, Christina;
Garber, Gary
<?xml version='1.0' encoding='utf-8'?> <rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#" xmlns:adms="http://www.w3.org/ns/adms#" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dct="http://purl.org/dc/terms/" xmlns:dctype="http://purl.org/dc/dcmitype/" xmlns:dcat="http://www.w3.org/ns/dcat#" xmlns:duv="http://www.w3.org/ns/duv#" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:frapo="http://purl.org/cerif/frapo/" xmlns:geo="http://www.w3.org/2003/01/geo/wgs84_pos#" xmlns:gsp="http://www.opengis.net/ont/geosparql#" xmlns:locn="http://www.w3.org/ns/locn#" xmlns:org="http://www.w3.org/ns/org#" xmlns:owl="http://www.w3.org/2002/07/owl#" xmlns:prov="http://www.w3.org/ns/prov#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:schema="http://schema.org/" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:vcard="http://www.w3.org/2006/vcard/ns#" xmlns:wdrs="http://www.w3.org/2007/05/powder-s#"> <rdf:Description rdf:about="https://zenodo.org/record/3666982"> <rdf:type rdf:resource="http://www.w3.org/ns/dcat#Dataset"/> <dct:type rdf:resource="http://purl.org/dc/dcmitype/Text"/> <dct:identifier rdf:datatype="http://www.w3.org/2001/XMLSchema#anyURI">https://zenodo.org/record/3666982</dct:identifier> <foaf:page rdf:resource="https://zenodo.org/record/3666982"/> <dct:creator> <rdf:Description rdf:about="http://orcid.org/0000-0002-1483-2188"> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <dct:identifier rdf:datatype="http://www.w3.org/2001/XMLSchema#string">0000-0002-1483-2188</dct:identifier> <foaf:name>Brown, Kevin Antoine</foaf:name> <foaf:givenName>Kevin Antoine</foaf:givenName> <foaf:familyName>Brown</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>Daneman, Nick</foaf:name> <foaf:givenName>Nick</foaf:givenName> <foaf:familyName>Daneman</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>Schwartz, Kevin L.</foaf:name> <foaf:givenName>Kevin L.</foaf:givenName> <foaf:familyName>Schwartz</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>Langford, Bradley</foaf:name> <foaf:givenName>Bradley</foaf:givenName> <foaf:familyName>Langford</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>McGeer, Allison</foaf:name> <foaf:givenName>Allison</foaf:givenName> <foaf:familyName>McGeer</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>Quirk, Jacquelyn</foaf:name> <foaf:givenName>Jacquelyn</foaf:givenName> <foaf:familyName>Quirk</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>Diong, Christina</foaf:name> <foaf:givenName>Christina</foaf:givenName> <foaf:familyName>Diong</foaf:familyName> </rdf:Description> </dct:creator> <dct:creator> <rdf:Description> <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/> <foaf:name>Garber, Gary</foaf:name> <foaf:givenName>Gary</foaf:givenName> <foaf:familyName>Garber</foaf:familyName> </rdf:Description> </dct:creator> <dct:title>The Urine-culturing Cascade: Variation in Nursing Home Urine Culturing and Association With Antibiotic Use and Clostridiodes difficile Infection</dct:title> <dct:publisher> <foaf:Agent> <foaf:name>Zenodo</foaf:name> </foaf:Agent> </dct:publisher> <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#gYear">2019</dct:issued> <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#date">2019-06-14</dct:issued> <owl:sameAs rdf:resource="https://zenodo.org/record/3666982"/> <adms:identifier> <adms:Identifier> <skos:notation rdf:datatype="http://www.w3.org/2001/XMLSchema#anyURI">https://zenodo.org/record/3666982</skos:notation> <adms:schemeAgency>url</adms:schemeAgency> </adms:Identifier> </adms:identifier> <owl:sameAs rdf:resource="https://doi.org/10.1093/cid/ciz482"/> <dct:description>Background: Rates of antibiotic use vary widely across nursing homes and cannot be explained by resident characteristics. Antibiotic prescribing for a presumed urinary tract infection is often preceded by inappropriate urine culturing. We examined nursing home urine-culturing practices and their association with antibiotic use. Methods We conducted a longitudinal, multilevel, retrospective cohort study based on quarterly nursing home assessments between April 2014 and January 2017 in 591 nursing homes and covering &gt;90% of nursing home residents in Ontario, Canada. Nursing home urine culturing was measured as the proportion of residents with a urine culture in the prior 14 days. Outcomes included receipt of any systemic antibiotic and any urinary antibiotic (eg, nitrofurantoin, trimethoprim/sulfonamides, ciprofloxacin) in the 30 days after the assessment and Clostridiodes difficile infection in the 90 days after the assessment. Adjusted Poisson regression models accounted for 14 resident covariates. Results: A total of 131 218 residents in 591 nursing homes were included; 7.9% of resident assessments had a urine culture in the prior 14 days; this proportion was highly variable across the 591 nursing homes (10th percentile = 3.4%, 90th percentile = 14.3%). Before and after adjusting for 14 resident characteristics, nursing home urine culturing predicted total antibiotic use (adjusted risk ratio [RR] per doubling of urine culturing, 1.21; 95% confidence interval [CI], 1.18–1.23), urinary antibiotic use (RR, 1.33; 95% CI, 1.28–1.38), and C. difficile infection (incidence rate ratio, 1.18; 95% CI, 1.07–1.31). Conclusions Nursing homes have highly divergent urine culturing rates; this variability is associated with higher antibiotic use and rates of C. difficile infection.</dct:description> <dct:accessRights rdf:resource="http://publications.europa.eu/resource/authority/access-right/PUBLIC"/> <dct:accessRights> <dct:RightsStatement rdf:about="info:eu-repo/semantics/openAccess"> <rdfs:label>Open Access</rdfs:label> </dct:RightsStatement> </dct:accessRights> <dcat:distribution> <dcat:Distribution> <dcat:accessURL rdf:resource="https://zenodo.org/record/3666982"/> </dcat:Distribution> </dcat:distribution> <dcat:distribution> <dcat:Distribution> <dcat:accessURL>https://doi.org/10.1093/cid/ciz482</dcat:accessURL> <dcat:byteSize>576123</dcat:byteSize> <dcat:downloadURL>https://zenodo.org/record/3666982/files/article.pdf</dcat:downloadURL> <dcat:mediaType>application/pdf</dcat:mediaType> </dcat:Distribution> </dcat:distribution> </rdf:Description> </rdf:RDF>
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