Quality standard

Quality statement 3: Laboratory reporting – differentiation of E. coli and non-E. coli organisms

Quality statement 3: Laboratory reporting – differentiation of E. coli and non-E. coli organisms

Quality statement

Infants, children and young people with a urinary tract infection caused by coliform bacteria have results of microbiology laboratory testing differentiated by Escherichia coli (E. coli) or non-E. coli organisms.

Rationale

Most urine infections are caused by E. coli bacteria, which belong to a group of bacteria called coliforms.

If a urinary tract infection is caused by a non-E. coli coliform or any other type of bacteria, there is an increased risk of serious underlying pathology. NICE guidance recommends that infants, children and young people (under 16 years) with atypical urinary tract infection (which includes infection with non-E. coli organisms) should have ultrasound of the urinary tract during the acute infection. It is therefore important that laboratory test reports differentiate between E. coli and non-E. coli organisms to identify whether further investigations are needed.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that microbiology laboratories detecting coliform bacteria as a cause of a urinary tract infection report results differentiated by E. coli or non-E. coli organisms.

Data source: Local data collection.

Process

Proportion of infants, children and young people with a urinary tract infection caused by coliform bacteria who have results of microbiology laboratory testing differentiated by E. coli or non-E. coli organisms.

Numerator – the number of people in the denominator who have results of microbiology laboratory testing differentiated by E. coli or non-E. coli organisms.

Denominator – the number of infants, children and young people (under 16 years) with a urinary tract infection caused by coliform bacteria.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for infants, children and young people with a urinary tract infection caused by coliform bacteria to have results of microbiology laboratory testing differentiated by E. coli or non-E. coli organisms.

Healthcare practitioners ensure that infants, children and young people with a urinary tract infection caused by coliform bacteria have results of microbiology laboratory testing differentiated by E. coli or non-E. coli organisms.

Commissioners ensure that they commission services for infants, children and young people with a urinary tract infection caused by coliform bacteria that report results of microbiology laboratory testing differentiated by E. coli or non-E. coli organisms.

Infants, children and young people under 16 with a urinary tract infection caused by coliform bacteria (a type of bacteria that usually live in the digestive system) have laboratory test results that show whether these bacteria were E. coli or not, to identify whether further investigations are needed.

Source guidance

Derived from definitions of atypical urinary tract infection as outlined in the NICE guideline on urinary tract infection in under 16s: diagnosis and management.

Definitions of terms used in this quality statement

The NICE guideline on urinary tract infection in under 16s specifies atypical causes of urinary tract infection, and includes non-E. coli organisms as an atypical cause in infants, children and young people.