From the Research
For urinalysis (UA) or urine culture (UCx) showing Bacillus species non-anthracis, treatment should only be initiated if clinical symptoms of urinary tract infection are present, such as dysuria, frequency, urgency, or systemic symptoms, as these species often represent contamination rather than true infection. The decision to treat is based on the presence of symptoms, as asymptomatic patients may not require antibiotic treatment 1.
Key Considerations
- Bacillus species are gram-positive, spore-forming bacteria commonly found in the environment, which explains why they frequently appear as contaminants in urine specimens 1.
- Proper collection technique for repeat specimens can help distinguish between contamination and true infection.
- If treatment is necessary, empiric options may include trimethoprim-sulfamethoxazole (TMP-SMX), ciprofloxacin, or amoxicillin-clavulanate, but the choice of antibiotic should be guided by local resistance patterns and patient-specific factors 1.
Prevention of CAUTI
- The greatest modifiable risk factor for developing a CAUTI is duration of catheterization, including initial indwelling catheter placement when it may not otherwise be necessary 1.
- Alternatives to indwelling urinary catheters, such as intermittent straight catheterization and the use of external catheters, should be considered in applicable patients.
- Aseptic insertion technique and maintenance should be performed if an indwelling urinary catheter is required.
Treatment Approach
- Empiric treatment with antibiotics should be reserved for patients with symptoms of urinary tract infection, as the presence of Bacillus species non-anthracis in urine often represents contamination rather than true infection 1.
- The choice of antibiotic and duration of treatment should be guided by clinical guidelines, local resistance patterns, and patient-specific factors.