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Urinary tract infection diagnosis and response to therapy in long-term care: A prospective observational study.

Daley P, Penney C, Wakeham S, Compton G, McKim A, O'Keefe J, Barrett B, Nicolle L - Can J Infect Dis Med Microbiol (2015 May-Jun)

Bottom Line: Treatment did not lead to improvement in activities of daily living scores at two days or seven days.Significant growth cannot be well predicted based on clinical variables; thus, the decision to submit urine is somewhat arbitrary.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Memorial University, Winnipeg, Manitoba;

ABSTRACT

Background: The prevalence of asymptomatic bacteriuria among residents of long-term care (LTC) facilities is high, and is a source of inappropriate antibiotic prescription.

Objective: To establish symptoms and signs associated with a positive urine culture, and to determine whether antibiotic therapy is associated with functional improvement.

Methods: A total of 101 LTC patients were prospectively observed after submission of urine for culture.

Results: The culture positivity rate was consistent with the expected asymptomatic bacteriuria rate. Change in mental status and male sex were associated with culture positivity. Treatment decisions were not consistent with culture results. Treatment did not lead to improvement in activities of daily living scores at two days or seven days.

Discussion: Significant growth cannot be well predicted based on clinical variables; thus, the decision to submit urine is somewhat arbitrary. Because urine culture testing and treatment does not lead to functional improvement, restricting access to the test may be reasonable.

Conclusion: Urine culture testing in LTC facilities does not lead to functional improvement.

No MeSH data available.


Related in: MedlinePlus

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f1-idmm-26-133: Participant recruitment

Mentions: A total of 174 urine specimens were considered, and 101 episodes from 101 patients were observed (Figure 1). Thirty-eight (37.6%) of 101 episodes demonstrated significant growth of bacteria in urine. In 36.6% of episodes, the nurse making the decision to collect urine was interviewed; in other episodes, alternate nurses also familiar with the patient were interviewed. Patient demographics are summarized in Table 1. The mean (± SD) age was 84.0±8.6 years, 79.2% were women and there were a mean of 1.8±1.0 comorbidities per patient. Baseline ADL score was 11.9±8.7, with zero representing total independence and 28 representing total dependence.


Urinary tract infection diagnosis and response to therapy in long-term care: A prospective observational study.

Daley P, Penney C, Wakeham S, Compton G, McKim A, O'Keefe J, Barrett B, Nicolle L - Can J Infect Dis Med Microbiol (2015 May-Jun)

Participant recruitment
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507838&req=5

f1-idmm-26-133: Participant recruitment
Mentions: A total of 174 urine specimens were considered, and 101 episodes from 101 patients were observed (Figure 1). Thirty-eight (37.6%) of 101 episodes demonstrated significant growth of bacteria in urine. In 36.6% of episodes, the nurse making the decision to collect urine was interviewed; in other episodes, alternate nurses also familiar with the patient were interviewed. Patient demographics are summarized in Table 1. The mean (± SD) age was 84.0±8.6 years, 79.2% were women and there were a mean of 1.8±1.0 comorbidities per patient. Baseline ADL score was 11.9±8.7, with zero representing total independence and 28 representing total dependence.

Bottom Line: Treatment did not lead to improvement in activities of daily living scores at two days or seven days.Significant growth cannot be well predicted based on clinical variables; thus, the decision to submit urine is somewhat arbitrary.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Memorial University, Winnipeg, Manitoba;

ABSTRACT

Background: The prevalence of asymptomatic bacteriuria among residents of long-term care (LTC) facilities is high, and is a source of inappropriate antibiotic prescription.

Objective: To establish symptoms and signs associated with a positive urine culture, and to determine whether antibiotic therapy is associated with functional improvement.

Methods: A total of 101 LTC patients were prospectively observed after submission of urine for culture.

Results: The culture positivity rate was consistent with the expected asymptomatic bacteriuria rate. Change in mental status and male sex were associated with culture positivity. Treatment decisions were not consistent with culture results. Treatment did not lead to improvement in activities of daily living scores at two days or seven days.

Discussion: Significant growth cannot be well predicted based on clinical variables; thus, the decision to submit urine is somewhat arbitrary. Because urine culture testing and treatment does not lead to functional improvement, restricting access to the test may be reasonable.

Conclusion: Urine culture testing in LTC facilities does not lead to functional improvement.

No MeSH data available.


Related in: MedlinePlus