Urinary tract infection diagnosis and response to therapy in long-term care: A prospective observational study
| Autor: | Glenda Compton, Brendan J. Barrett, Susan Wakeham, Peter Daley, Lindsay E. Nicolle, Carla Penney, Aaron McKim, Judy O’Keefe |
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| Přispěvatelé: | University of Manitoba |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Microbiology (medical)
Pediatrics medicine.medical_specialty Response to therapy Urinary system Infectious and parasitic diseases RC109-216 urologic and male genital diseases Microbiology Long-term care Diagnosis medicine Asymptomatic bacteriuria Antibiotic stewardship Urinary tract infection business.industry Infection diagnosis Antibiotic prescription QR1-502 Infectious Diseases Antibiotic Stewardship Observational study Original Article business |
| Zdroj: | The Canadian Journal of Infectious Diseases & Medical Microbiology Canadian Journal of Infectious Diseases and Medical Microbiology, Vol 26, Iss 3, Pp 133-136 (2015) |
| ISSN: | 1918-1493 1712-9532 |
| Popis: | Urinary tract infections are common in long-term care facilities. However, these infections may actually be overdiagnosed in this setting due to factors such as a high rate of asymptomatic culture positivity, altered mental status and dehydration among residents of long-term care facilities, which can lead to inappropriate prescription of antibiotics. The authors of this study aimed to assess the symptoms associated with positive urine cultures, prescription of antibiotics and response to antibiotic treatments. 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. |
| Databáze: | OpenAIRE |
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