Abstract
Background
Overdiagnosis of urinary tract infections (UTIs) is one of the most common reasons for the unnecessary use of antibiotics in nursing homes, increasing the risk of missing serious conditions. Various decision tools and algorithms aim to aid in UTI diagnosis and the initiation of antibiotic therapy for residents. However, due to the lack of a clear reference standard, these tools vary widely and can be complex, with some requiring urine testing. As part of the European-funded IMAGINE project, aimed at improving antibiotic use for UTIs in nursing home residents, we have reviewed the recommendations.
Objectives
This review provides a comprehensive summary of the more relevant tools and algorithms aimed at identifying true UTIs among residents living in nursing homes and discusses the challenges in using these algorithms based on updated research.
Sources
The discussion is based on a relevant medical literature search and synthesis of the findings and published tools to provide an overview of the current state of improving the diagnosis of UTIs in nursing homes.
Content
The following topics are covered: prevalence of asymptomatic bacteriuria, diagnostic challenges, clinical criteria, urinary testing, and algorithms to be implemented in nursing home facilities.
Overdiagnosis of urinary tract infections (UTIs) is one of the most common reasons for the unnecessary use of antibiotics in nursing homes, increasing the risk of missing serious conditions. Various decision tools and algorithms aim to aid in UTI diagnosis and the initiation of antibiotic therapy for residents. However, due to the lack of a clear reference standard, these tools vary widely and can be complex, with some requiring urine testing. As part of the European-funded IMAGINE project, aimed at improving antibiotic use for UTIs in nursing home residents, we have reviewed the recommendations.
Objectives
This review provides a comprehensive summary of the more relevant tools and algorithms aimed at identifying true UTIs among residents living in nursing homes and discusses the challenges in using these algorithms based on updated research.
Sources
The discussion is based on a relevant medical literature search and synthesis of the findings and published tools to provide an overview of the current state of improving the diagnosis of UTIs in nursing homes.
Content
The following topics are covered: prevalence of asymptomatic bacteriuria, diagnostic challenges, clinical criteria, urinary testing, and algorithms to be implemented in nursing home facilities.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Clinical Microbiology and Infection |
| Vol/bind | 30 |
| Udgave nummer | 12 |
| Sider (fra-til) | 1523-1528 |
| Antal sider | 6 |
| ISSN | 1198-743X |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:We would like to acknowledge the contribution of the other members of the IMAGINE project: Anders Bjerrum, Ana Garc\u00EDa-Sangen\u00EDs, Daniela Modena, Ramon Monf\u00E0, and Rosa Morros Pedr\u00F3s, from IDIAP; Athina Chalkidou and Tina Marloth, from the Department of Clinical Microbiology at Copenhagen University Hospital; Susanne D\u00F8ssing Berntsen, Nina Camilla D\u00F8ssing-Poulsen, Anders Munck, Jonas Kanstrup Olsen, and Asbj\u00F8rn Tang Hall, from University of Southern Denmark; Beatriz Gonz\u00E1lez L\u00F3pez-Valc\u00E1rcel, Ana Squaglia, Marina Elistratova, and Laura Vallejo-Torres, from the University of Las Palmas; Marilena Anastasaki, Agapi Angelaki, Maria-Nefeli Karkana, Christos Lionis, Elena Petelos and Greta Tsoulchai, from University of Crete; Andr\u00E1s Balint, Ria Benk\u0151, from Szeged University; Laura \u00C1lvarez, Sergi Briones, and Marta Ricart, from the Spanish Society of Family Medicine; Maciej Godycki-Cwirko, from the Medical University of Lodz; Jozef Glasa and Helena Glasov\u00E1, from the Slovak Medical University; and Lina Jaruseviciene and Ruta Radzeviciene, from Ltd Mano Seimos Gydytojas.
Publisher Copyright:
© 2024 The Author(s)