Urinary tract infection diagnosis and response to therapy in long-term care facilities: a prospective, observational study

Penney, Carla (2017) Urinary tract infection diagnosis and response to therapy in long-term care facilities: a prospective, observational study. Masters thesis, Memorial University of Newfoundland.

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Abstract

Background: Urinary tract infection (UTI) is common, often over-diagnosed, in long-term care (LTC) facilities and a source of inappropriate antibiotic prescription. Objectives: (1) Establish factors associated with a nurse’s decision to send a urine culture (UC), and if those factors were associated with a positive culture result; (2) to determine if antimicrobial therapy is associated with functional improvement. Method(s): 101 LTC residents were prospectively identified and assessed after submission of a urine specimen for culture. Logistic regression was performed to identify variables associated with a positive culture result. Result(s): Change in behaviour, dysuria, and change in character of urine were the three main reasons for UC collection. Male sex and change in mental status were the only significant predictors of culture positivity. Treatment did not lead to significant improvement in ADL score. Conclusion: UCs obtained from LTC residents is often not appropriate and antibiotic treatment of residents from whom urine specimens are obtained does not lead to functional improvement.

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