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Am J Infect Control. 2018 Jan;46(1):67-72. doi: 10.1016/j.ajic.2017.07.002. Epub 2017 Aug 23.

Urinary tract infection surveillance in residential aged care.

Author information

1
Infection Control and Epidemiology Unit, Monash Health, Clayton, Victoria, Australia. Electronic address: sue.ryan@monashhealth.org.
2
Infection Control and Epidemiology Unit, Monash Health, Clayton, Victoria, Australia.
3
Infection Control and Epidemiology Unit, Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia; Department of Medicine, Monash University, Clayton, Victoria, Australia; National Centre for Antimicrobial Stewardship, Melbourne, Victoria, Australia.

Abstract

OBJECTIVES:

The aim of this research was to determine the prevalence of urinary tract infections (UTIs) in 2 aged care homes (ACHs) and examine the extent to which presumed UTIs met the 2012 McGeer infection surveillance definitions.

DESIGN:

Retrospective observational study.

SETTING:

Two ACHs: a 30-bed facility and a 100-bed facility PARTICIPANTS: Residents of the 2 ACHs diagnosed with UTI.

METHODS:

A retrospective review was conducted of UTIs clinically diagnosed at the 2 facilities over a 16-month period, utilizing surveillance and microbiologic data, resident progress notes, and medication charts. This data was reviewed to determine how many diagnosed UTIs met the revised McGeer definitions.

RESULTS:

Overall, 119 UTIs were diagnosed in 57 residents over 16 months. Only 7 of the diagnosed UTIs met the McGeer definitions. Forty-seven did not meet the clinical evidence, 17 did not meet the microbiologic evidence, and 48 did not meet either surveillance criteria.

CONCLUSIONS:

This study demonstrated the disparity between the clinical diagnosis of UTI and the surveillance definitions for UTI, and highlights the limitations of the McGeer definitions in those with cognitive or communication deficits. There is an urgent need for antimicrobial stewardship programs and education in the ACH setting.

KEYWORDS:

Antimicrobial stewardship; Asymptomatic bacteriuria; McGeer definitions

PMID:
28844374
DOI:
10.1016/j.ajic.2017.07.002
[Indexed for MEDLINE]

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