Prospective evaluation of the management of urinary tract infections in 134 French nursing homes

Médecine et maladies infectieuses
L LemoineS Alfandari

Abstract

Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. Of 397 contacted facilities, 134 participated and informed 444 UTI episodes. Reported diagnostic criteria were burning urination (32%), malodorous urine (29%), confusion (28%), and turbid urine (19%). Twenty-one percent of diagnoses were based on erroneous criteria. Less than 50% of residents had a urine dipstick test performed and 94% a urine culture. The main pathogen was Escherichia coli. Reported indications were uncomplicated cystitis (32%), unspecified UTI (26%), complicated cystitis (9%), while no reason was given in 25% of cases. Only 10% of diagnoses were consistent with the guidelines: complicated cystitis (49%), asymptomatic bacteriuria (21%), acute pyelonephritis (21%), male UTI (9%). Almost 85% of prescriptions were active on the isolated bacteria. The empirical antibiotic therapy was consistent...Continue Reading

Citations

Apr 14, 2020·Journal of the American Medical Directors Association·Aaron M OgletreeDeborah Perfetto
Aug 26, 2020·Journal of the American Medical Directors Association·Anna Song BeeberPhilip D Sloane

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