Urinary tract infection surveillance in residential aged care

Publication date: Available online 23 August 2017
Source:American Journal of Infection Control
Author(s): Susan Ryan, Elizabeth Gillespie, Rhonda L. Stuart
ObjectivesThe 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.DesignRetrospective observational study.SettingTwo ACHs: a 30-bed facility and a 100-bed facilityParticipantsResidents of the 2 ACHs diagnosed with UTI.MethodsA 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.ResultsOverall, 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.ConclusionsThis 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.



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