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RI Hospital: Nearly half of older women diagnosed with UTI not confirmed in urine culture
Date:4/22/2013

PROVIDENCE, R.I. Older adults represent an important and growing demographic in emergency departments (ED) across the country, with urinary tract infections (UTIs) being one of the leading causes for ED visits. In fact, UTIs, which can progress to serious health concerns, are the fourth most common diagnosis in women over age 65. But a new study at Rhode Island Hospital has found that many such women receive treatment for a UTI, but have no firm evidence of such an infection, resulting in the prescribing of unnecessary antibiotics. The study is published online in advance of print in the Journal of the American Geriatrics Society.

The study, conducted by Leonard Mermel, D.O., medical director of the department of epidemiology and infection control at Rhode Island Hospital, and his colleagues found that collection of urine to rule in, or rule out, a UTI in this patient population is best done by inserting a temporary catheter into the bladder to collect the specimen rather than collecting urine by the so-called 'clean catch' method. Researchers found the latter method more often leads to contamination of the urine specimen.

"Our study had two important findings: elderly women presenting to emergency departments are often presumed to have a UTI and are treated as such, despite a lack of supportive evidence, and that collecting urine by the so-called 'clean catch' method more often leads to contamination of the urine specimen," Mermel said.

Often, a clinician in an emergency department will base a UTI diagnosis in great part on the patient's symptoms, particularly in older women for whom UTIs are common. While the patient will have completed a urinalysis, often by clean catch, the results are typically not available during the patient's visit to the emergency department. Therefore, the clinician will often prescribe antibiotics to treat the UTI, despite the fact that a diagnosis is not definitive.

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Contact: Ellen Slingsby
eslingsby@lifespan.org
401-444-6421
Lifespan
Source:Eurekalert

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