Navigation Links
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.

The researchers studied the medical records of 153 older women who were diagnosed with a UTI during a visit to an emergency department. They found that only 57 percent of the 153 women who were given a diagnosis of a UTI actually had urine cultures that confirmed the diagnosis. Of the remaining patients whose urine studies did not confirm a UTI, 95 percent were administered or prescribed antibiotics in the ED. Inappropriate antibiotic use in the ED setting for presumed UTIs has been associated with antimicrobial resistance and undesired side-effects as antibiotics are the second leading class of drugs to cause adverse events, such as diarrhea due to Clostridium difficile (C-diff), in patients over age 65.

"Ultimately, we found that a large proportion of older women were overdiagnosed and overtreated for UTI," Mermel said. "Physicians assessing such patients cannot rely on non-specific symptoms such as confusion to confirm a diagnosis of UTI. More widespread use of straight catheterization in this patient population may reduce false-positive results of urine studies, thereby reducing unnecessary antibiotic exposure and may prompt clinicians to assess these patients for other etiologies to explain their symptoms."

Researchers said that further study must be conducted to determine if straight catheterization is truly the better method for obtaining urine for culture in this patient population, and to identify other strategies that will improve the accuracy of the diagnosis.


'/>"/>

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

Related medicine news :

1. RI Hospital: Co-infections not associated with worse outcomes during H1N1 pandemic
2. RI Hospital: Traumatic brain injury worsens outcomes for those with nonepileptic seizures
3. RI Hospital: Radiation can be reduced while maintaining high quality in CT colonography
4. RI Hospital: Standardized road test results differ from older adults natural driving
5. RI Hospital: Near-complete blood flow restoration critical for best outcomes in stroke
6. Many Test Results Left Unread as Patients Leave Hospital: Study
7. Inhaled Steroids Lead to Big Drop in Asthma Deaths at Texas Hospital: Study
8. Nearly 30 percent of women fail to pick up new prescriptions for osteoporosis, study finds
9. Fosamax Lawsuit Update: Bernstein Liebhard LLP Notes Nearly 2,600 Claims Alleging Fosamax Femur Fractures, Other Side Effects, Pending in New Jersey State Litigation
10. Causes of migraines nearly impossible to determine
11. Nearly 30 Percent of Americans Have High Blood Pressure: CDC
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... ... March 24, 2017 , ... Texas Physical Therapy Specialists (TexPTS) is ... 9618 Huebner Road. The clinic is the group’s 7th location in San Antonio and ... Higgins, PT, will provide care from the clinic, which opened March 22, 2017. ...
(Date:3/24/2017)... ... 24, 2017 , ... As the standards bearer of advanced ... that positions them as the go-to thought leader in all matters concerning oncology ... an always-on, always-fresh news, views and advocacy engine, called ONS Voice. , The ...
(Date:3/24/2017)... ... March 24, 2017 , ... ... ) announced their partnership to prep patients for colonoscopy at the HyGIeaCare® Center ... in 87th Ave., Miami, FL. , The HyGIeaCare® Prep, cleared by ...
(Date:3/24/2017)... ... March 24, 2017 , ... “Vintage and Harvest A ... minister and college Bible teacher residing in North Carolina with his wife, Anna Marie. ... blessed them with six grandchildren. David is also the author of “Shadow and Substance.” ...
(Date:3/23/2017)... (PRWEB) , ... March 23, 2017 , ... The physicians ... location in the greater Houston Area. The new location is located at 2255 E. ... Hospital in Springwoods Village. This newest location will provide patients living in the north ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... , March 24, 2017   The ... organization within medical affairs in the pharmaceutical industry ... the chair of a newly formed scientific advisory ... members to form the first ever medical affairs ... For more information about the ACMA, please visit  ...
(Date:3/24/2017)... FinancialBuzz.com News Commentary   ... Medical cannabis products around the world are projected to gain popularity. A ... market will reach a value of USD 55.8 billion by 2025. ... growing industry. By the end of 2016, 28 states have now laws ... conservative states like Arkansas and North ...
(Date:3/24/2017)... , March 24, 2017 A ReportsnReports.com report ... been growing rapidly as the global sales of Adcetris and Kadcyla ... in the antibody drug conjugates market is driven by large number ... and wider therapeutic window offered by ADCs. ... Browse 3 Tables and 94 Figures, 10 ...
Breaking Medicine Technology: