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:5/27/2017)... ... 27, 2017 , ... From May 21-23, hearing healthcare professionals gained a competitive ... at the Marriott Syracuse Downtown Hotel in Syracuse, New York. , As EarQ’s ... hearing healthcare providers to help them stay ahead in the industry. At the event, ...
(Date:5/26/2017)... ... May 26, 2017 , ... Leading CEOs from biotech, ... 30th and 31st at The Four Seasons Hotel Boston. , The Boston ... sciences, offering exclusive access to key decision makers who influence deal making and ...
(Date:5/26/2017)... ... May 26, 2017 , ... A new analysis of ... the healthiest seniors are located in the Midwest. With the average cost of healthcare ... people are concerned with both the quality and affordability of where they live. An ...
(Date:5/26/2017)... ... ... After raising nearly $30,000 on Kickstarter , about three-times its original ... discounted crowdfunding price on Indiegogo . , “Along with creating an anti-stress gadget ... a fidget toy to the market that was made of superior quality and wouldn’t ...
(Date:5/26/2017)... ... May 26, 2017 , ... Dr. Alex Rabinovich, a highly-skilled ... a new, informational blog post on insurance options. If a Bay Area patient has ... help save time and money. Visiting an in-network provider for a second opinion can ...
Breaking Medicine News(10 mins):
(Date:5/22/2017)... N.Y. , May 22, 2017  Lilac ... treatment Gene-Eden-VIR/Novirin, announces the launch of a ... English, the results of a clinical study that ... year treatment with Gene-Eden-VIR/Novirin in individuals suffering from ... to note that there are no other treatments ...
(Date:5/15/2017)... , May 15, 2017  Amy Baxter MD, ... industry leader in noninvasive pain relief, was awarded a ... magazine. Baxter was recognized at the MM&M Top ... New York City on May 10, 2017. ... the biopharma industry go "beyond the pill."  ...
(Date:5/10/2017)... May 10, 2017 Hologic, Inc. (Nasdaq: ... for the fiscal second quarter ended April 1, 2017 ... $1.84 increased 666.7% compared to the prior year period ... in a significant gain, while non-GAAP diluted EPS of ... or 3.8% in constant currency terms.  Excluding the effects ...
Breaking Medicine Technology: