A retrospective comparison of guidelines to assess hospital-diagnosed urinary tract infection in nursing home residents
A retrospective comparison of guidelines to assess hospital-diagnosed urinary tract infection in nursing home residents
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DOI：
10.1016/j.ajic.2021.04.001
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发表时间：
2021-10-22
影响因子：
4.9
通讯作者：
Lee, Shoou-Yih D.
中科院分区：
文献类型：
--
作者：
Cooper, Denise L.;Buterakos, Roxanne;Lee, Shoou-Yih D.
背景资料：不适当的抗生素治疗尿路感染（UTI）在疗养院（NH）的居民是常见的，并有助于抗生素耐药性。已发表的指南旨在提高UTI的准确评估，诊断和治疗。本研究评估了NH住院居民诊断为UTI的记录，同时比较了库珀工具和斯通标准，是否支持适当的治疗。研究方法：使用电子病历（EMR）数据进行了回顾性图表审查，这些数据来自3个住院3年以上被诊断为UTI的NH居民。使用库珀工具和斯通标准评估治疗适当性。结果如下：在79例接受UTI治疗的住院患者中，11例（13.9%）根据库珀工具进行了适当治疗，9例（11.4%）根据斯通进行了适当治疗。9例病例符合2项标准，包括100%使用导管的病例。72%的居民进行了尿分析，24%的居民有文化和敏感性的记录。结论：使用两种工具的适当UTI治疗率较低，但使用导管的治疗率要高得多。未来的研究是必要的，以验证这些工具在医院环境中的使用，有可能提高治疗的准确性和减少不必要的抗生素使用。(c)2021感染控制和流行病学专业人员协会爱思唯尔公司出版All rights reserved.
Background: Inappropriate antibiotic treatments for urinary tract infection (UTI) in nursing home (NH) residents are common and contribute to antibiotic resistance. Published guidelines aim to improve accurate assessment, diagnosis, and treatment of UTIs. This study assessed whether records from hospitalized NH residents diagnosed with UTI, while comparing the Cooper Tool and Stone criteria, supported appropriate treatment. Methods: A retrospective chart review was conducted using electronic medical record (EMR) data from residents of 3 NHs who were diagnosed with UTI when hospitalized over a 3-year period. The Cooper Tool and Stone criteria were used to assess treatment appropriateness. Results: Of 79 hospitalized residents treated for UTI, 11 (13.9%) were appropriately treated according to the Cooper Tool and 9 (11.4%) according to Stone. The 2 criteria agreed in 9 of the cases including 100% of those with catheters. Urinalysis was documented in 72% of residents and 24% had documentation of culture and sensitivity. Conclusions: Appropriate UTI treatment rates using both tools were low but much higher in those with catheters. Future research is necessary to validate the use of these tools in the hospital setting which have the potential to improve treatment accuracy and reduce unnecessary antibiotics use. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.