The influence of mental status on reported local urinary tract symptoms in patients with bacteraemic urinary tract infections.
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
30
04
2020
accepted:
23
09
2020
pubmed:
30
9
2020
medline:
28
4
2021
entrez:
29
9
2020
Statut:
ppublish
Résumé
In elderly patients with a urinary tract infection, the influence of mental status on the frequency of local urinary tract symptoms is uncertain. We aim to compare the frequency of reported local urinary tract symptoms between mentally intact and cognitively impaired older people with a bacteraemic urinary tract infection. We retrospectively selected consecutive patients aged 65 years or older hospitalised in internal medicine departments in a regional hospital from 1 January 2015 to 31 December 2016 if they had identical bacteria isolated from blood and urine cultures. Mentally intact patients were those who were alert on admission and throughout their hospitalisation and without a prior or new diagnosis of dementia. Of 222 patients with a bacteraemic urinary tract infection, 125 (56.3%) did not have local urinary tract symptoms, 68.8% (86/125, 95% CI-60.7%-76.9%) cognitively impaired, compared with 40.2% (39/97, 95% CI-30.4%-50.7%) in those mentally intact (P < .001). The absence of local urinary tract symptoms in elderly patients with a bacteraemic urinary tract infection is less frequent but common in those mentally intact, and should not preclude the need for a urine culture or antibiotic therapy.
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13741Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
Rowe TA, Juthani-Mehta M. Diagnosis and management of urinary tract infection in older adults. Infect Dis Clin North Am. 2014;28:75-89.
Detweiler K, Mayers D, Fletcher SG. Bacteriuria and urinary tract infections in the elderly. Urol Clin North Am. 2015;42:561-568.
Nicolle LE, Gupta K, Colgan BSF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;2019:1611-1615.
Caterino JM, Ting SA, Sisbarro SG, Espinola JA, Camargo CAJ. Age, nursing home residence, and presentation of urinary tract infection in U.S. Emergency Departments, 2001-2008. Acad Emergency Med. 2012;19:1173-1180.
High KP, Bradley SF, Mehr GS, et al. Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis. 2008;2009:149-171.
Choosing Wisely. An initiative of the ABIM foundation. http://www.choosingwisely.org/societies/american-geriatrics-society/. Accessed November 19, 2019.
Arnold SH, Jensen JN, Kousgaard MB, Siersma V, Bjerrum L, Holm A. Reducing antibiotic prescriptions for urinary tract infection in nursing homes using a complex tailored intervention targeting nursing home staff: protocol for a cluster randomized controlled trial. JMIR Res Protoc. 2020;9:e17710.
Woodford HJ, Graham C, Meda M, Miciuleviciene J. Bacteremic urinary tract infection in hospitalized older patients-are any currently available diagnostic criteria sensitive enough? J Am Geriatr Soc. 2011;59:567-568.
Woodford HJ, George J. Diagnosis and management of urinary tract infection in hospitalized older people. J Am Geriatr Soc. 2009;57:107-114.
Shimoni Z, Glick J, Hermush V, Froom P. Sensitivity of the dipstick in detecting bacteremic urinary tract infections in elderly hospitalized patients. PLoS One. 2017;12:e0187381.
Bååth C, Hall-Lord ML, Idvall E, Wiberg-Hedman K, Wilde LB. Interrater reliability using Modified Norton Scale, Pressure Ulcer Card, Short Form-Mini Nutritional Assessment by registered and enrolled nurses in clinical practice. J Clin Nurs. 2008;17:618-626.
Shimoni Z, Cohen R, Froom P. Prevalence, impact, and management strategies for asymptomatic bacteriuria in the acute care elderly patient: a review of the current literature. Expert Rev Anti Infect Ther. 2020;18:453-460.