Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-Acute and Long-Term Care Settings

Publication Date: January 15, 2020

Key Points

Key Points

Definitions of Urinary Tract Infections (UTIs):

  • Urinary tract infection (UTI) refers to an infection anywhere in the genitourinary tract.
    • Cystitis: urinary symptoms are usually confined to the bladder/lower urinary tract.
    • Pyelonephritis: More severe infection involving the renal parenchyma/upper urinary tract.
    • Catheter-associated urinary tract infection (CAUTI): UTIs that develop in individuals with an indwelling urinary catheter.
  • Asymptomatic bacteriuria (ASB5) refers to the presence of bacteria (in quantitative counts ≥10 cfu/mL) in an individual without signs or symptoms of infection that localize to the urinary tract. Individuals with ASB will have a positive urine culture with or without pyuria, defined as white blood cells on urinalyses.

Recognition

...cognition...

...: What are the Signs and Symptoms of UTIs?...

...Warning signs: Presence of...


...Which Symptoms Are No Longer Considered To Be...

...uating for other potential causes of non-specif...

...or odor of urine:Changes such as dark, clo...

...fall is not considered a symptom of a uri...

...l status:Current recommendations suggest that t...


Assessment

Assessmen...

...Criteria Are Available for the Diagnosis an...


...Should A Diagnostic Test Be Sent For A Poten...


STEP 5: What Are The Best Methods For Ur...


Treatment

Treatm...

...ize When To Initiate Empiric Antibiotics...


STEP 7: Choosing Empiric Antibiotics...


...P 8: De-Escalation of Antibiotics...


...ermining the Length of Therapy...


...able 1. Diagnosis and Treatment for Urinary Trac...


...Consensus Recommendations for Empirical Treatment...


Table 3. Factors That May Predispose Reside...


Monitoring

Monitor...

STEP 10: Monitoring of Individuals Wit...

...ive monitoring protocol includes frequent m...

...ample of an Active Monitoring Order Set

... Obtain vital signs (BP, Pul...


...itoring of Individuals Treated and At Risk...

...Monitor vital signs, oral intake,...


...toring the Nursing Home's Perf...

...cility’s Quality Measure report regarding...


Appendices

...pendices

...ppendix A: Loeb Minimum Criteria f...


...Suspected UTI SBAR Toolkit...


Appendix C: Internal Delphi Consens...


...ernal Delphi Consensus Criteria Decision Tool for...


...ppendix D: IOU Consensus Criteria Algor...


...ix E: Applying the CDC’s Core Elements...