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 (ASB) refers to the presence of bacteria (in quantitative counts ≥105 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...

...the Signs and Symptoms of UTIs?...

...arning signs: Presence of warn...


...P 2: Which Symptoms Are No Longer Considered To...

...evaluating for other potential causes of non-spec...

...or or odor of urine:Changes such as dar...

...not considered a symptom of a urinary...

...mental status:Current recommendations suggest th...


Assessment

...ssessment

...hich Criteria Are Available for the Diagnosis a...


...4: When Should A Diagnostic Test Be Sent For A Po...


...What Are The Best Methods For Urine...


Treatment

...reatment

...gnize When To Initiate Empiric Antibi...


...Choosing Empiric Antibiotics...


...Escalation of Antibiotics...


...EP 9: Determining the Length of Therapy...


...osis and Treatment for Urinary Tract Infections...


...Consensus Recommendations for Empirical Treat...


Table 3. Factors That May Predispose Re...


Monitoring

...nitoring...

...toring of Individuals With a Change in Conditi...

...itoring protocol includes frequent monito...

...an Active Monitoring Order Set...

...❑ Obtain vital signs (BP, Pulse, Resp Rat...


...onitoring of Individuals Treated and At Risk for...

...or vital signs, oral intake, cognition and func...


...P 12: Monitoring the Nursing Home...

...w the facility’s Quality Measure report...


Appendices

...pendices

Appendix A: Loeb Minimum Criteria for...


...pendix B: Suspected UTI SBAR Toolkit...


...Internal Delphi Consensus Criteria Decis...


...dix C: Internal Delphi Consensus Criteria Decision...


...dix D: IOU Consensus Criteria Algorithm...


...x E: Applying the CDC’s Core Elemen...