1887

Abstract

Background

Urinary tract infection (UTI) contributes significantly to healthcare burden, accounting for 23 % of hospital acquired infections and 2–3 % of general practice consultations. Unfortunately, difficulties exist in obtaining an accurate diagnosis, with studies showing misdiagnosis rates above 40 % in elderly populations. Furthermore, numerous hospitals across the UK still advocate the use of Trimethoprim for UTI, despite high rates of resistance. These factors combined leads to a sub-optimal experience for patients.

Aim

We aimed to identify the practices surrounding the diagnosis and treatment of UTIs in elderly patients within Royal Bolton Hospital, a large district general hospital in the North-West of England. We also aimed to identify unique patterns of presentation of UTIs in elderly patients which could lead to diagnostic difficulty. Finally, we assessed local antibiotic resistance rates.

Methods

A retrospective case-note analysis of 100 patients, over the age of 65 years, diagnosed with UTI was carried out in 3 cycles between 2016–2018. The final cycle was conducted following removal of Trimethoprim from antibiotic guidance.

Results

Of patients diagnosed with UTI and had MSU (mid-stream urine) sample analysed, only 28.8 % displayed microbial growth. 39.1 % of patients with confirmed UTI displayed neither signs nor symptoms of UTI. 20 % diagnosed with UTI did not have a MSU sample requested. Resistance rates of 39.1 % were reported to Trimethoprim, with E. coli accounting for 56.5 % of all UTIs.

Conclusions

Diverse presentation and incomplete diagnostics contributes to misdiagnosis of UTI. Trimethoprim is not an effective treatment option and guidelines should reflect this.

Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.ac2019.po0272
2019-04-08
2020-01-22
Loading full text...

Full text loading...

http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.ac2019.po0272
Loading

Most cited articles

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error