Sean Mayne1, Pär-Daniel Sundvall2,3, Ronny Gunnarsson1,2,3. 1. Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia. 2. Närhälsan Research and Development Unit, Primary Health Care and Dental Care, Southern Alvsborg County, Region Vastra Gotaland, Sweden. 3. Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, Goteborg University, Gothenburg, Sweden.
Abstract
OBJECTIVES: To quantify the prevalence of documented urinary tract infection (UTI), nonspecific symptoms, and antibiotic treatment of suspected UTI in nursing homes (NHs) in the tropics and to describe the typical resident likely to receive antibiotic treatment for suspected UTI and factors associated with the development of confusion, fatigue, and restlessness. DESIGN: Cross-sectional. SETTING: Five far north Queensland NHs in tropical Australia. PARTICIPANTS: NH residents (N = 450). MEASUREMENTS: Chart reviews of NH residents between August 28, 2015, and June 21, 2016, to determine the prevalence of documented UTI, new or worsening nonspecific and specific symptoms that are specific or nonspecific to the urinary tract, antibiotic use, medical conditions, and medication factors. RESULTS: UTI accounted for 33% of all current infections treated with antibiotics and 40% of all infections treated with antibiotics within the last 30 days. One in 5 NH residents had received antibiotics within the last 30 days, of which 45% were for UTI. The most significant factors independently associated with antibiotics for UTI were urinary catheter (OR = 13, 95% CI = 2.4-67, P = .003), urinary frequency (OR = 10, 95% CI = 2.2-47, P = .003), fever (OR = 10, 95% CI = 1.3-85, P = .028), new-onset hypotension (OR = 10, 95% CI = 1.4-73, P = .024), and confusion (OR = 8.9, 95% CI = 3.1-26, P < .001). Of these, confusion was the most prevalent factor in the population. CONCLUSION: UTI is commonly documented in NH residents, with new or worsening confusion being one of the strongest factors associated with antibiotic treatment for suspected UTI.
OBJECTIVES: To quantify the prevalence of documented urinary tract infection (UTI), nonspecific symptoms, and antibiotic treatment of suspected UTI in nursing homes (NHs) in the tropics and to describe the typical resident likely to receive antibiotic treatment for suspected UTI and factors associated with the development of confusion, fatigue, and restlessness. DESIGN: Cross-sectional. SETTING: Five far north Queensland NHs in tropical Australia. PARTICIPANTS: NH residents (N = 450). MEASUREMENTS: Chart reviews of NH residents between August 28, 2015, and June 21, 2016, to determine the prevalence of documented UTI, new or worsening nonspecific and specific symptoms that are specific or nonspecific to the urinary tract, antibiotic use, medical conditions, and medication factors. RESULTS: UTI accounted for 33% of all current infections treated with antibiotics and 40% of all infections treated with antibiotics within the last 30 days. One in 5 NH residents had received antibiotics within the last 30 days, of which 45% were for UTI. The most significant factors independently associated with antibiotics for UTI were urinary catheter (OR = 13, 95% CI = 2.4-67, P = .003), urinary frequency (OR = 10, 95% CI = 2.2-47, P = .003), fever (OR = 10, 95% CI = 1.3-85, P = .028), new-onset hypotension (OR = 10, 95% CI = 1.4-73, P = .024), and confusion (OR = 8.9, 95% CI = 3.1-26, P < .001). Of these, confusion was the most prevalent factor in the population. CONCLUSION: UTI is commonly documented in NH residents, with new or worsening confusion being one of the strongest factors associated with antibiotic treatment for suspected UTI.
Authors: Esther A R Hartman; Wim G Groen; Silje Rebekka Heltveit-Olsen; Morten Lindbæk; Sigurd Høye; Pär-Daniel Sundvall; Ingmarie Skoglund; Egill Snaebjörnsson Arnljots; Ronny Gunnarsson; Anna Kowalczyk; Maciek Godycki-Cwirko; Katarzyna Kosiek; Tamara N Platteel; Alma C van de Pol; Theo J M Verheij; Annelie A Monnier; Cees M P M Hertogh Journal: Age Ageing Date: 2022-06-01 Impact factor: 12.782
Authors: Sif Helene Arnold; Jette Nygaard Jensen; Marius Brostrøm Kousgaard; Volkert Siersma; Lars Bjerrum; Anne Holm Journal: JMIR Res Protoc Date: 2020-05-08