Clinical Features to Identify Urinary Tract Infection in Nursing Home Residents: A Cohort Study
作者： Manisha Juthani-Mehta , Vincent Quagliarello , Eleanor Perrelli , Virginia Towle , Peter H. Van Ness
DOI: 10.1111/J.1532-5415.2009.02227.X
关键词: Cohort study 、 Intensive care medicine 、 Urinary system 、 Urinalysis 、 Relative risk 、 Pyuria 、 Urine 、 Bacteriuria 、 Dysuria 、 Medicine 、 Internal medicine
摘要: OBJECTIVES: To identify clinical features associated with bacteriuria plus pyuria in noncatheterized nursing home residents clinically suspected urinary tract infection (UTI). DESIGN: Prospective, observational cohort study from 2005 to 2007. SETTING: Five New Haven, Connecticut area homes. PARTICIPANTS: hundred fifty-one each followed for 1 year the development of UTI. MEASUREMENTS: The combined outcome (>100,000 colony forming units urine culture) (>10 white blood cells urinalysis). RESULTS: After 178,914 person-days follow-up, 228 participants had 399 episodes UTI a urinalysis and culture performed; 147 (36.8%) pyuria. were dysuria (relative risk (RR)=1.58, 95% confidence interval (CI)=1.10–2.03), change character (RR=1.42, CI=1.07-1.79), mental status (RR=1.38, CI=1.03–1.74). CONCLUSION: Dysuria, urine, significantly Absence these identified at low having (25.5%), whereas presence one or both other high (63.2%). Diagnostic uncertainty still remains vast majority who meet only feature. If validated future cohorts, may serve as an evidence-based definition assist management decisions.
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