Ryan Susan, Gillespie Elizabeth, Stuart Rhonda L
Infection Control and Epidemiology Unit, Monash Health, Clayton, Victoria, Australia.
Infection Control and Epidemiology Unit, Monash Health, Clayton, Victoria, Australia.
Am J Infect Control. 2018 Jan;46(1):67-72. doi: 10.1016/j.ajic.2017.07.002. Epub 2017 Aug 23.
The aim of this research was to determine the prevalence of urinary tract infections (UTIs) in 2 aged care homes (ACHs) and examine the extent to which presumed UTIs met the 2012 McGeer infection surveillance definitions.
Retrospective observational study.
Two ACHs: a 30-bed facility and a 100-bed facility PARTICIPANTS: Residents of the 2 ACHs diagnosed with UTI.
A retrospective review was conducted of UTIs clinically diagnosed at the 2 facilities over a 16-month period, utilizing surveillance and microbiologic data, resident progress notes, and medication charts. This data was reviewed to determine how many diagnosed UTIs met the revised McGeer definitions.
Overall, 119 UTIs were diagnosed in 57 residents over 16 months. Only 7 of the diagnosed UTIs met the McGeer definitions. Forty-seven did not meet the clinical evidence, 17 did not meet the microbiologic evidence, and 48 did not meet either surveillance criteria.
This study demonstrated the disparity between the clinical diagnosis of UTI and the surveillance definitions for UTI, and highlights the limitations of the McGeer definitions in those with cognitive or communication deficits. There is an urgent need for antimicrobial stewardship programs and education in the ACH setting.
本研究旨在确定两家老年护理院（ACHs）中尿路感染（UTIs）的患病率，并检查推定的UTIs在多大程度上符合2012年McGeer感染监测定义。
回顾性观察研究。
两家ACHs：一家拥有30张床位的机构和一家拥有100张床位的机构。
两家ACHs中被诊断为UTI的居民。
利用监测和微生物学数据、居民病程记录和用药图表，对这两家机构在16个月期间临床诊断的UTIs进行回顾性审查。对这些数据进行审查，以确定有多少诊断出的UTIs符合修订后的McGeer定义。
总体而言，在16个月内，57名居民中诊断出119例UTIs。只有7例诊断出的UTIs符合McGeer定义。47例不符合临床证据，17例不符合微生物学证据，48例不符合任何一项监测标准。
本研究表明UTI的临床诊断与UTI的监测定义之间存在差异，并突出了McGeer定义在认知或沟通有缺陷的人群中的局限性。在老年护理院环境中，迫切需要抗菌药物管理计划和教育。
