Researchers Develop New Diagnostic Algorithm for UTIs in Long-Term Care Residents

​Researchers have developed an algorithm to differentiate uncomplicated cystitis urinary tract infections (UTIs) from asymptomatic bacteriuria (ASB) in noncatheterized nursing home residents. In a study published in JAMDA on July 20, 2018, the researchers identified five signs and symptoms indicating uncomplicated cystitis and developed the diagnostic algorithm to promote antibiotic stewardship that can be used across all older-adult care settings. Researchers began with a literature review of common signs and symptoms potentially related to UTIs. Using Delphi survey rounds, a 20-person panel of physicians from the postacute/long-term care setting, helped narrow the list of signs and symptoms to five: dysuria, urinary frequency, urinary urgency, gross hematuria, and suprapubic pain. The study's authors then categorized suspected UTIs into three domains: complicated UTI or other non-UTI infection, likely cystitis, and unlikely cystitis (e.g., ASB), which can then inform clinicians on whether to conduct further diagnostic testing and treatment.