Prospective evaluation of the management of urinary tract infections in 134 french nursing homes

Lemoine, L.; Dupont, Corrine; Capron, A.; Cerf, E.; Yilmaz, M.; Verloop, David; Blanckaert, K.; Senneville, Eric; Alfandari, Serge

Type de document :

Article dans une revue scientifique: Article original

DOI :

10.1016/j.medmal.2018.04.387

PMID :

29747905

URL permanente :

http://hdl.handle.net/20.500.12210/17348

Titre :

Prospective evaluation of the management of urinary tract infections in 134 french nursing homes

Auteur(s) :

Lemoine, L. [Auteur]
Dupont, Corrine [Auteur]
Capron, A. [Auteur]
Cerf, E. [Auteur]
Yilmaz, M. [Auteur]
Verloop, David [Auteur]
Blanckaert, K. [Auteur]
Senneville, Eric [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Alfandari, Serge [Auteur]

Titre de la revue :

Medecine et maladies infectieuses

Nom court de la revue :

Med Mal Infect

Date de publication :

2018-05-07

ISSN :

1769-6690

Mot(s)-clé(s) en anglais :

Antibiotics
Urinary tract infections
Nursing homes
Elckrly

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

OBJECTIVE: Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. METHODS: A 50-question form had to be filled in for up to five consecutive residents ...
Lire la suite >OBJECTIVE: Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. METHODS: A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. RESULTS: Of 397 contacted facilities, 134 participated and informed 444 UTI episodes. Reported diagnostic criteria were burning urination (32%), malodorous urine (29%), confusion (28%), and turbid urine (19%). Twenty-one percent of diagnoses were based on erroneous criteria. Less than 50% of residents had a urine dipstick test performed and 94% a urine culture. The main pathogen was Escherichia coli. Reported indications were uncomplicated cystitis (32%), unspecified UTI (26%), complicated cystitis (9%), while no reason was given in 25% of cases. Only 10% of diagnoses were consistent with the guidelines: complicated cystitis (49%), asymptomatic bacteriuria (21%), acute pyelonephritis (21%), male UTI (9%). Almost 85% of prescriptions were active on the isolated bacteria. The empirical antibiotic therapy was consistent with the diagnosis in 16% of cases (30% for reclassified diagnoses). The two most prescribed antibiotic classes were fluoroquinolones (22.1%) and oral third-generation cephalosporins (19.1%). Only two of 157 possible de-escalations were performed. Duration of treatment was adequate for 19% of UTIs (9.6% of reclassified cases). CONCLUSIONS: Our study revealed multiple deficiencies in diagnosis, antibiotic choice, treatment duration, and reevaluation.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T18:19:06Z

Numéro de version	Lien	Date de modification
2	20.500.12210/17348	2024-04-18T09:26:13Z
1	20.500.12210/17348.1*	2019-12-09T18:19:06Z

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