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Highlights:

* Identified the overtreatment of asymptomatic bacteriuria in aged care homes.

* Demonstrated the disparity between clinical diagnosis and McGeer surveillance definitions.

* Identified the limitations of the McGeer definitions for UTI in those with impaired communication or cognition.

* Highlighted the need for antimicrobial stewardship programs in aged care homes.

* Identified the need for nursing and medical education about urinary tract infection signs and symptoms.

Objectives: 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.

Design: Retrospective observational study.

Setting: Two ACHs: a 30-bed facility and a 100-bed facility

Participants: Residents of the 2 ACHs diagnosed with UTI.

Methods: 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.

Results: 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.

Conclusions: 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.

Copyright (C) 2018 by the Association for Professionals in Infection Control and Epidemiology, Inc.