A scoping review of urinary tract infection management in residential aged care settings.

IF 2.6 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2026-08-20 DOI:10.1016/j.ajic.2026.08.014

Monina Hernandez, Anastasia F Hutchinson, Monica Schoch, Stéphane L Bouchoucha

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引用次数: 0

Abstract

Background: Urinary tract infections (UTI) are the most prevalent health care associated infection in residential aged care homes (RACH), affecting 23.6% of older people in any settings. Management strategies vary significantly. This scoping review evaluates best practice UTI management in RACHs over the last 13 years.

Methods: A systematic search of Medline, CINAHL, and Embase was conducted to identify studies reporting UTI management using current diagnostics criteria. Studies published between January 2013 to January 2026 were included.

Results: Of 1,112 studies identified, 33 met inclusion criteria. Studies were categorized by outcome with 9 evaluating UTI interventions and measuring UTI rates, 10 measuring diagnostic accuracy and 19 reporting antimicrobial prescribing and several reporting multiple outcomes.

Discussion: Multifaceted UTI management programs including antimicrobial stewardship and a combination of staff education, guidelines, decision-support tools and use of change champions effectively reduced UTI rates. Diagnostic inconsistencies exist when applying McGeer surveillance criteria, Loeb's minimum criteria, and specific organizational criteria potentially resulting in inappropriate antimicrobial prescribing.

Conclusions: A standardized, validated UTI definition is needed to improve diagnostic accuracy and support antimicrobial stewardship for older populations. Further, multifaceted programs are effective but additional research is warranted to evaluate the full impact of interventions and aspects that work.

查看原文本刊更多论文

住宅老年护理机构尿路感染管理的范围综述。

背景：尿路感染（UTI）是住宅养老院（RACH）中最普遍的医疗保健相关感染，在全球范围内影响23.6%的老年人。管理策略因地区和组织而异。这一范围审查评估了过去13年来乡村地区尿路感染管理的最佳实践。方法：系统检索Medline、CINAHL和Embase，以确定报告尿路感染管理符合当前诊断标准的研究，纳入2013年1月至2026年1月发表的论文。结果：在确定的1112项研究中，33项符合纳入标准并进行了回顾。这些研究按结果分类，其中9项评估尿路感染干预措施并测量尿路感染率，10项测量诊断准确性，19项报告抗菌药物处方。一些研究报告了多种结果。讨论：目前的证据表明，多方面的尿路感染管理方案，包括抗菌药物管理，以及员工教育、指南、决策支持工具和使用变革倡导者的结合，有效地降低了尿路感染发生率。此外，在应用McGeer监测标准、Loeb最低标准和特定组织标准时，存在诊断不一致，导致不适当的抗菌药物处方。结论：为有效降低尿路感染发生率，变革领军者的具体职责和选择标准有待进一步研究。迫切需要一个标准化的、经过验证的尿路感染定义，以提高诊断准确性并支持老年人群的抗菌药物管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)