Diagnosis of urinary tract infection in older persons in the emergency department: To pee or not to pee, that is the question

Ellen Burkett; Christopher R Carpenter; Glenn Arendts; Carolyn Hullick; David L Paterson; Jeffrey M Caterino

doi:10.1111/1742-6723.13376

Diagnosis of urinary tract infection in older persons in the emergency department: To pee or not to pee, that is the question

Emerg Med Australas. 2019 Oct;31(5):856-862. doi: 10.1111/1742-6723.13376. Epub 2019 Sep 2.

Authors

Ellen Burkett^{1

2}, Christopher R Carpenter³, Glenn Arendts^{4

5}, Carolyn Hullick^{6

7}, David L Paterson⁸, Jeffrey M Caterino⁹

Affiliations

¹ Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
² Healthcare Improvement Unit, Clinical Excellence Queensland, Brisbane, Queensland, Australia.
³ School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
⁴ School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
⁵ Emergency Department, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁶ Emergency Department, John Hunter Hospital, Newcastle, New South Wales, Australia.
⁷ Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia.
⁸ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
⁹ Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Abstract

Doreen is a 79-year-old woman referred by her general practitioner to the ED for intravenous antibiotics for a urinary tract infection (UTI). She lives in a residential aged care facility (RACF) and staff report malodourous and cloudy urine. She denies dysuria or frequency. On examination Doreen is frail with vital signs of: temperature 37.7°C, pulse 87 bpm, blood pressure 130/70; there is no suprapubic or flank tenderness. Do you perform a dipstick test on Doreen’s urine for a suspected UTI?

MeSH terms

Aged
Aged, 80 and over
Disease Management
Emergency Service, Hospital / organization & administration
Emergency Service, Hospital / statistics & numerical data*
Female
Humans
Male
Urinary Tract Infections / diagnosis*
Urinary Tract Infections / epidemiology
Urine Specimen Collection / methods
Urine Specimen Collection / statistics & numerical data

Grants and funding

R01 AG050801/AG/NIA NIH HHS/United States