Urinary Tract Infection in Emergency Settings (UnItES)
Research type
Research Study
Full title
Urinary Tract Infection in Emergency Settings
IRAS ID
337341
Contact name
Simon Conroy
Contact email
Sponsor organisation
University College London Hospital
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Urinary Tract Infection (UTI) is common in all healthcare settings. For the most part, UTI is a self-limiting illness, and readily treated in primary care. However, UTI can be more serious, especially for older people, for whom it can lead to hospitalisation. In older people, the diagnosis can be trickier due to ‘non-specific’ presentations, such as falls or delirium.
An additional consideration in older people is the presence of bacteria in urine but without any urinary symptoms (‘Asymptomatic Bacturia’). As many as 25-50% of older women and 15-40% of older men in long-term care facilities have Asymptomatic Bacturia. Asymptomatic Bacturia should not be treated but may be misinterpreted as the cause of the presentation, which increases the risk of side-effects from unneeded antibiotics, as well as risking the true cause of the presentation being missed or overlooked. On the other hand under-diagnosis is also an important risk, as typical clinical markers for infection may not be helpful (e.g. fever) and urine and/or blood tests are not very reliable in older people. Over- and under-diagnosis rates can be as high as 40%, leading to patient harm, increased costs, antibiotic resistance, and longer hospital stays.
The overarching aim of this work is to develop a better approach to diagnosing UTI in older people. This proposal is to test out a new ‘gold standard’ diagnosis of UTI designed for use in research studies (not clinical practice). It will also assess the feasibility of collecting a range of clinical information, blood and urine tests in older people attending acute hospital. The data will inform the design of a future, larger study to assess more accurate approaches to UTI diagnosis, and it will also allow us to contribute to a sister study that is tackling the same issue in Leiden, the Netherlands.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
24/LO/0649
Date of REC Opinion
28 Nov 2024
REC opinion
Further Information Favourable Opinion