North East Valley Division of General Practice
Aged Care GP Panels Initiative
Revised January 2006
References to support Urine Testing Protocol
These references are organised into topic groups. References considered most useful by
NEVDGP Aged Care Initiative staff are included. There are others that support the content of
the Urine Protocol and these can be provided on request. Copies of the majority of the listed
references may be obtained from North East Valley Division of General Practice by contacting
Clare Chiminello on 03 9496 4333 or clare@nevdgp.org.au
Diagnosis of Urinary Tract Infections
1) Urinary tract infection in geriatric and institutionalised patients
Current Opinion in Urology, Vol 12 (1), Jan 2002 pp51-55, Nicolle, L E
2) Urinary tract infection in old age: over-diagnosed and over-treated
Commentary, Age and Ageing 2000; 29: 297-298
3) Urinary tract infections in long-term care facility residents
Clin Infect Dis 2000; 31:757-761 Nicolle LE
A comprehensive review of the problem of symptomatic and asymptomatic UTI in residents of
long term care facilities, with recommendations for diagnosis, management and prevention
4) Urinary tract infections in long term care facilities
Infect Control Hosp Epidemiol 2001; 22:167-175. Nicolle LE, SHEA Long-Term-Care
Committee
An evidence-based position paper addressing issues of prevention, diagnosis, and
surveillance for UTIs in long term care facilities. Accession Number: 00042307-20020100000010
5) Development of minimum criteria for the initiation of antibiotics in residents of longterm care facilities: Results of a consensus conference
Infect Control Hosp Epidemiol 2001; 22:120-124. Loeb M. Bentley DW, Bradley S, et al.
Bibliographic Links Summary of a consensus meeting which identified minimum clinical and
laboratory criteria which should be present before initiating antimicrobial therapy in residents
of long term care facilities. For UTI in the noncatheterized resident, new onset of acute
symptoms localized to the genitourinary tract is necessary.
6) Why are antibiotics prescribed for asymptomatic bacteriuria in institutionalized
elderly people?
Can Med Assoc J 2000; 163:273-277. Walker S, McGeer A, Simor AE, et al This qualitative
study addresses the issue of why physicians and nurses working in long term care facilities
continue to prescribe antimicrobials for asymptomatic bacteriuria in institutionalized elderly
people. A major theme is that in the face of nonspecific clinical deterioration, most nurses and
physicians feel that patients with positive urine cultures should be treated.
Negative dipstick cannot exclude UTI
7) Urinary tract infection (lower) – women
(PRODIGY) Practical Support for Clinical Governance
1994, UK: Department of Health www.prodigy.nhs.uk
8) Urine sampling and culture in the diagnosis of urinary tract infection in adults
From UpToDate online topic review, August 2004, Meyrier, A, Zaleznik, D
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North East Valley Division of General Practice
Aged Care GP Panels Initiative
Revised January 2006
Clinical assessment of resident with fever or
suspected infection
9) Practice Guidelines for evaluation of Fever and Infection in Long-Term Care
Facilities
Guidelines from the Infectious Diseases Society of America
Clinical Infectious Diseases 2000; 31L:640-653, Bentley DW, Bradley S, High K, et al
This guideline addresses the appropriate use of urinalysis and urine culture in managing long
term care facility residents with fever
Asymptomatic bacteriuria
10) Screening for asymptomatic bacteriuria in the elderly
Nicolle, LE, Chapter 81 of Canadian Guide to Clinical Preventative Health Care, Canadian
Task Force on the Periodic Health Examination, Editor. 1994, Health Canada: Otawa. p. 966973.
When to use antibiotics
11) Resistant pathogens in urinary tract infections
J Am Geriatr Soc. 2002 Jul; 50 (7 Suppl): S230-5, Nicolle, LE
Topical oestrogen use in older women to reduce UTI
risk
12) Estrogen and recurrent UTI in postmenopausal women
American Journal of nursing. 102 (8): 44-53, August 2002, Maloney, C
Cranberry Juice
13) Cranberries for preventing urinary tract infections
The Cochrane Database of Systemic Reviews 2004
Issue 2, Art No: CD001321.DOI:10.1002/14651858.CD001321.pub3
Jepson, Mihaljevic, Craig
14) Cranberry for the prevention of urinary tract infection
Complementary and Alternative Medicine website
www.cam.org.nz/cranberry.htm
15) Cranberries for treating urinary tract infections
The Cochrane Database of Systemic Reviews 1998
Issue 4, Art No: CD001322.DOI:10.1002/14651858.CD001322
Jepson, Mihaljevic, Craig
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