McGeer et al proposed criteria for identification of patients in long term care facilities with symptomatic urinary tract infections.
Diagnosis of symptomatic urinary tract infection requires that 1 of the following 2 criteria be met.
Criteria 1 - Patient without an indwelling urinary catheter and 3 or more of the following:
(1) fever >= 38°C or chills
(2) new flank or suprapubic pain or tenderness
(3) change in character of the urine
(4) worsening of mental or functional status (including new or worsening incontinence)
(5) new or increased burning pain on urination, frequency or urgency
Criteria 2 - Patient with an indwelling urinary catheter and 2 or more of the following
(1) fever >= 38°C or chills
(2) new flank or suprapubic pain or tenderness
(3) change in character of the urine
(4) worsening of mental or functional status
where:
• Items 1 through 4 are the same for both criteria.
• Change in character of the urine may include (a) new onset of bloody urine; (b) new onset of foul smell to urine; (c) increased in sediment; (d) new onset pyuria on urinalysis; (e) new onset microscopic hematuria on urinalysis.
• Results of urine cultures are not included in the criteria. Culture results of an appropriately collected, processed and evaluated are reported, but no guidance is given on how to use this information.
