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Improving UTI diagnosis and treatment in care homes


Southampton researchers are leading a study to improve the treatment of urinary tract infections (UTIs) in care homes.


Antibiotic resistant infections are difficult to treat, making even minor infections potentially life-threatening. Overuse of antibiotics is contributing to a global rise in these hard-to-treat infections.


The DISCO UTI study, led by Professor Nick Francis, is helping tackle this by reducing the amount of antibiotics prescribed in care homes.


It is looking at new ways to accurately diagnose and treat UTIs in these locations.


This month, one of the diagnostic tools in the study has made headlines by winning a decade-long competition to tackle superbugs.


A difficult choice


UTIs are a common problem, especially in the care home population.


Diagnosing UTIs in this population is challenging because symptoms are often non-specific. Residents with cognitive impairment may not be able to accurately describe their symptoms.


It is also common for care home residents to have bacteria in the urine even when they don’t have an infection, and collecting uncontaminated urine samples can be difficult.


Furthermore, current testing methods for UTIs take about three days. This leaves prescribers with a difficult choice.


If they delay treatment, the UTI could get worse and become serious. Alternatively, if they give antibiotics to a patient with no infection, it contributes to the rise in antibiotic resistance.


Speeding up diagnosis


The DISCO UTI study aims to improve the targeting of antibiotic treatment and reduce the overall amount of antibiotics prescribed.


One of the approaches being tested is the PA-AST system, developed by Sysmex Astrego. This can diagnose a UTI from a urine sample.


Within 15 minutes, the test can reveal whether the infection is bacterial, and within 45 minutes, which antibiotics would work to treat it.


It has been awarded the £8 million Longitude prize for tackling antibiotic resistance.


The National Institute for Health and Care Excellence is assessing its impact on patients as well as its cost-effectiveness.


Tackling antibiotic resistance


Antibiotic resistance happens when bacteria evolve defences against the antibiotics used to kill them.


When bacteria are exposed to an antibiotic frequently, only the toughest survive. These resistant bacteria, which cannot be killed by the antibiotic, then multiply.


Professor Francis is Professor of Primary Care Research at the University of Southampton. He is leading the DISCO UTI study as part of the NIHR Southampton Biomedical Research Centre.


He explained: “Antibiotic resistance is a growing threat to health worldwide. Reducing unnecessary use of antibiotics is key, and a large proportion of antibiotics are prescribed for UTIs.


“We aim to explore whether new technologies, such as the PA-AST system, can help prescribers make informed decisions in the care home population. This will help to reduce unnecessary antibiotic use and tackle this growing threat.”


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