Many thanks to the authors for this review.1 Although it has been clear for a while and is increasingly so, it’s an important reminder that older people in residential care can develop non-specific symptoms for many reasons, and a positive urine dip is not nearly conclusive evidence that the cause is the ever-suspected ‘UTI’.
Regarding the studies analysed — it is (as the authors acknowledge) difficult to assess the clinical condition of the participants — in practice, it is almost always the case that the patient being discussed has ‘something’, for example, acute confusion, drowsiness, reduced appetite, and so on, that has led to the urinalysis in the first place. However, on further questioning, UTI-specific symptoms such as suprapubic pain, dysuria, frequency, or urgency are often absent (usually complicated by the patient’s background cognitive impairment making communication of symptoms difficult).
Is there any distinction to be made in further research between completely asymptomatic patients, those with non-specific symptoms, and those with symptoms that truly are indicative of UTI?
- © British Journal of General Practice 2022
