{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:36:59Z","timestamp":1789220219386,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,4,16]],"date-time":"2013-04-16T00:00:00Z","timestamp":1366070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2013,5]]},"abstract":"\n Objectives<\/jats:title>\n \n To determine how often older women presenting to an emergency department (\n ED<\/jats:styled-content>\n ) are diagnosed with a urinary tract infection (\n UTI<\/jats:styled-content>\n ) without a positive urine culture and to investigate whether collecting urine by catheterization instead of clean catch improves the accuracy of the urinalysis (\n UA<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective chart review.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n Academic\u2010affiliated\n ED<\/jats:styled-content>\n in\n P<\/jats:styled-content>\n rovidence,\n R<\/jats:styled-content>\n hode\n I<\/jats:styled-content>\n sland.\n <\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n One hundred fifty\u2010three women aged 70 and older with diagnosis of\n UTI<\/jats:styled-content>\n in the\n ED<\/jats:styled-content>\n between\n D<\/jats:styled-content>\n ecember 1, 2008, and\n M<\/jats:styled-content>\n arch 1, 2010.\n <\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n \n Chief complaint, review of systems, results of\n UA<\/jats:styled-content>\n and culture, urine procurement (clean catch, straight catheter, or newly inserted\n F<\/jats:styled-content>\n oley catheter), antibiotic administered or prescribed, and diagnosis. A confirmed\n UTI<\/jats:styled-content>\n was defined as a positive urine culture, with microbial growth of 10,000 colony\u2010forming units (\n CFU<\/jats:styled-content>\n )\/ mL or more for clean\u2010catch specimens and 100\u00a0\n CFU<\/jats:styled-content>\n \/mL or more for newly inserted catheter specimens; an\n ED<\/jats:styled-content>\n diagnosis of\n UTI<\/jats:styled-content>\n was defined as the designation by an\n ED<\/jats:styled-content>\n physician.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 153 individuals with an\n ED<\/jats:styled-content>\n \u2010diagnosed\n UTI<\/jats:styled-content>\n , only 87 (57%) had confirmed\n UTI<\/jats:styled-content>\n according to culture. Of the remaining 66 with negative cultures, 63 (95%) were administered or prescribed antibiotics in the\n ED<\/jats:styled-content>\n . The method of urine procurement affected the ability of a\n UA<\/jats:styled-content>\n to predict the culture result (\n P<\/jats:italic>\n \u00a0=\u00a0.02), with catheterization yielding a lower proportion of false\u2010positive\n UA<\/jats:styled-content>\n (31%) than clean catch (48%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Nearly half of older women diagnosed with a\n UTI<\/jats:styled-content>\n in an\n ED<\/jats:styled-content>\n setting did not have confirmatory findings on urine culture and were therefore inappropriately treated. Catheterization improved the accuracy of\n UA<\/jats:styled-content>\n when assessing older women for possible\n UTI<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.12203","type":"journal-article","created":{"date-parts":[[2013,4,16]],"date-time":"2013-04-16T10:48:55Z","timestamp":1366109335000},"page":"788-792","source":"Crossref","is-referenced-by-count":61,"title":["Overtreatment of Presumed Urinary Tract Infection in Older Women Presenting to the Emergency Department"],"prefix":"10.1111","volume":"61","author":[{"given":"Lesley B.","family":"Gordon","sequence":"first","affiliation":[{"name":"Warren Alpert Medical School Brown University Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Waxman","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Albany Medical College Albany New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna","family":"Ragsdale","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Department of Surgery Duke University Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard A.","family":"Mermel","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School Brown University Providence Rhode Island"},{"name":"Department of Epidemiology and Infection Control Rhode Island Hospital Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.121523"},{"key":"e_1_2_6_3_1","unstructured":"NiskaR BhuiyaF XuJ.National hospital ambulatory medical care survey: 2007 emergency department summary. 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