MDS Alert
F315 Survey Guidance Incorporates McGeer Criteria
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"Indications to Treat a UTI Because many residents have chronic bacteriuria, the research-based literature suggests treating only symptomatic UTIs. Symptomatic UTIs are based on the following criteria:13 Residents without a catheter should have at least three of the following signs and symptoms: Fever (increase in temperature of >2 degrees F (1.1 degrees C) or rectal temperature >99.5 degrees F (37.5 degrees C) or single measurement of temperature >100 degrees F (37.8 degrees C) );14 New or increased burning pain on urination, frequency or urgency; New flank or suprapubic pain or tenderness; Change in character of urine (e.g., new bloody urine, foul smell, or amount of sediment) or as reported by the laboratory (new pyuria or microscopic hematuria); and/or Worsening of mental or functional status (e.g., confusion, decreased appetite, unexplained falls, incontinence of recent onset, lethargy, decreased activity). 15 Residents with a catheter should have at least two of the following signs and symptoms: Fever or chills; New flank pain or suprapubic pain or tenderness; Change in character of urine (e.g., new bloody urine, foul smell, or amount of sediment) or as reported by the laboratory (new pyuria or microscopic hematuria); and/or Worsening of mental or functional status. Local findings such as obstruction, leakage, or mucosal trauma (hematuria) may also be present.16 13 McGeer, A., Campbell, B., Emori, T.G., Hierholzer, W.J., Jackson, M.M., Nicolle, L.E., et al. (1991). Definitions of Infections for Surveillance in Long Term Care Facilities. American Journal of Infection Control, 19(1), 1-7." Source: The above is printed verbatim from the State Operations Manual, Appendix PP (www.cms.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf).
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