Recognition
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STEP 2: Which Symptoms Are No Longer Considered To Be
Suggestive of UTI?
Consider evaluating for other potential causes of non-specific symptoms
that do not suggest the diagnosis of UTI, especially in the absence of
genito-urinary tract-specific signs and symptoms.
Change in color or odor of urine:
➤ Changes such as dark, cloudy or foul-smelling urine are not sufficient
to indicate a UTI in the absence of clinical signs and symptoms that
localize to the genito-urinary tract. It may reflect mild dehydration or
changes to diet or medications.
Fall:
➤ A fall is not considered a symptom of a urinary tract infection,
especially in the absence of genito-urinary tract-specific signs and
symptoms. Therefore, resident should be carefully evaluated for an
alternative explanation for the fall in such scenarios.
Change in mental status:
➤ Current recommendations suggest that there should be systemic or
specific urinary findings to attribute a UTI as the cause of mental
status change. A diagnosis of UTI should only be considered in those
residents with unequivocal delirium who have no other cause for these
acute, fluctuating symptoms. For older adults with a change in mental
status, the diagnosis of a UTI or CAUTI is a diagnosis of exclusion.