Table 4.

Guidelines Providing Criteria for the Clinical Diagnosis of Urinary Tract Infection (UTI) in Residents of Long-Term Care Facilities (LTCFs).

Reference	Proposed Use	Residents without indwelling catheters	Residents with indwelling catheters
Loeb et al, (28)	Minimum criteria for the initiation of antibiotic therapy for urinary infection	Acute dysuria alone, or fever [> 37.9°C (100°c) or 1.5°C (2.4°F) above baseline] and one or more of: new or worsening urgency, frequency, suprapubic pain, gross hematuria, costovertebral angle tenderness, or urinary continence.	Presence of at least one of the following: Fever (>37.9°C or 1.5°C above baseline) New costovertebral angle tenderness, rigors (shaking, chills) with or without identified cause, New onset delirium
High et al, (29)	Evaluation of fever and infection in older residents of LTCFs.	Acute onset of UTI associated symptoms and signs (e.g., fever, dysuria, gross hematuria, new or worsening urinary incontinence, and/or suspected bacteremia).	Suspected urosepsis (i.e., fever, shaking, chills, hypotension or delirium), especially in the context of recent catheter obstruction or change.
Stone et al, (24)	Surveillance definitions for infection in long term care.	At least one of the following symptoms or signs: acute dysuria or acute pain, swelling or tenderness of the testes, epididymis or prostate. Fever or leukocytosis [single oral temperature > 37.8°C (>100°F), or repeated oral temperature >37.2°C (99°F) or rectal temperatures >37.5°C (99.5°F or single temperature ≥1.1°C (2°F) over baseline from any site]; leukocytosis, neutrophila (>14,000 leukocytes/cubic mm) or left shift (>6% bands or 1,500 bands/cubic mm)] and at least one of the following localizing subcriteria: Acute costovertebral angle pain or tenderness; 2. Suprapubic pain; 3. Gross hematuria; 4. New or marked increasing incontinence or urgency or frequency; 5. Urgency In the absence of fever or leukocytosis, then two or more of the above localizing urinary tract sub-criteria.	At least one of the following signs or symptoms: Fever, rigors, or new onset of hypotension with no alternate source of infection Either acute change in mental status or acute functional decline, with no alternate diagnosis and leukocytosis New onset suprapubic pain or costovertebral angle pain or tenderness Purulent discharge from around the catheter or acute pain, swelling or tenderness of the testes, epididymis or prostate