SCI Model Systems Complicated Urinary Tract Infection (cUTI) Guidelines: International Consensus on cUTI Likelihood Based on Symptoms.

Complicated urinary tract infection (cUTI) is prevalent among people with spinal cord injury and disease (SCI/D). Diagnostic guidelines are neither consistent nor evidence based. To establish consensus around symptoms-based diagnostic and decision-making criteria for cUTI for SCI/D. A representative...

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Publicado en:Topics in Spinal Cord Injury Rehabilitation Vol. 31; no. 3; pp. 101 - 121
Autores principales: Tractenberg, Rochelle E., Aguirre Guemez, Ana Valeria, Petriello, Marla, Groah, Suzanne L.
Formato: algorithm questionnaire/scale research tables/charts Journal Article
Publicado: KnowledgeWorks Global, Ltd Summer2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Summer2025
      vid: 31
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      pub: KnowledgeWorks Global, Ltd
      place: Richmond, Virginia
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        atl: SCI Model Systems Complicated Urinary Tract Infection (cUTI) Guidelines: International Consensus on cUTI Likelihood Based on Symptoms.
      aug:
        au:
          Tractenberg, Rochelle E.
          Aguirre Guemez, Ana Valeria
          Petriello, Marla
          Groah, Suzanne L.
        affil: Collaborative for Research on Outcomes and -Metrics and Departments of Neurology, Rehabilitation Medicine, and Biostatistics, Bioinformatics & Biomathematics, Georgetown University Medical Center, Washington, DC
      sug:
        subj:
          Practice Guidelines
          Urinary Tract Infections Symptoms
          Spinal Cord Injuries Complications
          Models, Theoretical
          Consensus
          Urinary Tract Infections Diagnosis
          Decision Making, Clinical
          Diagnosis, Laboratory
          Human
          Funding Source
          Delphi Technique
          Bladder, Neurogenic Complications
          United States
          Interviews
          Questionnaires
          Urinary Catheterization, Intermittent
          Catheters Adverse Effects
          Survey Research
          Urinary Tract Infections, Catheter-Related Risk Factors
          Multimethod Studies
          Protocols
          Psychometrics
          Cognition Evaluation
          Task Performance and Analysis
          Biological Markers Urine
          Urinary Tract Infections Microbiology
          Thematic Analysis
          Attitude of Health Personnel
          Pyuria Diagnosis
          Antibiotics Therapeutic Use
          Prescriptions, Drug
          Urinalysis
          Bacteriuria Diagnosis
          Descriptive Statistics
      ab: Complicated urinary tract infection (cUTI) is prevalent among people with spinal cord injury and disease (SCI/D). Diagnostic guidelines are neither consistent nor evidence based. To establish consensus around symptoms-based diagnostic and decision-making criteria for cUTI for SCI/D. A representative sample of clinicians from PM&R, infectious disease, urology, and primary care within the United States (phase 1) and internationally (phase 2) participated in this study. Phase 1 involved focus groups and interviews to refine a decision-making paradigm for cUTI based on reliable and validated Urinary Symptom Questionnaires for Neurogenic Bladder (USQNBs: intermittent catheterization, indwelling catheterization, and voider versions). The phase 2 international Delphi survey on cUTI diagnostic criteria reflected phase 1 results. These criteria feature 6 "profiles": combinations of symptom number and types with associated likelihood of cUTI for each USQNB (18 total decisions). Analyses of the phase 1 transcripts (n = 32) led to the Delphi design. Across the United States and internationally, 24 responses were obtained on the complete Delphi, with 48 responses on the USQNB for intermittent catheterization only. We achieved the a priori target 80% consensus on 13 of 18 decisions. The remaining 5 decisions reached 62.2% to 77.8% agreement. Changes were made based on respondent suggestions to clarify decisions and slightly modify risk descriptors. One hundred percent consensus among subject matter experts from 9 collaborating SCI model systems centers was achieved for the revisions. This is the first international and empirical initiative to establish cUTI symptoms-based guidelines for cUTI in SCI/D. These guidelines provide a coherent and evidence-based approach to decision making based on symptoms for clinicians and patients.
      pubtype: Academic Journal
      doctype:
        algorithm
        questionnaire/scale
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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