Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol
Introduction Suspected urinary tract infection (UTI) ranks among the most common reasons for antibiotic use in nursing homes. However, diagnosing UTI in this setting is challenging because UTI often presents with non-specific symptomatology. Moreover asymptomatic bacteriuria is common in elderly, wh...
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BMJ Publishing Group
2019-08-01
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| author | Sacha D Kuil Soemeja Hidad Johan C Fischer Janneke Harting Cees MPM Hertogh Jan M Prins Frank van Leth Menno D de Jong Caroline Schneeberger |
| author_facet | Sacha D Kuil Soemeja Hidad Johan C Fischer Janneke Harting Cees MPM Hertogh Jan M Prins Frank van Leth Menno D de Jong Caroline Schneeberger |
| author_sort | Sacha D Kuil |
| collection | DOAJ |
| description | Introduction Suspected urinary tract infection (UTI) ranks among the most common reasons for antibiotic use in nursing homes. However, diagnosing UTI in this setting is challenging because UTI often presents with non-specific symptomatology. Moreover asymptomatic bacteriuria is common in elderly, which complicates attribution of causality to detection of bacteria in urine. These diagnostic challenges contribute to overuse of antibiotics and emergence of antimicrobial resistance in nursing homes. Given the diagnostic challenges, there is a need for point-of-care (POC) diagnostic tests to support clinical rules for diagnosing UTI. Procalcitonin (PCT) and C reactive protein (CRP) are inflammatory blood markers that have been proven useful to support diagnosis and monitoring of (bacterial) respiratory tract infections and sepsis. While limited studies suggest their usefulness in supporting UTI diagnosis, their utility has not been studied in elderly populations for this purpose.Methods and analysis In a 24-month matched prospective study, ‘PROGRESS’ will assess and compare the sensitivity of rapid POC measurements of blood CRP and PCT levels to support clinical rules for diagnosing UTI in nursing home residents. The primary outcome measure is sensitivity of the POC tests to identify patients with true UTI based on the predefined definition, as derived from receiver operating curves.Ethics and dissemination This study will be conducted in accordance with Good Clinical Practice guidelines and the principles of the Declaration of Helsinki. The study protocol is approved by the Medical Ethical Committee of Amsterdam UMC location VUmc with reference number 2017.350 and National Central Committee on Research involving Human Subjects with reference number NL62067.029.17.Trial registration number NTR6467. |
| format | Article |
| id | doaj-art-0e4cfce9b36b4dfdb91a618355b85f9f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-0e4cfce9b36b4dfdb91a618355b85f9f2024-11-27T02:45:10ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2019-031269Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocolSacha D Kuil0Soemeja Hidad1Johan C Fischer2Janneke Harting3Cees MPM Hertogh4Jan M Prins5Frank van Leth6Menno D de Jong7Caroline Schneeberger81 Medical Microbiology, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands1 Medical Microbiology, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands2 Clinical Chemistry, Amsterdam UMC University of Amsterdam, Amsterdam, The NetherlandsPublic and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam Public Health research institute, Amsterdam, The Netherlands4 General Practice and Elderly Care Medicine, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, The Netherlands5 Internal Medicine, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands6 Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The NetherlandsInfectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam, The NetherlandsDepartment of Microbiology, Amsterdam UMC-Locatie AMC, Amsterdam, The NetherlandsIntroduction Suspected urinary tract infection (UTI) ranks among the most common reasons for antibiotic use in nursing homes. However, diagnosing UTI in this setting is challenging because UTI often presents with non-specific symptomatology. Moreover asymptomatic bacteriuria is common in elderly, which complicates attribution of causality to detection of bacteria in urine. These diagnostic challenges contribute to overuse of antibiotics and emergence of antimicrobial resistance in nursing homes. Given the diagnostic challenges, there is a need for point-of-care (POC) diagnostic tests to support clinical rules for diagnosing UTI. Procalcitonin (PCT) and C reactive protein (CRP) are inflammatory blood markers that have been proven useful to support diagnosis and monitoring of (bacterial) respiratory tract infections and sepsis. While limited studies suggest their usefulness in supporting UTI diagnosis, their utility has not been studied in elderly populations for this purpose.Methods and analysis In a 24-month matched prospective study, ‘PROGRESS’ will assess and compare the sensitivity of rapid POC measurements of blood CRP and PCT levels to support clinical rules for diagnosing UTI in nursing home residents. The primary outcome measure is sensitivity of the POC tests to identify patients with true UTI based on the predefined definition, as derived from receiver operating curves.Ethics and dissemination This study will be conducted in accordance with Good Clinical Practice guidelines and the principles of the Declaration of Helsinki. The study protocol is approved by the Medical Ethical Committee of Amsterdam UMC location VUmc with reference number 2017.350 and National Central Committee on Research involving Human Subjects with reference number NL62067.029.17.Trial registration number NTR6467.https://bmjopen.bmj.com/content/9/8/e031269.full |
| spellingShingle | Sacha D Kuil Soemeja Hidad Johan C Fischer Janneke Harting Cees MPM Hertogh Jan M Prins Frank van Leth Menno D de Jong Caroline Schneeberger Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol BMJ Open |
| title | Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol |
| title_full | Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol |
| title_fullStr | Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol |
| title_full_unstemmed | Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol |
| title_short | Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol |
| title_sort | sensitivity of point of care testing c reactive protein and procalcitonin to diagnose urinary tract infections in dutch nursing homes progress study protocol |
| url | https://bmjopen.bmj.com/content/9/8/e031269.full |
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