Rapid Molecular Testing for UTIs: A Diagnostic Stewardship Perspective.

Area of Science:

• Infectious Diseases
• Clinical Diagnostics
• Healthcare Management

Background:

• Antimicrobial stewardship is increasingly important in post-acute, long-term care (PALTC) settings.
• Molecular diagnostics, including polymerase chain reaction (PCR), are used for diagnosing urinary tract infections (UTIs).
• The role of rapid molecular diagnostics in PALTC UTI stewardship compared to standard methods is underexplored.

Purpose of the Study:

• To outline a framework for diagnostic stewardship in PALTC settings.
• To critically evaluate the use of molecular diagnostics for UTI diagnosis in PALTC.
• To assess the impact of molecular diagnostics on patient outcomes and antimicrobial stewardship.

Main Methods:

• A 5-step process is proposed for evaluating novel diagnostics in PALTC.
• Comparison of molecular methods with standard urinalysis and culture with antimicrobial susceptibility testing.
• Focus on critical evaluation before widespread adoption of new diagnostic tests.

Main Results:

• No studies currently compare rapid molecular diagnostics with standard methods for UTI stewardship in PALTC.
• A framework is presented to guide the evaluation of molecular diagnostics for UTIs in PALTC.
• Understanding limitations of new tests is key before implementation.

Conclusions:

• A structured approach is needed to evaluate molecular diagnostics for UTIs in PALTC.
• Diagnostic stewardship is essential for optimizing the use of novel tests.
• Further investigation is required to understand the full impact of molecular diagnostics on patient outcomes and antimicrobial use in PALTC.