The criteria that define infections for surveillance purposes were selected to increase the likelihood that the events captured by application of the definitions are true infections. Presentations of infection in older residents of long-term care facilities (LTCFs), may be atypical, so failure to meet surveillance definitions may not fully exclude the presence of infection. For this reason, the surveillance definitions presented here may not be adequate for real-time case finding, diagnosis, or clinical decision making (eg, antibiotic initiation). Separate clinical guidelines address early identification of infections and appropriate initiation of antibiotic therapy in LTCF residents, which are both important for impacting resident outcomes.
Tract
Revised McGeer Criteria for Urinary Tract Infection Surveillance (UTIs)
The definitions for UTI presented here differ substantially from the original surveillance definitions1 for both (A) residents without an indwelling catheter and (B) residents with an indwelling catheter. The revised definitions take into account the low probability of UTI in residents without indwelling catheters if localizing symptoms are not present, as well as the need for microbiologic confirmation for diagnosis.
ROME II Diagnostic Criteria for Functional Disorders of the Biliary Tract and the Pancreas
The diagnosis of a Functional Disorder of the Biliary Tract and Pancreas always pre-sumes the absence of a structural or biochemical explanation for the symptoms.
ROME II Diagnostic Criteria for Functional Disorders of the Biliary Tract and the Pancreas
The diagnosis of a Functional Disorder of the Biliary Tract and Pancreas always presumes the absence of a structural or biochemical explanation for the symptoms.
E1. Gallbladder Dysfunction
Episodes of severe steady pain located in the epigastrium and right upper quadrant, and all of the following:
- Symptom episodes last 30 minutes or more, with pain-free intervals;
- Symptoms have occurred on one or more occasions in the previous 12 months;
- The pain is steady and interrupts daily activities or requires consultation with a physician;
- There is no evidence of structural abnormalities to explain the symptoms; and
- There is abnormal gallbladder functioning with regard to emptying.