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The University of Southampton
Primary Care Research Centre

DISCO - DIagnoSing Care hOme UTI Study



DISCO logo

Overview of project:

Urinary tract infections (UTIs) are common in care home residents. Accurate diagnosis of UTI is important because not treating an infection may lead to serious consequences. However, giving antibiotic treatment when there isn’t an infection causes side effects and antibiotic resistance, making future infections harder to treat. 

Unfortunately, there are several challenges that mean that it is difficult to diagnose UTI accurately in care home residents: 

  • UTIs don’t always cause clear symptoms for people who live in care homes. They sometimes just cause symptoms like confusion which can have lots of different possible causes. 
  • It may be hard for people living with dementia to say how they are feeling or to easily provide a urine sample. 
  • Many people who live in care homes have bacteria present in their urine even when they are well, but this not harmful and does not need treatment.
  • Urine tests that are currently available do not give accurate or quick results. 

We have thought about some new ways that might help show us if someone in a care home really has a UTI but we don’t know yet whether these will work. Our ideas include: 

  1. Working out which symptoms or signs mean a UTI is more likely 
  2. Detecting new markers of infection in urine samples
  3. Trying out new bedside tests that give rapid results

For this study we plan to recruit 100 care home residents who will be followed up over 6 months. All 100 participants will provide information and a urine sample at the beginning of the study. 25 of these participants will also provide repeated weekly samples for 4 weeks to look at any changes in the urine over time. Additional information and urine samples will be collected if a participant develops a possible UTI during the study and any treatments will be recorded.  

Our findings will be used to develop an application for a larger study aiming to improve the diagnosis of UTI in care home residents. 



Funded by NIHR School for Primary Care Research - FR3, project 578

Chief Investigators:

Prof Nick Francis, Professor of Primary Care Research, University of Southampton

Dr Abigail Moore, Wellcome Doctoral Research Fellow, University of Oxford



Prof Gail Hayward, Associate Professor of Primary Care Research, University of Oxford 

Dr Mark Lown, GP and Clinical Lecturer, University of Southampton 

Professor Beth Stuart, Professor of Medical Statistics and Clinical Trials Co-Director of the Pragmatic Trials Unit, Queen Mary, University of London 

Prof Alastair Hay, GP and Professor of Primary Care, University of Bristol 

Prof Mike Moore, Professor of Primary Care Research, University of Southampton 

Prof Paul Little, Professor of Primary Care Research, University of Southampton

Dr Kristin Veighey, Consultant Nephrologist, NIHR Academic Clinical Lecturer in GP, University of Southampton

Prof Chris Butler, Professor of Primary Care Research, University of Oxford

Dr Mandy Wootton, Consultant Scientist, Specialist Antimicrobial Chemotherapy Unit, Public Health Wales

Dr Lim Jones, Consultant Microbiologist, Public Health Wales

Dr Elizabeth Miles Lecturer in Nutritional Immunology, University of Southampton

Dr Chris Wilcox, GP Academic Clinical Fellow, University of Southampton

Dr Margaret Glogowska, Senior Qualitative Researcher, University of Oxford

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