An Ohio State medical researcher has received a $2.8 million federal grant to support a multi-institutional study that may help improve diagnosis of urinary tract infections (UTIs) among older patients in hospital emergency departments (EDs).
Jeffrey Caterino, MD, MPH, associate professor in the departments of Emergency Medicine and Internal Medicine at The Ohio State University College of Medicine, is principal investigator for the five-year grant from the National Institute on Aging.
Other team members on the study, which is titled “Urine Antimicrobial Proteins in Older Adults: Aging, Infection and Innate Immunity,” include: Courtney Hebert, MD, Carson Reider, PhD, Lauren Southerland, MD, Julie Stephens, MS, Lai Wei, PhD and Randell Wexler, MD, MPH, all of Ohio State; Andrew Schwaderer, MD, of Nationwide Children’s Hospital; David Hains, MD, of the University of Tennessee Health Science Center; and Carlos Camargo Jr., MD, DrPH, of Massachusetts General Hospital.
Caterino says one of the many challenges of emergency medicine is accurately diagnosing UTIs in older adults. Typically they do not show symptoms of UTIs, and current diagnostic tests are also often inaccurate.
To improve diagnostic accuracy, this collaborative study will examine new clues for identifying UTIs, Caterino says, explaining that antimicrobial peptides—proteins that are part of the human immune system—could give insight into which patients entering the ED have a UTI. Preliminary data have shown that antimicrobial peptides in the urinary tract increase with infection. The objectives of Caterino and his team are to better characterize baseline levels of proteins in urine of older adults, identify how levels differ from those in younger adults and measure the levels in those with suspected UTIs in the ED The ultimate goal is to develop a clinical decision rule to guide UTI diagnosis in older adults.
This work expands on techniques developed by Drs. Schwaderer and Hains in studying pediatric populations at Nationwide Children’s Hospital. Including patients from both the family medicine clinics and the ED is an example of a translational research project bringing basic science research to the bedside.
“We are excited by the ability to extend lab studies to the clinical arena and increase the collaboration between Ohio State and Nationwide Children’s Hospital,” says Caterino.
The team’s approach to testing for UTIs is novel, as current testing methods are often inaccurate in older adults. If successful, as suspected by preliminary data, scientists will develop a UTI diagnostic test for the geriatric population in acute care settings, improving diagnostic accuracy and preventing antibiotic overuse.