Older care home residents face higher UTI burden and poorer outcomes
A study has found that urinary tract infections (UTIs) are more common among older adults living in care homes and are linked to worse outcomes than among clinically and socioeconomically comparable older adults living at home.
The study, published in the Lancet Healthy Longevity carried out by researchers from Imperial College London and City St George’s, University of London, as part of the Fleming Initiative, analysed large linked data from London and found that UTIs were more than three times as common among care home residents, and they also experienced higher risk of complications and deaths after contracting UTI, driven by disconnect with diagnostic capabilities to identify infections in a timely manner and support treatment decisions.
Dr Nina Zhu, the senior author of this study, said:
“Our study is the first such analysis to systematically assess the burden, management, and patient outcomes of UTIs in care homes, providing critical insights to support development of tailored infection prevention and stewardship interventions for this setting. Specifically, our results highlight the importance of access to infection diagnostics to ensure timely and accurate case identification, comprehensive surveillance, so that patient outcomes can be improved.”
The findings pinpoint a specific need amid the long-standing weaknesses in the care sector identified by the UK Covid-19 Inquiry’s Module 6 report on adult social care, published on 20 October 2026. Its findings on fragmented responsibilities, workforce pressures, and gaps in planning and support provide important wider context for this study. Together, the research study and the report highlight the need for reliable access to clinical expertise, diagnostic testing, infection prevention and control, and timely communication between care homes and the wider health and care system – in everyday care as well as during public health emergencies.
Professor Alison Holmes, Director of the Fleming Initiative said:
“Through a focus on UTIs, which are extremely common infections, this investigation increases our understanding of how care for older adults is managed in the community. The differing risks and outcomes identified are most concerning and must now drive improvements and interventions at a systems level. The Fleming Initiative has an extensive portfolio of work committed to understanding how ageing and infectious diseases intersect, and ensuring that advances in prevention, diagnosis and treatment benefit the populations who need them most.”