BackgroundPatient sharing between hospitals and long-term care facilities (LTCF) is widespread. However, surveillance criteria for noncatheter associated urinary tract infection (UTI) vary by healthcare setting. Consequently, patients with identical features of UTI may meet criteria in LTCF but not in hospitals. A common definition that spans hospitals and LTCF may inform UTI surveillance efforts across healthcare facilities.MethodsWe performed a cohort analysis of all suspected UTI cases in women ≥65 years from 21 LTCF enrolled in a clinical trial evaluating cranberry capsules to reduce bacteriuria plus pyuria from August 2012 to October 2015. We applied 2017 hospital National Healthcare Safety Network (NSHN), 2012 LTCF NSHN, and proposed criteria (Figure 1) to all suspected UTI cases. Proposed criteria were derived a priori. Differences in the correlated proportions of UTI detected per criteria were assessed using McNemar’s test.ResultsOf 350 suspected UTI cases, LTCF NSHN criteria detected more UTI (22/350, 6.3%) compared with hospital NHSN (15/350, 4.3%; P = 0.04) and proposed (15/350, 4.3%; P = 0.02) criteria (Table 1). Half (11/22) of LTCF NHSN UTI included ≥102 CFU/mL of organisms from a catheterized urine as the microbiological criterion. Four UTI meeting LTCF NHSN or proposed criteria did not meet the hospital NHSN criteria because fever is only a listed clinical feature for patients ≤65 years.Table 1.UTI Detection by Surveillance Criteria.Criteria P valueLTCF NHSN Hospital NHSN PresentAbsentPresent132Absent93260.04 LTCF NHSN Proposed PresentAbsentPresent150Absent73280.02 ConclusionCurrent hospital and LTCF NHSN criteria both have limitations. The hospital NHSN criteria exclude fever in older adults as a clinical feature. The LTCF NHSN criteria include insensitive microbiological criteria. Our proposed surveillance criteria address these limitations and may be generalizable to both hospitals and LTCF.Disclosures M. Juthani-Mehta, Iterum Therapeutics: Scientific Advisor, Consulting fee.