Materiały źródłowe

• #1 Uncomplicated Urinary Tract Infections – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470195/

  Uncomplicated urinary tract infections (UTIs) are among the most common bacterial infections encountered in clinical practice. […] Prompt and accurate diagnosis of uncomplicated UTIs is crucial for timely and appropriate management. Diagnosis relies on clinical history, urinalysis, and urine culture, with proper specimen collection being essential. […] An uncomplicated urinary tract infection (UTI) is a bacterial infection of the bladder and associated structures. […] UTI diagnosis is based on clinical history and urinalysis, with confirmation through a urine culture. Proper urine sample collection is crucial for accurate evaluation and culture. […] A UTI diagnosis is based on a combination of signs, symptoms, and urinalysis results, which is confirmed with a urine culture. […] Although urine cultures are not absolutely required to detect uncomplicated UTIs, they are still recommended due to increasing antibiotic resistance patterns and their role in differentiating recurrent infections from relapsing ones.

• #1 Diagnosis and Treatment of Acute Uncomplicated Cystitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1001/p771.html

  Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or urologic abnormalities. A urinalysis, but not urine culture, is recommended in making the diagnosis. […] The history is the most important tool for diagnosing acute uncomplicated cystitis, and it should be supported by a focused physical examination and urinalysis. By definition, the diagnosis of acute uncomplicated cystitis implies an uncomplicated UTI in a premenopausal, nonpregnant woman with no known urologic abnormalities or comorbidities. […] The new onset of frequency and dysuria, with the absence of vaginal discharge or irritation, has a positive predictive value of 90 percent for UTI.

• #1

  https://www.beaumont.org/treatments/diagnosing-urinary-tract-infection

  There are many tests to help diagnose urinary tract infections. The fastest and simplest test is a urinalysis, which analyzes a sample of your urine, looking for bacteria and blood cells (both white and red). […] If you have signs or symptoms of a UTI, see your doctor to get an official diagnosis and treatment.

• #1 UTI Test | Lead Blood Test for Exposure | Quest®

  https://www.questhealth.com/product/urinalysis-urinary-tract-infection-uti-test-5463M.html?srsltid=AfmBOooXOceF8CW0n5Wk9_KunDB2McJg5R5L3qpA7o0lVqGI8c6F58Yy

  This urinalysis (urine test) checks for indications of a urinary tract infection (UTI). […] Treatment options may be available after your test if your results are positive or abnormal. […] This urinary tract infection test identifies abnormalities in the urines appearance, content, and concentration. The UTI urinalysis involves a visual, chemical (dipstick test), and microscopic examination of your urine sample to help identify signs of infection. […] Urinalysis is not required to make a diagnosis, but it can offer a pathway to effective treatment, symptom relief, and complication prevention. An abnormal urinalysis by itself does not necessarily mean you have a UTI and need treatment. It is also possible to have a negative urinalysis and still have a UTI. […] This test is specifically used to check for an antibody response to the virus, which can take time to develop. This test is not for those who may still have an active COVID-19 infection.

• #1 Dipstick Urinalysis for the Diagnosis of Acute UTI | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0515/od2.html

  How accurate is dipstick urinalysis for the diagnosis of acute urinary tract infection (UTI)? […] Dipstick urinalysis moderately improves the accuracy of clinical symptoms in establishing or excluding acute UTI in women. […] A positive nitrite test is more useful than a positive leukocyte esterase (LE) test, although both increase the odds of a UTI diagnosis. […] If nitrite and LE tests are negative, the odds of a UTI decrease by 40 to 60 percent. […] A meta-analysis evaluating the diagnostic value of individual signs and symptoms in diagnosing UTIs in females older than 14 years showed that findings of nitrite and LE on dipstick urinalysis improved diagnostic accuracy compared with symptoms alone. […] Dipstick urinalysis was more accurate than any individual symptom. […] A systematic review and meta-analysis assessing whether a negative result on dipstick urinalysis was sufficiently accurate to exclude a UTI found that it reduced the odds of UTI by about 50 to 80 percent.

• #1 Urinary tract infection (UTI) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453

  Cystoscopy allows a health care provider to view the lower urinary tract to look for problems, such as a bladder stone. Surgical tools can be passed through the cystoscope to treat certain urinary tract conditions. […] Tests and procedures used to diagnose urinary tract infections include: […] Analyzing a urine sample. Your health care provider may ask for a urine sample. The urine will be looked at in a lab to check for white blood cells, red blood cells or bacteria. […] Growing urinary tract bacteria in a lab. Lab analysis of the urine is sometimes followed by a urine culture. This test tells your provider what bacteria are causing the infection. It can let your provider know which medications will be most effective. […] Creating images of the urinary tract. Recurrent UTIs may be caused by a structural problem in the urinary tract. Your health care provider may order an ultrasound, a CT scan or MRI to look for this issue. A contrast dye may be used to highlight structures in your urinary tract.

• #1 Uncomplicated Urinary Tract Infections – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470195/

  Classic teaching for diagnosing a UTI typically sets the threshold for culturing infected urine at more than 100,000 colony-forming units (CFUs) per milliliter (CFU/mL). However, recent literature and the American Urological Association Core Curriculum now indicate that a patient with symptoms and a urine culture showing more than 1000 CFU/mL should be diagnosed with a UTI. […] A urine culture is recommended if a patient is sick enough to visit an urgent care center, physician’s office, clinic, or hospital Emergency Department.

• #1 Urinary Tract Infection (UTI) and Cystitis (Bladder Infection) in Females Workup: Approach Considerations, Urinalysis, Urine Culture

  https://emedicine.medscape.com/article/233101-workup

  A study of 196 women with painful and/or frequent urination found that most could be classified as having a low or high risk for UTI by asking the following questions: Does the patient think they have a UTI? Is there at least considerable pain on urination? Is there vaginal irritation? […] The most accurate method to measure pyuria is counting leukocytes in unspun fresh urine using a hemocytometer chamber; greater than 10 white blood cells (WBCs)/mL is considered abnormal. […] Pyuria is a sensitive (80-95%) but nonspecific (50-76%) sign of UTI. […] Urine culture remains the criterion standard for the diagnosis of UTI. Collected urine should be sent for culture immediately; if not, it should be refrigerated at 4C. […] The 2010 Infectious Disease Society of America (IDSA) consensus limits for cystitis and pyelonephritis in women are more than 1000 colony-forming units (CFU)/mL and more than 10,000 CFU/mL, respectively, for clean-catch midstream urine specimens.

• #1 Urinary Tract Infection (UTI) and Cystitis (Bladder Infection) in Females Workup: Approach Considerations, Urinalysis, Urine Culture

  https://emedicine.medscape.com/article/233101-workup

  In the 1980s, many experts felt that urine cultures were unnecessary in young women with probable cystitis because almost all of these were caused by pan-susceptible isolates of Escherichia coli. Since then, however, antibiotic resistance in uropathogenic E coli has become a significant concern. Resistance also has been emerging among other common cystitis pathogens, including Enterococcus faecalis, Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis. […] Nevertheless, according to 2010 guidelines from the American College of Obstetricians and Gynecologists, a urine culture is not required for the initial treatment of women with a symptomatic lower urinary tract infection (UTI) with pyuria or bacteriuria or both. […] Urine cultures should be obtained in all cases of cystitis in immunosuppressed patients and in those with a recent history of instrumentation, exposure to antibiotics, or recurrent infection. Obtaining cultures also is advisable in elderly women, who have a high rate of upper tract involvement.

• #1 Bacterial Urinary Tract Infections – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/urinary-tract-infections-utis/bacterial-urinary-tract-infections

  Bacterial urinary tract infections (UTIs) can involve the urethra, prostate, bladder, or kidneys. […] Diagnosis is based on analysis and culture of urine. […] Diagnosis by culture is not always necessary. If done, diagnosis by culture requires demonstration of significant bacteriuria in properly collected urine. […] Urinalysis […] Sometimes urine culture […] Urine collection […] To obtain a clean-catch, midstream specimen, the urethral opening is washed with a mild, nonfoaming disinfectant and air dried. […] Diagnosis of Bacterial UTIs […] Urine testing […] Microscopic examination of urine is useful but not definitive. […] Cultures are recommended in patients whose characteristics and symptoms suggest complicated UTI or an indication for treatment of bacteriuria. […] Diagnosis reference

• #1 Bladder Infection: Symptoms, Diagnosis, and Treatment

  https://www.webmd.com/a-to-z-guides/understanding-bladder-infections-diagnosis-and-treatment

  You may get more advanced tests if you belong to one of these groups: […] Children […] Men (Because they tend not to get bladder infections, it could be a sign of something else.) […] People who have kidney damage […] Women who get three or more bladder infections in a year or have blood in their urine […] To find the cause of a bladder infection, your doctor can use: […] Cystoscopy. Your doctor inserts a cystoscope — a thin tube with a camera — into your urethra to look for problems or to get a tissue sample for more testing (biopsy). […] Imaging. An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues. […] Intravenous urogram (IVU). This X-ray uses contrast dye to take images of the kidneys, ureters, and bladder. […] Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.

• #1 Bacterial Urinary Tract Infections – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/urinary-tract-infections-utis/bacterial-urinary-tract-infections

  Urinary tract infections are a common cause of hospital-acquired bacteremia. […] In women, pyelonephritis is a common cause of community-acquired bacteremias. […] Pyelonephritis is uncommon in men with a normal urinary tract. […] Symptoms may be absent or include urinary frequency, urgency, dysuria, lower abdominal pain, and flank pain. […] The affected kidney is usually enlarged because of inflammatory polymorphonuclear neutrophils and edema. […] Infection is focal and patchy, beginning in the pelvis and medulla and extending into the cortex as an enlarging wedge. […] Urinary tract imaging choices include ultrasonography, CT, and intravenous urography (IVU). […] Most adults do not require assessment for structural abnormalities unless the following occur: The patient has 2 episodes of pyelonephritis.

• #1 Investigation of recurrent urinary tract infection (UTI)

  https://www.urineincontinence.com.au/urinary-tract-infection/investigation-recurrent-urinary-tract-infection-uti

  Treatment can be started with an appropriate antibiotic as soon as the MSU has been taken, and can be changed if needed when the result of the MSU is available. […] Recommended investigations in recurrent UTIs include Mid-stream urine testing (MSU). […] Imaging of the urinary tract with either a renal tract ultrasound or CT scan: This checks for predisposing factors such as stones and congenital (present since birth) abnormalities in the urinary tract. […] Cystoscopy an examination of the urethra and bladder using a small telescope inserted via the urethra (urine pipe draining the bladder) designed to directly inspect the lining of the urethra and bladder.

• #1 Urinary Tract Infections (UTIs): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/primary-care/urinary-tract-infection-utis/treatment

  Diagnosing urinary tract infections in elderly patients can be difficult since they do not experience the same symptoms as younger people. […] A primary care doctor can diagnose a UTI in their office by using a dipstick urinalysis to detect bacterial infections. […] The treatment for common urinary tract infections (uncomplicated) is usually antibiotics. The type of antibiotic prescribed depends on which bacteria is causing the urinary tract infection. […] Never stop taking an antibiotic just because you’re feeling better. Continue the medication until it is finished to ensure total eradication of the infection.

• #1 Urinary Tract Infection (UTI) in Males Workup: Approach Considerations, Urine Studies, Imaging Studies

  https://emedicine.medscape.com/article/231574-workup

  The workup of urinary tract infections (UTIs) is dependent on the suspected diagnosis. Urinalysis, Gram staining, and urine culture should always be obtained. The threshold for establishing true UTI includes documenting 2-5 or more white blood cells (WBCs) or 15 bacteria per high-power field (HPF) in a centrifuged urine sediment. […] Urine culture remains the gold standard for the diagnosis of UTI. Collected urine should be immediately sent for culture; if not, it should be refrigerated at 4C. Two culture techniques (dip slide, agar) are used widely and are accurate. […] The exact number of bacteria in a urine culture that is needed to define UTI in a man is a bit controversial; generally, positive results are seen if there are more than 1000 colony-forming units (CFU)/mL of urine, much lower than the threshold for women.

• #1 Urinary Tract Infections in Pregnant Individuals | ACOG

  https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2023/08/urinary-tract-infections-in-pregnant-individuals

  Summary: Urinary tract infection (UTI) is one of the more common perinatal complications, affecting approximately 8% of pregnancies. These infections represent a spectrum, from asymptomatic bacteriuria, to symptomatic acute cystitis, to the most serious, pyelonephritis. The presence of UTIs has been associated with adverse pregnancy outcomes, including increased rates of preterm delivery and low birth weight. Screening for and treating asymptomatic bacteriuria have been shown in multiple studies to reduce the incidence of pyelonephritis in pregnancy. Given the frequency at which UTIs are encountered in pregnancy, the ability to recognize, diagnose, and treat them is essential for those providing care to pregnant individuals. […] Urinary tract infections are classified based on the site of infection: lower urinary tract (ASB or cystitis) or upper urinary tract (pyelonephritis). Asymptomatic bacteriuria, the presence of significant bacterial counts in the urine without symptoms, is identified in 210% of pregnant patients. Screening for and treating ASB have been shown in multiple studies to reduce the incidence of pyelonephritis in pregnancy.

• #1 Urinary Tract Infection (UTI) | MicroGen Diagnostics

  https://microgendx.com/patients/urinary-tract-infection-uti/

  A urinary tract infection (UTI) is an infection in any part of your urinary system your kidneys, bladder, ureters (the tubes that carry urine from the kidneys to the bladder) or urethra (the tube that carries urine out of the body). […] An evaluation and culture (growing microbes from your sample in a lab) are often used to diagnose UTIs. However, standard cultures may come back negative even when you actually do have an infection, and that means your infection wont be treated. […] Rather than relying on culture, a MicroGenDX test detects the DNA of all microbes in your sample, along with how much of each is present, and uses that information to identify the bacteria in your infection and the drugs that can best treat it. […] Your doctor should consult the „antimicrobials for consideration” chart on your MicroGenDX report to decide what antibiotic is right for you.

• #1 Point-of-care testing for urinary tract infections — NIHR Community Healthcare MIC

  https://www.community.healthcare.mic.nihr.ac.uk/reports-and-resources/horizon-scanning-reports/point-of-care-testing-for-urinary-tract-infections

  In diagnosing patients with suspected urinary tract infections, what is the accuracy and utility of point-of-care tests compared to the current standard of urine microscopy, culture and antibiotic sensitivity analysis? […] The current standard for diagnosing patients with suspected UTI is microscopy, culture and antibiotic sensitivity analysis of a midstream, clean-catch urine specimen, although this is not recommended for first-time uncomplicated UTI. […] The results of these tests are typically available within 24-72 hours after the microbiology laboratory receives the specimen. […] In routine practice, clinicians can perform a urine dipstick test which confirms the presence of a urinary tract infection with 45% sensitivity and 99% specificity based on positive urine leucocyte esterase and nitrites.

• #1 How Home Tests for Urinary Tract Infections (UTI) Work

  https://www.webmd.com/a-to-z-guides/home-test-for-uti

  A urinary tract infection (UTI) affects your urinary tract. […] If you think you have a UTI, see your doctor. Theyll find out whether your symptoms are caused by that or something else. A home test can help you find out faster. […] Home test kits might be useful if you have UTIs that keep coming back. But the results can be affected by a number of things, like medications youre taking. And studies show that urine cultures are far more reliable for showing whether you have a UTI. […] The bottom line: See your doctor to be sure, no matter what your UTI home test reveals. A home test can give you an idea if you have a UTI, but it can’t diagnose you.

• #1 Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/10/581

  The urine culture, the cornerstone for laboratory diagnosis of urinary tract infection (UTI), is associated with a high frequency of false-positive and false-negative results, and its diagnostic threshold is debated. […] The authors review current expert guidance on the use of urine culture, including approaches to ordering, processing, and reporting of urine cultures, with the goal of reducing unnecessary antibiotic use and misdiagnosis of UTI. […] Current guidance based on an expert panel consensus by Claeys et al recommends appropriate laboratory urine testing and interpretation of the results when the potential for UTI is being assessed. […] The guidance describes approaches to reduce unnecessary antibiotic use and the misdiagnosis of UTI and is organized according to the procedure for urine culture: ordering, processing, and reporting.

• #1 EAU Guidelines on Urological Infections – Uroweb

  https://uroweb.org/guidelines/urological-infections/chapter/the-guideline

  Although the benefits to patients of antibiotic use are clear, overuse and misuse have contributed to the growing problem of resistance amongst uropathogenic bacteria, which is a serious threat to public health. […] In response, a worldwide initiative seeks to incorporate antimicrobial stewardship programmes in healthcare. […] Antimicrobial Stewardship aims to optimise clinical outcomes and ensure cost-effective therapy whilst minimising unintended consequences of antimicrobial use such as healthcare associated infections including Clostridioides difficile, toxicity, selection of virulent organisms and emergence of resistant bacterial strains. […] The important components of antimicrobial stewardship programmes are regular training of staff in best use of antimicrobial agents; adherence to local, national or international guidelines; regular ward visits and consultation with infectious diseases physicians and clinical microbiologists; audit of adherence and treatment outcomes; regular monitoring and feedback to prescribers of their performance and local pathogen resistance profiles.

• #1 Does my patient need to be screened or treated for a urinary tract infection? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/12/695

  Patients with symptoms consistent with urinary tract infection (UTI) do not need to be tested and should be treated. […] Patients with classical UTI symptoms that include new or acutely worsening dysuria, urinary frequency, urgency, suprapubic pain, and hematuria, particularly in the absence of vaginal symptoms, can be diagnosed and treated for UTI without the need of urine studies. […] When patients present with symptoms that are suggestive but not clearly diagnostic of UTI, urine studies should be obtained. […] Together with symptoms, the presence of bacteria, leukocyte esterase or white blood cells, nitrites, and hemoglobin or red blood cells in the urine support the diagnosis of UTI and its treatment. […] Screening and treatment for asymptomatic bacteriuria, or bacteria in the urine without symptoms, should only be done in patients who are pregnant or preparing for a procedure associated with urologic mucosal trauma.

• #1 New and emerging technologies for the diagnosis of urinary tract infections

  https://www.degruyter.com/document/doi/10.1515/labmed-2021-0085/html?lang=en

  Knowledge of antibiotic susceptibility of an infection, in addition to the identification of the pathogen, is essential to providing appropriate therapy. The standard method of determining Antibiotic susceptibility testing (AST) is through phenotypic bacterial growth assays in the presence of antibiotics, where the strain is classified as resistant, susceptible, or intermediate. […] A timely diagnosis of UTIs is essential to prevent inappropriate antibiotic treatments and to promote antibiotic stewardship, thereby. The pathogen and its antibiotic susceptibility should be identified within a few hours of sample collection, such that the correct therapy can be started within the same day that the patient visits the doctor. New diagnostic technologies have the potential to promote both patient care and management as well as antibiotic stewardship by delivering rapid results.

• #1 Diagnosing urinary tract infection in primary care — NIHR Community Healthcare MIC

  https://www.community.healthcare.mic.nihr.ac.uk/news/blogs/diagnosing-urinary-tract-infection-in-primary-care

  Urinary tract infection (UTI) is the most common bacterial infection among women attending primary care, with half of all women experiencing at least one UTI in their lifetime. […] Accurate early diagnosis of UTI is important as it allows suitable treatment, usually antibiotics, to be prescribed appropriately, while avoiding unnecessary prescriptions being given to those who will not benefit from them. […] We found that 61% (311/509) of women classified as UTI likely had a positive urine culture, with 13% (64/509) having a negative urine culture and the remainder being mixed growth, meaning that a UTI could neither be confirmed nor ruled out. […] Our study quantifies the performance of current guidelines for the first time. Although we think the guidelines have some diagnostic capability, we think it is important for GPs to recognise that they have the potential for significant levels of misdiagnosis, and do not always identify the individuals who are most likely to benefit from an antibiotic prescription. […] For these reasons, a research priority should be to investigate the performance of point-of-care tests for UTI which can be used at the time of first consultation.

• #2 Diagnosing Urinary Tract Infections | NYU Langone Health

  https://nyulangone.org/conditions/urinary-tract-infections/diagnosis

  Urinary tract infection (UTI) is the second most common type of infection, leading to millions of doctor visits per year in the United States. Doctors at NYU Langone are skilled in diagnosing and treating UTI in both men and women. […] A UTI can occur at any point along this tract. […] Symptoms of a UTI can include a strong urge to urinate, burning with urination, passing small amounts of urine, or urine that is cloudy, red, pink, brown, or strong-smelling. […] To diagnose a UTI, your NYU Langone doctor asks about your medical history, performs a physical exam, and may recommend one or more tests. […] This urine sample is tested for bacteria in the doctors office. A positive result indicates a high likelihood of infection. […] If you have frequent urinary tract infections, your doctor may order an ultrasound to check the kidneys and bladder for irregularities that may require treatment. […] Your doctor may perform a CT scan to provide clear, three-dimensional images of the urinary tract. […] Sometimes a cystoscopy is performed to diagnose the cause of a recurrent UTI.

• #2 Diagnosis and Treatment of Acute Uncomplicated Cystitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1001/p771.html

  The physical examination of patients with acute uncomplicated cystitis is typically normal, except in the 10 to 20 percent of women with suprapubic tenderness. […] A colony count greater than or equal to 103 colony-forming units per mL of a uropathogen is diagnostic of acute uncomplicated cystitis. […] Further studies beyond urinalysis and urine cultures are rarely needed to diagnose acute uncomplicated cystitis.

• #2 Urinary Tract Infections in the Primary Care Setting – Investigation – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/urinary-tract-infections

  Symptoms, clinical history, and demographics determine the approach to diagnosis and testing. […] In premenopausal women, the presence of acute dysuria, frequency and no vaginal discharge has a 90% positive predictive value of UTI. […] In non-pregnant women, antibiotic-sparing strategies can be considered based on patient preference, symptom severity and risk of complications. […] Do not order routine urine cultures in the absence of symptoms, even in patients with recurrent UTI and/or on prophylactic antibiotics.

• #2 Urinary Tract Infections (UTIs): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/primary-care/urinary-tract-infection-utis/treatment

  How is a Urinary Tract Infection (UTI) Diagnosed? Diagnosis Most urinary tract infections are easy to recognize and diagnose because of their distinct symptoms. Diagnosing a UTI is most times done right in the doctors office. A urinary tract infection will usually show up in a urine test. However, the doctor might send the urine to a laboratory for further inspection and to discern which type of antibiotic would work best. […] Further tests are generally done to determine the correct treatment in cases of more serious urinary tract infections. Common tests used to detect a UTI include: […] A urinalysis will detect the type of bacteria or germs causing the infection. […] A urine culture is sent to a laboratory for further examination for bacteria, yeast, or other microorganisms that could be growing in the urinary tract. The results are used to determine the course of treatment.

• #2 UTI Test | Lead Blood Test for Exposure | Quest®

  https://www.questhealth.com/product/urinalysis-urinary-tract-infection-uti-test-5463M.html?srsltid=AfmBOooXOceF8CW0n5Wk9_KunDB2McJg5R5L3qpA7o0lVqGI8c6F58Yy

  If you suspect that you may have a urinary tract infection, it is recommended that you see your healthcare provider in-person to evaluate your symptoms. […] The presence of white blood cells in the urine indicates a bacterial infection in the urinary tract or kidneys. […] This test can help healthcare professionals diagnose a urinary tract infection by identifying the presence or absence of bacteria that may cause infection. […] Bacteria are not normally present in the urine so the presence of bacteria is a good indication of an infection. […] A UTI may cause a variety of uncomfortable signs and symptoms, including painful urination (dysuria), a strong, persistent urge to urinate despite having an empty bladder, burning sensation while urinating, passing frequent, small amounts of urine, urine that is cloudy or milky, has an unusual odor, or contains blood, pressure or cramping in the lower abdomen, pelvic pain, including pain around the pubic bone.

• #2 Dipstick Urinalysis for the Diagnosis of Acute UTI | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0515/od2.html

  The authors recommend empiric antibiotic treatment if nitrite results are positive, or if LE and blood results are positive. […] An evidence-based guideline from the University of Michigan estimates that dipstick urinalysis for LE is 75 to 96 percent sensitive and 94 to 98 percent specific. […] The American College of Obstetricians and Gynecologists states that dipstick urinalysis for LE or nitrite is a rapid and inexpensive screening test, with a sensitivity of 75 percent and specificity of 82 percent. […] In women with symptoms but negative test results, a urine culture and/or urinalysis should be performed because false-negative results are common. […] The European Association of Urology recommends dipstick urinalysis to detect pyuria, hematuria, and nitrite if UTI is suspected.

• #2 Urine Culture: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/22126-urine-culture

  A urine culture is a test healthcare providers use to check for a urinary tract infection (UTI) by seeing if bacteria or fungi can grow from a sample of your pee. A urine culture test can also identify bacteria or yeast causing a UTI and which drugs work best to treat the infection. If you have symptoms and a culture is positive, you have a UTI. […] Healthcare providers order urine cultures to check for urinary tract infections (UTIs). Your provider may recommend one if you have symptoms of a UTI, like pain when you pee, urgent need to pee, frequent urination or leaking pee. […] A urine culture test also identifies the bacteria or yeast causing the infection and lets your provider know which antibiotics will work to kill the germs. This helps your provider select the most effective treatment.

• #2 Urinary Tract Infection (UTI) and Cystitis (Bladder Infection) in Females Workup: Approach Considerations, Urinalysis, Urine Culture

  https://emedicine.medscape.com/article/233101-workup

  An uncomplicated UTI (cystitis) does not require a urine culture unless the woman has experienced a failure of empiric therapy. Obtain a urine culture in patients suspected of having an upper UTI or a complicated UTI, as well as those in whom initial treatment fails. […] If a Gram stain of an uncentrifuged, clean-catch, midstream urine specimen reveals the presence of 1 bacterium per oil-immersion field, it represents 10,000 bacteria/mL of urine.

• #2 Urinary Tract Infections in the Primary Care Setting – Investigation – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/urinary-tract-infections

  UTI is a clinical diagnosis. […] Urine microscopy is NOT recommended for investigating UTI. […] Urine dipstick is more helpful in some scenarios than others: In women with a clear presentation of acute cystitis (high pre-test probability), the dipstick is not required as the result will not change management. A negative dipstick is not sensitive enough to rule out infection in this scenario. […] However, in women with atypical or unclear symptoms (low pre-test probability), a positive urine dipstick can support the diagnosis, while a negative urine dipstick can rule out UTI. […] Male UTIs are atypical and dipstick testing is warranted for suspected UTI. […] Urine culture is not required in most cases of cystitis. It should be requested only when there is a higher risk of resistant uropathogen, or in specific circumstances to confirm the diagnosis.

• #2 Bacterial Urinary Tract Infections – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/urinary-tract-infections-utis/bacterial-urinary-tract-infections

  Bacterial urinary tract infections (UTIs) can involve the urethra, prostate, bladder, or kidneys. […] Diagnosis is based on analysis and culture of urine. […] Diagnosis by culture is not always necessary. If done, diagnosis by culture requires demonstration of significant bacteriuria in properly collected urine. […] Urinalysis […] Sometimes urine culture […] Urine collection […] To obtain a clean-catch, midstream specimen, the urethral opening is washed with a mild, nonfoaming disinfectant and air dried. […] Diagnosis of Bacterial UTIs […] Urine testing […] Microscopic examination of urine is useful but not definitive. […] Cultures are recommended in patients whose characteristics and symptoms suggest complicated UTI or an indication for treatment of bacteriuria. […] Diagnosis reference

• #2 Urinary Tract Infection (UTI): Symptoms, Causes, and Treatments

  https://www.healthline.com/health/urinary-tract-infection-adults

  A urinary tract infection (UTI) is an infection in the organs of your urinary tract, which includes the bladder and kidneys. […] To confirm a diagnosis of a UTI, your doctor will need to have your urine tested for microbes. […] The urine sample needs to be a clean catch sample. This means the urine sample is collected at the middle of your urinary stream rather than at the beginning. […] Your doctor will also order a urine culture to test for bacteria or fungi. The culture can help identify the cause of the infection. […] If your doctor suspects the UTI is viral, special testing may need to be performed. […] If your doctor suspects that you have an upper tract UTI, they may need to order a complete blood count (CBC) and blood cultures in addition to a urine test. […] A blood culture can confirm that your infection hasn’t spread to your bloodstream.

• #2 Urinary tract infection (UTI) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453

  Using a scope to see inside the bladder. If you have recurrent UTIs, your health care provider may perform a cystoscopy. The test involves using a long, thin tube with a lens, called a cystoscope, to see inside the urethra and bladder. The cystoscope is inserted in the urethra and passed through to the bladder.

• #2 Urinary Tract Infection Causes and Diagnoses | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/urology/urinary-tract-infections/causes-and-diagnoses

  Normal urine is sterile, without any bacteria or fungi. A UTI happens when germs, often from the digestive tract, travel through the urethra and into the bladder. […] Most UTIs are caused by E. coli bacteria, which occur naturally in the digestive tract. […] Your physician will review your medical history and perform a physical exam. Other tests may include: A urinalysis to detect blood cells, germs (like bacteria) or excess protein in the urine. A urine culture through which a lab will attempt to grow potential bacteria or yeast found in the urine to help in diagnosis and treatment. […] If UTIs become a repeated problem, other tests may be used to see if the urinary tract is normal. These tests may include: Cystourethroscopy also known as a cystoscopy, to examine the inside of your bladder and urethra. It is often used to diagnose and evaluate urinary tract disorders, such as urinary tract inflammation, bladder stones and bladder tumors. Kidney and bladder ultrasound to show the size and shape of the bladder and kidneys through high-frequency sound waves. This test can locate a mass, stones, cysts, blockages and abnormalities. CT scan to make detailed images of the urinary tract through the use of X-rays and a computer.

• #2 Bacterial Urinary Tract Infections – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/urinary-tract-infections-utis/bacterial-urinary-tract-infections

  Infections are complicated. […] Nephrolithiasis is suspected. […] There is painless gross hematuria or new renal insufficiency. […] Fever persists for 72 hours. […] In general, culture urine in suspected complicated UTI but not in uncomplicated cystitis. […] If available, consider local resistance patterns when choosing antibiotic therapy for UTI. […] For women with 3 UTIs/year despite behavioral prophylactic measures, consider continuous or postcoital antibiotic prophylaxis.

• #2 Bladder Infection: Symptoms, Diagnosis, and Treatment

  https://www.webmd.com/a-to-z-guides/understanding-bladder-infections-diagnosis-and-treatment

  You may get more advanced tests if you belong to one of these groups: […] Children […] Men (Because they tend not to get bladder infections, it could be a sign of something else.) […] People who have kidney damage […] Women who get three or more bladder infections in a year or have blood in their urine […] To find the cause of a bladder infection, your doctor can use: […] Cystoscopy. Your doctor inserts a cystoscope — a thin tube with a camera — into your urethra to look for problems or to get a tissue sample for more testing (biopsy). […] Imaging. An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues. […] Intravenous urogram (IVU). This X-ray uses contrast dye to take images of the kidneys, ureters, and bladder. […] Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.

• #2 Urinary Tract Infections in the Primary Care Setting – Investigation – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/urinary-tract-infections

  New onset confusion and delirium alone are NOT considered symptoms of UTI. In elderly or debilitated patients with new cognitive or functional changes and no symptoms of UTI, testing for, and treatment of, UTI is not warranted. […] Urine microscopy (white blood cells, red blood cells and bacteria) is NOT needed to diagnose a UTI. […] A urine culture should be requested in specific circumstances to confirm the diagnosis (if needed) and to guide antibiotic therapy. […] This test may be positive due to UTI, asymptomatic bacteriuria or contamination from skin, perineal or gastrointestinal flora. […] The laboratory workup considers both the number of different bacterial species identified and their respective concentrations. […] For this protocol, UTI is classified as cystitis, where the infection is confined to the bladder, or complicated UTI, with extension outside the bladder.

• #2 Urinary Tract Infections in Pregnant Individuals | ACOG

  https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2023/08/urinary-tract-infections-in-pregnant-individuals

  Clinicians should screen for ASB with a urine culture once at a visit early in prenatal care. There is insufficient evidence to recommend for or against repeat screening during pregnancy after a negative initial culture result. […] Clinicians should evaluate patients with symptoms of acute cystitis with a urine culture. UTI should be suspected based on the presence of symptoms, may be supported by a positive urinalysis result, and is confirmed by urine culture showing 100,000 CFU/mL or more. […] Pyelonephritis should be suspected in the presence of fever of 38.0 C or higher and urine studies suggesting UTI, with additional symptoms of upper genitourinary tract infection, such as flank pain or costovertebral angle tenderness, supporting the diagnosis. […] Clinicians initially should manage pyelonephritis in pregnancy in the inpatient setting. Empiric antibiotic therapy should have adequate renal tissue penetration and be targeted against the most likely pathogens. Antibiotic therapy should be adjusted as needed based on urine culture and sensitivity. Parenteral antibiotics should be continued until the patient is clinically improving. Patients should complete a total of 14 days of antibiotic therapy. There is insufficient evidence to guide management after treatment of pyelonephritis in pregnancy. Clinicians may consider suppressive therapy for the remainder of the pregnancy, as for recurrent UTI.

• #2 New and emerging technologies for the diagnosis of urinary tract infections

  https://www.degruyter.com/document/doi/10.1515/labmed-2021-0085/html?lang=en

  Urinary tract infections affect 150 million people worldwide, yet the diagnosis of this common infection is not straightforward. Misdiagnoses and incorrect prescriptions are frequent in the treatment of urinary tract infections; this also contributes to the increase in antibiotic resistance among pathogens. Present diagnostic practices take 23 days for pathogen identification and antibiotic susceptibility testing. New technologies are urgently needed for improved patient care as well as to promote antibiotic stewardship. An ideal new diagnostic technology will test clinical urine samples directly and identify the pathogen and determine its antibiotic susceptibilities within a few hours such that the patient can be prescribed the appropriate antibiotic treatment the same day. […] Urine culture is considered the most diagnostic test for UTIs. The most common cause of UTIs across all age groups is Escherichia coli. Other common uropathogens are the Enterobacteriaceae family, Proteus, Klebsiella, Staphylococcus saprophyticus and Enterococcus sp. Group B Streptococcus is frequently isolated from pregnant women.

• #2 Urinary Tract Infection (UTI) | MicroGen Diagnostics

  https://microgendx.com/patients/urinary-tract-infection-uti/

  Some bacteria that cause UTIs can develop resistance to specific antibiotics, so that they cannot be effectively treated with those antibiotics. This is why all MicroGenDX diagnostic tests include detection of antibiotic resistance genes in your sample, and then provide alternative antibiotics for your doctor to consider prescribing to you.

• #2 Point-of-care testing for urinary tract infections — NIHR Community Healthcare MIC

  https://www.community.healthcare.mic.nihr.ac.uk/reports-and-resources/horizon-scanning-reports/point-of-care-testing-for-urinary-tract-infections

  However, the test cannot specify the causative uropathogen(s) involved and antibiotic sensitivities. […] Under usual circumstances when patients present with UTI symptoms, clinicians prescribe antibiotics empirically (for broad-spectrum coverage of the most common uropathogens) or based on a positive urine dipstick test. […] The corollary of empirical treatment is the emergence of multi-drug-resistant uropathogenic organisms especially among Enterobacteriaceae family members, which are increasingly acquiring extended-spectrum -lactamases (ESBLs), such as cefotaximases (CTX-Ms), oxacillinases (OXAs), AmpC-type -lactamases and carbapenemases. […] The prevalence of these multi-drug resistant infections is on the rise, which will evidently augment the health and economic burden of this disease.

• #2 3 Best At-Home UTI Tests of 2022 – Testing.com

  https://www.testing.com/tests/at-home-uti-test/

  A urinary tract infection (UTI) is an illness in which bacteria or other microbes cause an infection in the urinary tract. […] UTIs are the most common infections that occur outside of hospitals in the U.S. Approximately 50% to 60% of adult women will experience at least one UTI in their lifetime. […] At-home UTI testing is one method of detecting a urinary tract infection. Also called a urine dipstick, this test involves dipping a test strip into a sample of urine to check for substances that are often present when you have a urinary tract infection. […] Although at-home testing may provide helpful information, testing for a UTI at home is not appropriate if you don’t have symptoms. At-home testing is also not a replacement for a medical evaluation performed by a health professional who has more comprehensive test options to diagnose a UTI.

• #2 3 Best At-Home UTI Tests of 2022 – Testing.com

  https://www.testing.com/tests/at-home-uti-test/

  An at-home UTI test may provide helpful information if you want to learn whether your symptoms may be related to a urinary tract infection. […] Regardless of the result of your at-home UTI test results, it’s important to review results with a doctor. Diagnosing or ruling out a urinary tract infection may require several additional tests that can only be ordered and interpreted by a medical professional. […] If you have UTI symptoms, follow-up testing is necessary after using at-home UTI tests regardless of the test result.

• #2 Urinary Tract Infection Diagnostics | Pioneering Diagnostics

  https://www.biomerieux.com/corp/en/our-offer/hospital-laboratory/patient-condition/urinary-tract-infections.html

  Urinary tract infections (UTIs) are among the most common infections in the clinical environment. […] Most UTIs are caused by Gram-negative bacteria, most commonly Escherichia coli or species of Klebsiella, Proteus, Pseudomonas, or Enterobacter, although other strains, such as Staphlyococcus and Serratia, are emerging. […] Although UTIs are usually uncomplicated and can be treated with a short course of antibiotics, they can be painful and recurrent. […] UTIs are involved in up to 40% of healthcare-associated infections (HAI), principally due to catheter use. […] UTIs are increasingly caused by drug-resistant bacteria, making it especially important to identify the pathogen involved and resistance mechanisms, to effectively orient antibiotic therapy. […] In the United States alone, UTI-related symptoms lead to almost 10 million office visits and around 3 million emergency visits each year.

• #2 Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/10/581

  The central tenets of the guidance are avoiding testing and treatment of asymptomatic bacteriuria, and avoiding fluoroquinolones as first-line treatment for acute cystitis, principles corroborated by other major guidelines. […] The main recommendations focus on optimizing urine culture diagnostic stewardship and antibiotic stewardship. […] The recommendations are broadly classified by ordering, processing, and reporting of urine cultures, along with associated appropriate and inappropriate practices. […] Appropriate practice for ordering a urine culture includes documentation of signs or symptoms of UTI in order to obtain a urine culture. […] Inappropriate practice is the inclusion of culture in standard order sets, or ordering urine cultures in response to a change of urine characteristics.

• #2 Does my patient need to be screened or treated for a urinary tract infection? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/12/695

  Treatment of UTI is always recommended when patients present with classical UTI urologic symptoms. In this case, urine studies are not needed to establish diagnosis. […] Urine studies should be attained when patients present with symptoms that are not clearly diagnostic of UTI. In this case, the presence of bacteria, white or red blood cells in the urine supports treatment. […] Patients with nonspecific findings not consistent with UTI should not routinely be evaluated or treated for UTI unless they have mental or physical disability that precludes them from experiencing or expressing urologic symptoms (such as spinal cord injury or mental retardation). […] Asymptomatic patients should not be screened for or treated for asymptomatic bacteriuria unless the patient is pregnant or preparing for a procedure associated with urologic mucosal trauma.

• #3 Urinary Tract Infection Diagnostics | Pioneering Diagnostics

  https://www.biomerieux.com/corp/en/our-offer/hospital-laboratory/patient-condition/urinary-tract-infections.html

  Urinary tract infections (UTIs) are among the most common infections in the clinical environment. […] Most UTIs are caused by Gram-negative bacteria, most commonly Escherichia coli or species of Klebsiella, Proteus, Pseudomonas, or Enterobacter, although other strains, such as Staphlyococcus and Serratia, are emerging. […] Although UTIs are usually uncomplicated and can be treated with a short course of antibiotics, they can be painful and recurrent. […] UTIs are involved in up to 40% of healthcare-associated infections (HAI), principally due to catheter use. […] UTIs are increasingly caused by drug-resistant bacteria, making it especially important to identify the pathogen involved and resistance mechanisms, to effectively orient antibiotic therapy. […] In the United States alone, UTI-related symptoms lead to almost 10 million office visits and around 3 million emergency visits each year.

• #3 Urinary Tract Infections in the Primary Care Setting – Investigation – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/urinary-tract-infections

  UTI is a clinical diagnosis. […] Urine microscopy is NOT recommended for investigating UTI. […] Urine dipstick is more helpful in some scenarios than others: In women with a clear presentation of acute cystitis (high pre-test probability), the dipstick is not required as the result will not change management. A negative dipstick is not sensitive enough to rule out infection in this scenario. […] However, in women with atypical or unclear symptoms (low pre-test probability), a positive urine dipstick can support the diagnosis, while a negative urine dipstick can rule out UTI. […] Male UTIs are atypical and dipstick testing is warranted for suspected UTI. […] Urine culture is not required in most cases of cystitis. It should be requested only when there is a higher risk of resistant uropathogen, or in specific circumstances to confirm the diagnosis.

• #3 Diagnosis of Bladder Infection in Adults – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults/diagnosis

  Health care professionals use your medical history, a physical exam, and lab tests to diagnose a bladder infection. […] Your health care professional will use your medical history, a physical exam, and lab and other tests to diagnose a bladder infection. […] Health care professionals may use lab tests to test your urine or your blood. […] Lab tests include urinalysis, urine culture, and blood tests. […] Urinalysis checks your urine sample for blood in the urine and white blood cells. […] Urine culture identifies some common types of bacteria in your urine. […] Blood tests look for a more serious infection, such as a kidney infection. […] If you have repeat bladder infections, your health care professional may also use urinary tract imaging to help identify the cause of your infection, such as a kidney stone. […] Your health care professional may also use cystoscopy to look inside the urethra and bladder.

• #3 Urinary Tract Infections in the Primary Care Setting – Investigation – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/urinary-tract-infections

  New onset confusion and delirium alone are NOT considered symptoms of UTI. In elderly or debilitated patients with new cognitive or functional changes and no symptoms of UTI, testing for, and treatment of, UTI is not warranted. […] Urine microscopy (white blood cells, red blood cells and bacteria) is NOT needed to diagnose a UTI. […] A urine culture should be requested in specific circumstances to confirm the diagnosis (if needed) and to guide antibiotic therapy. […] This test may be positive due to UTI, asymptomatic bacteriuria or contamination from skin, perineal or gastrointestinal flora. […] The laboratory workup considers both the number of different bacterial species identified and their respective concentrations. […] For this protocol, UTI is classified as cystitis, where the infection is confined to the bladder, or complicated UTI, with extension outside the bladder.

• #3 UTI Testing – Testing.com

  https://www.testing.com/uti-testing/

  This is a test that detects and identifies specific bacteria and yeast in a patient’s urine that may be causing a UTI. Urine cultures can also help doctors determine the best antibiotic for treating a UTI. […] Testing for a UTI usually takes place in a doctor’s office, laboratory, or hospital. Most tests for UTIs involve a urine sample obtained by clean-catch or catheterization. […] At-home kits are available that can detect two substances in the urine that are characteristic of a UTI: nitrites and leukocytes. […] At-home testing can only detect the most common types of UTIs, so a negative result does not necessarily rule out an infection. Testing for a UTI at home is not a substitute for either medical care or testing ordered by a doctor and conducted in a controlled laboratory.

• #3 Urinary tract infection (UTI): What does diagnosis involve?

  https://www.medicalnewstoday.com/articles/uti-diagnosis

  Diagnosing a UTI involves examining a urine sample to detect the presence of bacteria or using imaging tests to diagnose other underlying causes. […] A healthcare professional will be able to determine the underlying cause and recommend some of the tests that this article later discusses. […] Diagnosing a UTI usually involves a urine test. This requires obtaining a urine sample, which a doctor then examines for the presence of pathogens, such as bacteria, white blood cells, and other indicators of infection. […] A positive result for the presence of bacteria or a higher white blood cell count typically confirms the diagnosis of a UTI. […] In some cases, healthcare professionals may recommend imaging tests to assess the urinary tract for abnormalities. […] For recurrent or persistent UTIs, a healthcare professional may recommend a cystoscopy or ureteroscopy. These procedures involve inserting a thin, flexible tube with a camera into the urinary tract to visually inspect the bladder, urethra, and other structures for signs of infection or abnormalities.

• #3 Urinary Tract Infection (UTI) Test – NxGen MDx

  https://nxgenmdx.com/uti/

  With NxGen MDx, your doctor can prescribe an optimized treatment plan to clear your infection and help keep it from returning. […] Using culture to diagnose a UTI is significantly limited by false-negative results and long turnaround times. NxGen MDxs PCR-based UTI Test is about 25% more accurate than culture, giving you confidence in your patients results. […] Use NxGen MDxs UTI Test and give your patient the optimal treatment plan for their unique infection. […] Pregnant women are at an increased risk for both symptomatic and asymptomatic UTIs. Therefore, all pregnant women should be tested and treated for bacteriuria to reduce the risk of serious complications which include: […] The NxGen MDx UTI Test impacts patient care. […] Partnering with NxGen MDx has positively impacted my clinical practice and patient outcomes.

• #3 Inflammatory markers for improved recurrent UTI diagnosis in postmenopausal women | Life Science Alliance

  https://www.life-science-alliance.org/content/7/4/e202302323

  Recurrent urinary tract infection (rUTI) severely impacts postmenopausal women. The lack of rapid and accurate diagnostic tools is a major obstacle in rUTI management as current gold standard methods have 24-h diagnostic windows. […] This study aimed to identify urinary cytokines that could accurately diagnose UTI in a controlled cohort of postmenopausal women. […] Accurate diagnosis of UTI remains a clinical challenge. Initial UTI diagnosis is based on symptoms, physical examination, and urinalysis. Urine culture (UC) is the gold standard to confirm UTI diagnosis but has a diagnostic window of 48-72 h. […] Inflammatory cytokines secreted as part of the immune response to infection have the potential to be useful diagnostic biomarkers. […] Therefore, the aim of this study was to investigate urinary cytokines as diagnostic markers for rUTI in postmenopausal women.

• #3 Point-of-care testing for urinary tract infections — NIHR Community Healthcare MIC

  https://www.community.healthcare.mic.nihr.ac.uk/reports-and-resources/horizon-scanning-reports/point-of-care-testing-for-urinary-tract-infections

  Point-of-care (POC) testing for UTIs can potentially decrease the time involved in getting an accurate diagnosis. […] provide doctors with specific guidance on which antibiotics to prescribe for maximum therapeutic benefit. […] reduce laboratory load of urine specimens and associated costs. […] mitigate the increasing prevalence of antibiotic resistance with inappropriate broad-spectrum antibiotic prescribing. […] minimise the number of GP visits and hospital admissions associated with mismanaged urinary tract infections and adverse effects of inappropriately prescribed antibiotics. […] Urine microscopy, culture and sensitivity analysis in a microbiology laboratory is considered the reference standard for UTI diagnosis. […] However, this requires adequate laboratory facilities, it is expensive and labour-intensive (needing trained technicians and microbiologists to interpret the results), culminating in a 24-72 hour delay in diagnosis.

• #3 3 Best At-Home UTI Tests of 2022 – Testing.com

  https://www.testing.com/tests/at-home-uti-test/

  The purpose of UTI testing is to determine if an infection in the urinary tract could be the cause of your symptoms. […] At-home UTI testing allows you to look for evidence of a urinary tract infection quickly and in the privacy of your home. […] Performing a urine dipstick test at home involves submerging a test strip in a sample of urine. The dipstick is designed to detect substances that are typically found in the urine of people with a UTI. […] Although an at-home test may provide information about whether a UTI could be causing your symptoms, it is not a conclusive test. Diagnosing the cause of your symptoms can only be done by a health professional. […] At-home UTI tests check for two substances in the urine: leukocytes and nitrites. […] At-home UTI tests use a test strip called a dipstick to determine if there are nitrites or leukocytes in your urine.

• #3 Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/10/581

  Appropriate practice includes using an elevated white blood cell count on urine microscopy as a criterion for reflex culture when a urine culture is ordered by a clinician. […] Appropriate practice should include urine culture reports informing clinicians that counts greater than 100,000 colony-forming units (CFU)/mL may not represent true infection in the absence of symptoms, and reminding clinicians not to treat asymptomatic bacteriuria or mixed flora. […] The goal of the current guidance is different from the IDSA/American Society for Microbiology (ASM) guidelines in that the focus is the best implementation of urine testing for the optimal treatment for UTI. […] The clinical impact of the guidance can be stratified into 2 main categories: reduction in unnecessary antibiotic use, which is good antimicrobial stewardship practice, and cost avoidance through decreased urine culture testing and inappropriate therapy, which is good diagnostic stewardship practice.

• #4 Inflammatory markers for improved recurrent UTI diagnosis in postmenopausal women | Life Science Alliance

  https://www.life-science-alliance.org/content/7/4/e202302323

  We found that urinary concentrations of IL-1, IL-8, IL-18, MCP-1 are significantly elevated in women with active rUTI compared with controls. […] Our data indicate that overall, the PGE2, IL-8, IL-13 model had excellent sensitivity and specificity with the lowest misclassification rate for rUTI diagnosis in postmenopausal women. […] This research provides rationale for future studies to further validate urinary IL-8, PGE2, and IL-13 as immune diagnostic biomarkers of UTI and PGE2 as a rUTI prognostic biomarker in larger and more diverse cohorts including those with ASB and acute cystitis.

• #4 Point-of-care testing for urinary tract infections — NIHR Community Healthcare MIC

  https://www.community.healthcare.mic.nihr.ac.uk/reports-and-resources/horizon-scanning-reports/point-of-care-testing-for-urinary-tract-infections

  For this reason, there has been growing interest in developing new and efficient technology, which can (1) rapidly and accurately diagnose UTIs and (2) inform the clinician on which antibiotic to prescribe for maximum therapeutic benefit. […] Prompt diagnosis and treatment of UTI is necessary in reducing the morbidity and mortality associated with urosepsis, especially in the paediatric and geriatric population. […] However, in a primary care setting, full culture-based assay with microscopy and sensitivity analysis are not feasible. […] Implementation of an accurate, user-friendly UTI POC device which performs pathogen identification and sensitivity assays, promises to have far-reaching impact on clinical practice, patient outcomes and the demand on health-care resources.

• #4 Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/89/10/581

  The guidance by Claeys et al provides actionable measures to reduce unnecessary antibiotic use during each stage of the urine culture process, ie, ordering, processing, and reporting. […] The current recommendation is that the clinician be prompted to document signs and symptoms of infection when requesting a urine culture. […] The guidance places additional ordering demands on the clinician, and there should be a method in place to rapidly designate an exception to the laboratory that processes the specimens.

• #5 A clinical microscopy dataset to develop a deep learning diagnostic test for urinary tract infection | Scientific Data

  https://www.nature.com/articles/s41597-024-02975-0

  Urine microscopy and identification of urinary cells from freshly voided urine is an alternative POCT with greater sensitivity than both aforementioned methods. The presence of white blood cells (WBC, or pyuria) in an unspun, unstained specimen of urine examined shortly after void is particularly predictive of a UTI. […] The presence of epithelial cells (EPC) is also suggestive of infection as urinary epithelial cells are actively involved in antibacterial activities. […] Use of this test has been shown to improve patient outcomes. […] In our experience, treating patients with chronic UTI, we find that peak symptoms coincide with peak cell counts. […] We have produced an open image dataset of urinary cells which can be used to identify markers of infection using machine learning techniques. Our image dataset of voided urine is clinically representative of patients with known urine infection.

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