Urinary tract infection

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Definition

  • Bacterial infection of the urinary tract, either lower (cystitis) or upper (pyelonephritis)
  • When UTI causes sepsis syndrome, often referred to as urosepsis
  • Diagnostic criteria include clinical and laboratory symptoms:
    • Two or more clinical symptoms:
      • Fever > 38ºC
      • Urinary urgency or frequency
      • Acute dysuria
      • Hypogastric pain
      • Costovertebral angle tenderness
    • One or more laboratory finding:
      • Bacteriuria (> 100,000 CFUs/mL)
      • Pyuria (>10 WBCs/HPF)

Etiology

  • Typical organisms include:
    • E. coli
    • S. saprophicitus

Investigations

  • Labs
    • Urinalysis has high NPV (~100%) if negative for leukocyst esterase and nitrites is negative

References

  1. ^  Dimitri M. Drekonja, Barbara Trautner, Carla Amundson, Michael Kuskowski, James R. Johnson. Effect of 7 vs 14 Days of Antibiotic Therapy on Resolution of Symptoms Among Afebrile Men With Urinary Tract Infection. JAMA. 2021;326(4):324. doi:10.1001/jama.2021.9899.