Al-Buheissi S, Khasriya R, Maraj BH, Malone-Lee J. A simple validated scale to measure urgency. J Urol. 2008; 179:(3)1000-1005

Anderson GG, Palermo JJ, Schilling JD, Roth R, Heuser J, Hultgren SJ. Intracellular bacterial biofilm-like pods in urinary tract infections. Science. 2003; 301:(5629)105-107

Babar A, Leblanc V, Dudonne S, Desjardins Y, Howell A, Dodin S. Standardised high dose versus low dose cranberry Proanthocyanidin extracts for the prevention of recurrent urinary tract infection in healthy women [PACCANN]: a double blind randomised controlled trial protocol. BMC Urol. 2018; 18:(1)

Betschart P, Abt D, Schmid H-P, Viktorin P, Langenauer J, Zumstein V. Readability assessment of commonly used urological questionnaires. Investig Clin Urol. 2018; 59:(5)297-304

Bono MJ, Reygaert WC. Urinary Tract Infection.Treasure Island (FL): StatPearls Publishing; 2018

Collier S, Matjiu F, Jones G, Harber M, Hopkins S. A prospective study comparing contamination rates between a novel mid-stream urine collection device (Peezy) and a standard method in renal patients. J Clin Pathol. 2014; 67:(2)139-142

Davies EM, Lewis DA. Bacteriology of urine, 2nd edn. In: Hawkey P, Lewis DA (eds). Oxford: Oxford University Press; 2004

Dougherty L, Lister S, West-Oram A. The Royal Marsden manual of clinical nursing procedures, 9th edn. Chichester: Wiley Blackwell; 2015

Dukes C. Some observations on pyuria. Proc R Soc Med. 1928; 21:(7)1179-1183

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015; 13:(5)269-284

Gill K, Kang R, Sathiananthamoorthy S, Khasriya R, Malone-Lee J. A blinded observational cohort study of the microbiological ecology associated with pyuria and overactive bladder symptoms. Int Urogynecol J. 2018; 29:(10)1493-1500

Hällström KA, Hällström KO, Grönroos P, Ruosteenoja R. Uriglox and quantitative urine microscopy in diagnosis of urinary tract infection. Acta Med Scand. 1975; 198:(6)497-503

Haylen BT, de Ridder D, Freeman RM An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29:(1)4-20

Hiraoka M, Hida Y, Tuchida S Diagnosis of urinary tract infection by urine microscopy using a disposable counting chamber. Scand J Clin Lab Invest. 1993; 53:(7)705-709

Horsley H, Malone-Lee J, Holland D Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection. PLoS ONE. 2013; 8:(12)

Huysal K, Budak YU, Karaca AU Diagnostic accuracy of uriSed automated urine microscopic sediment analyzer and dipstick parameters in predicting urine culture test results. Biochem Med (Zagreb). 2013; 23:(2)211-217

Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P. The Bristol female lower urinary tract symptoms questionnaire: development and psychometric testing. Br J Urol. 1996; 77:(6)805-812

Kashef N, Djavid GE, Shahbazi S. Antimicrobial susceptibility patterns of community-acquired uropathogens in Tehran, Iran. J Infect Dev Ctries. 2010; 4:(4)202-206

Khasriya R, Khan S, Lunawat R The inadequacy of urinary dipstick and microscopy as surrogate markers of urinary tract infection in urological outpatients with lower urinary tract symptoms without acute frequency and dysuria. J Urol. 2010; 183:(5)1843-1847

Khasriya R, Sathiananthamoorthy S, Ismail S Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms. J Clin Microbiol. 2013; 51:(7)2054-2062

Lee BSB, Bhuta T, Simpson JM, Craig JC. Methenamine hippurate for preventing urinary tract infections. Cochrane Database Syst Rev. 2012; 10

Mysorekar IU, Hultgren SJ. Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract. Proc Natl Acad Sci USA. 2006; 103:(38)14170-14175

National Institute for Health and Care Excellence. Urinary tract infection (lower)—women: prevalence. Clinical knowledge summary. 2015. (accessed 3 January 2019)

Nik-Ahd F, Lenore Ackerman A, Anger J. Recurrent urinary tract infections in females and the overlap with overactive bladder. Curr Urol Rep. 2018; 19:(11)–3

Okragla E, Szychowska K, Wolska L. Mechanisms of urinary tract sterility maintenance (article in Polish). Postepy Hig Med Dosw (Online). 2014; 68:684-694

Panek J, El Alaoui H, Mone A Hijacking of host cellular functions by an intracellular parasite, the microsporidian Anncaliia algerae. PLoS ONE. 2014; 9:(6)

Pappas PG. Laboratory in the diagnosis and management of urinary tract infections. Med Clin North Am. 1991; 75:(2)313-325

Patel AK, Chapple CR. Anatomy of the lower urinary tract. Surgery (Oxford). 2008; 26:(4)127-132

Raza-Khan F, Kenton K, Shott S, Brubaker L. Usefulness of urine dipstick in an urogynecologic population. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 17:(5)489-491

Reigstad CS, Hultgren SJ, Gordon JI. Functional genomic studies of uropathogenic Escherichia coli and host urothelial cells when intracellular bacterial communities are assembled. J Biol Chem. 2007; 282:(29)21259-21267

Robinson D, Giarenis I, Cardozo L. The management of urinary tract infections in octogenarian women. Maturitas. 2015; 81:(3)343-347

Rosen JM, Klumpp DJ. Mechanisms of pain from urinary tract infection. Int J Urol. 2014; 21:26-32

Sorrentino F, Cartwright R, Digesu GA Associations between individual lower urinary tract symptoms and bacteriuria in random urine samples in women. Neurourol Urodyn. 2015; 34:(5)429-433

Swamy S, Barcella W, De Iorio M AS Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: what should we do?. Int Urogynecol J. 2018; 29:(7)1035-1043

Turner LC, Beigi R, Shepherd JP, Lowder JL. Utility of dipstick urinalysis in peri- and postmenopausal women with irritative bladder symptoms. Int Urogynecol J. 2014; 25:(4)493-497

Vickers D, Ahmad T, Coulthard MG. Diagnosis of urinary tract infection in children: fresh urine microscopy or culture?. Lancet. 1991; 338:(8770)767-770

Wagner TH, Patrick DL, Bavendam TG, Martin ML, Buesching DP. Quality of life of persons with urinary incontinence: development of a new measure. Urology. 1996; 47:(1)67-71

Watson R. Anatomy and physiology for nurses, 13th edn. Edinburgh: Bailliere Tindall/Elsevier; 2011

Yeoh M, Lai NK, Anderson D, Appadurai V. Macroscopic haematuria: a urological approach. Aust Fam Physician. 2013; 42:(3)

Diagnosis and management of a urinary tract infection

24 January 2019
5 min read
Volume 28 · Issue 2

A urinary tract infection (UTI) is a bacterial invasion of the urinary tract. They are among the commonest bacterial infections managed in general practice, and are the reason for 1–3% of all GP consultations (National Institute for Health and Care Excellence (NICE), 2015).

The urinary tract is constantly exposed to bacteria from the exterior environment, particularly because of the anatomical placement of the urethra in the vicinity of the rectum in females (Okragla et al, 2014). In the USA, for example, a UTI is a common medical condition that accounts for 7 to 8 million clinic visits by women per year (Robinson et al, 2015). Recent studies have shown that women are more frequently affected with a UTI than men, often requiring antibiotic treatment (Babar et al, 2018).

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