Laboratory Diagnosis of Urinary Tract Infections in Adult Patients
Abstract
Urinary tract infections (UTIs) are among the most common bacterial infections and account for a significant part of the workload in clinical microbiology laboratories. Enteric bacteria (in particular, Escherichia coli) remain the most frequent cause of UTIs, although the distribution of pathogens that cause UTIs is changing. More important is the increase in resistance to some antimicrobial agents, particularly the resistance to trimethoprim-sulfamethoxazole seen in E. coli. Physicians distinguish UTIs from other diseases that have similar clinical presentations with use of a small number of tests, none of which, if used individually, have adequate sensitivity and specificity. Among the diagnostic tests, urinalysis is useful mainly for excluding bacteriuria. Urine culture may not be necessary as part of the evaluation of outpatients with uncomplicated UTIs, but it is necessary for outpatients who have recurrent UTIs, experience treatment failures, or have complicated UTIs, as well as for inpatients who develop UTIs.
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Bacteria require a minimum of 4 hours to reduce nitrate to nitrite.
“This may have reflected the fact that bacteria require a minimum of 4 hours to reduce the nitrate to nitrite26”
From Performance of the dipstick screening test as a predictor of negative urine culture (2017) · cites this paper as [26]
Cites
Diagnosis of Coliform Infection in Acutely Dysuric Women
Stamm, W. E., Counts, G. W., Running, K. R., Fihn, S., Turck, M., & Holmes, K. K. (1982) · New England Journal of Medicine · doi:10.1056/nejm198208193070802 · Cited by 760 · see citing works
Prospective Multicenter Surveillance Study of Funguria in Hospitalized Patients
Kauffman, C. A., Vazquez, J. A., Sobel, J. D., Gallis, H. A., McKinsey, D. S., Karchmer, A. W., Sugar, A. M., Sharkey, P. K., Wise, G. J., Mangi, R., et al. (2000) · Clinical Infectious Diseases · doi:10.1086/313583 · Cited by 483 · see citing works
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Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital
Bebell, L. M., Ngonzi, J., Bazira, J., Fajardo, Y., Boatin, A. A., Siedner, M. J., Bassett, I. V., Nyehangane, D., Nanjebe, D., Jacquemyn, Y., et al. (2017) · PLOS ONE · doi:10.1371/journal.pone.0175456 · Cited by 86 · see citing works
Performance of the dipstick screening test as a predictor of negative urine culture
Marques, A. G., Doi, A. M., Pasternak, J., Damascena, M. D. S., França, C. N., & Martino, M. D. V. (2017) · Einstein (São Paulo) · doi:10.1590/s1679-45082017ao3936 · Cited by 33 · see citing works
“This may have reflected the fact that bacteria require a minimum of 4 hours to reduce the nitrate to nitrite(26) or that not all Gram-negative bacilli contain nitrate reductase, the enzyme responsible for this conversion.”
Background
- Authors
- Wilson, M. L., & Gaido, L.
- Affiliations
- Denver Health Medical Center (US)
- Corresponding author
- Wilson, Michael L.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-04-15
- Volume
- 38
- Issue
- 8
- Pages
- 1150-1158
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2165186144
- Cited by
- 680
- References
- 2
- Citations by year
- 2026: 18 · 2025: 28 · 2024: 46 · 2023: 64 · 2022: 49 · 2021: 38 · 2020: 46 · 2019: 47 · 2018: 38 · 2017: 51 · 2016: 42 · 2015: 31 · 2014: 37 · 2013: 29 · 2012: 20
- FWCI
- 6.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Urology and Nephrology Studies
- Keywords
- urinary tract infection, laboratory diagnosis, Escherichia coli, antimicrobial resistance, trimethoprim-sulfamethoxazole resistance, urine analysis, bacteriuria, urine culture, recurrent urinary tract infection, complicated urinary tract infection
- MeSH terms
- Adult, Enterobacteriaceae, Escherichia coli, Humans, Microbial Sensitivity Tests, Urinary Tract Infections, Urine, Bacterial Typing Techniques, Clinical Laboratory Techniques
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