Common errors in diagnosis and management of urinary tract infection. I: pathophysiology and diagnostic techniques.

Although general guidelines exist for UTI concerning diagnosis and classification, there is a wide variation in clinical practice. There are both errors The problem that are frequently committed and mysteries that are still unsolved. Active management is important because under some circumstances UTI may cause permanent Urinary tract infection (UTI) is one of the most renal scarring. Imaging procedures are a cornerstone common diseases, occurring from the neonate up to for critical evaluation of UTI, but avoidance of invest-geriatric age groups. Forty to 50% of adult women igative routines will allow a marked saving in terms of have a history of at least one UTI [1]. UTI is a major costs and in terms of unnecessary radiation and psycho-cause of Gram-negative sepsis in hospitalized patients logical stress to the patient. The prevention of recurrent and after renal transplantation [2]. General prac-UTI requires careful patient evalution to recognize ticioners, paediatricians, urologists, and nephrologists potential complicating factors including anatomical are frequently consulted because of symptoms suggest-abnormalities of the urinary tract. The underlying ive of UTI, but there are large differences in the complicating factors (reversible or permanent) influ-management of such patients with respect to definition ence antimicrobial treatment with respect to duration of UTI, diagnosis, and treatment. In particular, the of treatment, likelihood of antibiotic resistance, and clinical relevance of low-count bacteriuria and asymp-necessity of prophylaxis respectively. tomatic UTI as well as the potential indications for antimicrobial therapy continue to be controversial. UTI defines a condition in which the urinary tract The spectrum of urinary tract infection— is infected with a pathogen causing inflammation. definitions There is consensus that most uropathogenic microorganisms such as Escherichia coli colonize the colon, Significant bacteriuria the perianal region, and in females the introitus vaginae and the periurethral region. Facultatively they may Traditionally, the concept of significant bacteriuria for further ascend to the bladder and/or to the kidneys. If the diagnosis of UTI was based on the notion that structures of the urinary tract are invaded, accurate the quantitative bacterial count allowed distinction diagnosis and treatment are necessary in order to between infection and contamination. The utility and ensure optimal management and to prevent further consistency of the criterion of Á105 colony-forming complications. UTI results from the interaction units per millilitre (c.f.u./ml) of clean-catch urine for between uropathogen and the host. The micro-the diagnosis of UTI has been validated repeatedly. In organisms may have particular uropathogenic proper-children, …