Urinary tract infection

| Main Article
| Discussion
| Related Articles  [?]
| Bibliography  [?]
| External Links  [?]
| Citable Version  [?]

|
|
|
|
|
|
|
|

This editable Main Article is under development and subject to a disclaimer.

[edit intro]

## Contents

* 1 Classification
* 2 Cause
* 2.1 Males
* 3 Diagnosis
* 4 Treatment
* 5 Prevention
* 5.1 Patients without urinary catheterization
* 5.2 Patients with urinary catheterization
* 6 References

In medicine, urinary tract infections are "inflammatory responses of the epithelium of the urinary tract to microbial invasions. They are often bacterial infections with associated bacteriuria and pyuria."[1]

## Classification[edit]

More common types of urinary tract infections in include:

* Pyelonephritis
* Cystitis
* Urethritis

## Cause[edit]

### Males[edit]

In males, urinary tract infections are usually secondary to an underlying cause such as benign prostatic hyperplasia or genitourinary instrumentation.[2] However, a single episode is unlikely to be due to a serious underlying cause.[3]

## Diagnosis[edit]

The best symptoms and physical examination findings for diagnosis have been identified in a systematic review by the Rational Clinical Examination in 2002.[4]

Regarding symptoms, a subsequent study and clinical prediction rule found the best findings are urine cloudiness, offensive smell, moderately severe dysuria, moderately severe nocturia.[5]

A subsequent study and clinical prediction rule showed the best predictors were urinary nitrite, leucocyte esterase and blood[5] ; however, these tests may not be very accurate[6].

Urinary tract infections may be overdiagnosed in geriatric patients.[7]

Various testing strategies have been compared.[8]

## Treatment[edit]

Clinical practice guidelines are available"[9]

* Nitrofurantion 100 mg twice daily for 5 days is recommended and may be cost effective when:[10]
* TMP-SMX resistance is > 17%
* Quinolone resistance is > 12%

## Prevention[edit]

Cranberry juice probably does not help.[11]

### Patients without urinary catheterization[edit]

### Patients with urinary catheterization[edit]

Various interventions may reduce urinary tract infection.[12][13]

## References[edit]

1. ↑ Anonymous (2025), Urinary tract infection (English). Medical Subject Headings. U.S. National Library of Medicine.
2. ↑ Lipsky BA (January 1989). "Urinary tract infections in men. Epidemiology, pathophysiology, diagnosis, and treatment". Ann. Intern. Med. 110 (2): 138–50. PMID 2462391. [e]
3. ↑ Abarbanel J, Engelstein D, Lask D, Livne PM (July 2003). "Urinary tract infection in men younger than 45 years of age: is there a need for urologic investigation?". Urology 62 (1): 27–9. PMID 12837416. [e]
4. ↑ Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA 287 (20): 2701–10. PMID 12020306. [e]
5. ↑ 5.0 5.1 Little P, Turner S, Rumsby K, Warner G, Moore M, Lowes JA et al. (2009). "Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study.". Health Technol Assess 13 (19): iii-iv, ix-xi, 1-73. DOI:10.3310/hta13190. PMID 19364448. Research Blogging. Review in: Evid Based Med. 2009 Oct;14(5):155
6. ↑ Little P, Turner S, Rumsby K, Jones R, Warner G, Moore M et al. (2010). "Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women.". Br J Gen Pract 60 (576): 495-500. DOI:10.3399/bjgp10X514747. PMID 20594439. PMC PMC2894378. Research Blogging.
7. ↑ Woodford HJ, George J (November 2008). "Diagnosis and Management of Urinary Tract Infection in Hospitalized Older People". J Am Geriatr Soc. DOI:10.1111/j.1532-5415.2008.02073.x. PMID 19054190. Research Blogging.
8. ↑ Little P, Moore MV, Turner S, Rumsby K, Warner G, Lowes JA et al. (2010). "Effectiveness of five different approaches in management of urinary tract infection: randomised controlled trial.". BMJ 340: c199. DOI:10.1136/bmj.c199. PMID 20139214. PMC PMC2817051. Research Blogging.
9. ↑ Gupta, Kalpana; Thomas M. Hooton, Kurt G. Naber, Björn Wullt, Richard Colgan, Loren G. Miller, Gregory J. Moran, Lindsay E. Nicolle, Raul Raz, Anthony J. Schaeffer, David E. Soper (2011-03-01). "Executive Summary: International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases". Clinical Infectious Diseases 52 (5): 561 -564. DOI:10.1093/cid/cir102. PMID 21292658. Retrieved on 2011-03-08. Research Blogging.
10. ↑ McKinnell JA, Stollenwerk NS, Jung CW, Miller LG (2011). "Nitrofurantoin compares favorably to recommended agents as empirical treatment of uncomplicated urinary tract infections in a decision and cost analysis.". Mayo Clin Proc 86 (6): 480-8. DOI:10.4065/mcp.2010.0800. PMID 21576512. PMC PMC3104907. Research Blogging.
11. ↑ Barbosa-Cesnik C, Brown MB, Buxton M, Zhang L, DeBusscher J, Foxman B (2011). "Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial.". Clin Infect Dis 52 (1): 23-30. DOI:10.1093/cid/ciq073. PMID 21148516. Research Blogging.
12. ↑ Parker D, Callan L, Harwood J, Thompson DL, Wilde M, Gray M (2009 Jan-Feb). "Nursing interventions to reduce the risk of catheter-associated urinary tract infection. Part 1: Catheter selection.". J Wound Ostomy Continence Nurs 36 (1): 23-34. DOI:10.1097/01.WON.0000345173.05376.3e. PMID 19155821. Research Blogging.
13. ↑ Willson M, Wilde M, Webb ML, Thompson D, Parker D, Harwood J et al. (2009 Mar-Apr). "Nursing interventions to reduce the risk of catheter-associated urinary tract infection: part 2: staff education, monitoring, and care techniques.". J Wound Ostomy Continence Nurs 36 (2): 137-54. DOI:10.1097/01.WON.0000347655.56851.04. PMID 19287262. Research Blogging.