Definitions of Urinary Tract Infection in Current Research: A Systematic Review

Author:

Bilsen Manu P1ORCID,Jongeneel Rosa M H1,Schneeberger Caroline2,Platteel Tamara N3,van Nieuwkoop Cees45ORCID,Mody Lona67,Caterino Jeffrey M8,Geerlings Suzanne E9,Köves Bela10,Wagenlehner Florian11,Conroy Simon P12ORCID,Visser Leo G1ORCID,Lambregts Merel M C1ORCID

Affiliation:

1. Department of Infectious Diseases, Leiden University Medical Center , Leiden , The Netherlands

2. Center for Infectious Disease Control, National Institute for Public Health and the Environment , Bilthoven , The Netherlands

3. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands

4. Department of Internal Medicine, Haga Teaching Hospital , The Hague , The Netherlands

5. Health Campus The Hague, Department of Public Health and Primary Care, Leiden University Medical Center , Leiden , The Netherlands

6. Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School , Ann Arbor, Michigan , USA

7. Geriatrics Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System , Ann Arbor, Michigan , USA

8. Department of Emergency Medicine, The Ohio State University , Columbus, Ohio , USA

9. Amsterdam University Medical Center, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam Public Health Research Institute , Amsterdam , The Netherlands

10. Department of Urology, University of Szeged , Szeged , Hungary

11. Clinic for Urology, Paediatric Urology and Andrology, Justus Liebig University , Giessen , Germany

12. Medical Research Council Unit for Lifelong Health and Ageing, University College London , London , United Kingdom

Abstract

Abstract Defining urinary tract infection (UTI) is complex, as numerous clinical and diagnostic parameters are involved. In this systematic review, we aimed to gain insight into how UTI is defined across current studies. We included 47 studies, published between January 2019 and May 2022, investigating therapeutic or prophylactic interventions in adult patients with UTI. Signs and symptoms, pyuria, and a positive urine culture were required in 85%, 28%, and 55% of study definitions, respectively. Five studies (11%) required all 3 categories for the diagnosis of UTI. Thresholds for significant bacteriuria varied from 103 to 105 colony-forming units/mL. None of the 12 studies including acute cystitis and 2 of 12 (17%) defining acute pyelonephritis used identical definitions. Complicated UTI was defined by both host factors and systemic involvement in 9 of 14 (64%) studies. In conclusion, UTI definitions are heterogeneous across recent studies, highlighting the need for a consensus-based, research reference standard for UTI.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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