Urinary Tract Infections

Author:  Andrew Parfitt / Editor:  John P Sloan / Reviewer: Suzy Connor, Pragya Mallick / Code: O5 / Published: 25/05/2021

Description:

This session covers the urinary tract infections that are encountered in the emergency department. It discusses their diagnosis, complications and treatment.

By the end of this session you will be able to:

• Explain the usefulness of urine dipsticks as a diagnostic test for UTI
• Investigate the patient with UTI and pyelonephritis
• Describe the common pathogens and antibiotic sensitivities

References:

1. Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010;7:65360.
2. Shallcross, L.J. Diagnostic uncertainty and urinary tract infection in the emergency department: a cohort study from a UK hospital. BMC Emerg Med 20, 40 (2020).
3. Norris DL 2nd, Young JD. Urinary tract infections: diagnosis and management in the emergency department. Emerg Med Clin North Am. 2008; 26(2): 413-30.
4. Johnson JR. Acute Pyelonephritis in Adults. N Engl J Med 2018; 378:48-59.
5. Safrin S, Siegel D, Black D. Pyelonephritis in adult women inpatient versus outpatient treatment. Am J Med 1988; 85(6): 793-798.
6. Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S. Does this woman have an acute uncomplicated urinary tract infection? JAMA. 2002; 287(20): 2701-10.
7. Lammers RL, Gibson S, Kovacs D, Sears W, Strachan G. Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points. Ann Emerg Med. 2001; 38(5): 505-12.
8. Gian Carlo S. The ARESC study: an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections, International Journal of Antimicrobial Agents, Volume 34, Issue 5, 2009, 407-413.
9. Livermore DM, James D, Reacher M et al. Trends in fluoroquinolone (ciprofloxacin) resistance in enterobacteriaceae from bacteremias, England and Wales, 1990-1999. Emerg Infect Dis. 2002; 8(5): 473-8.
10. Gupta K, Sahm DF, Mayfield D et al. Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in women: a nationwide analysis. Clin Infect Dis. 2001; 33(1): 89-94. Epub 2001 Jun 5.
11. NICE, Urinary tract infections overview. NICE Pathway.
12. NICE, Lower urinary tract infection visual summary. [NG 109].
13. NICE, Pyelonephritis (acute): antimicrobial prescribing. NICE Visual summary.