期刊
OPEN FORUM INFECTIOUS DISEASES
卷 10, 期 7, 页码 -出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofad332
关键词
complicated urinary tract infection; cystitis; definition; pyelonephritis; urinary tract infection
Urinary tract infection (UTI) definitions in current research studies are highly varied in terms of clinical signs and diagnostic tests. Most studies do not meet the criteria outlined in existing research guidelines. This systematic review highlights the need for a consensus-based, research reference standard for defining UTI.
Urinary tract infection definitions used in current research studies are highly heterogeneous in terms of clinical signs and diagnostic tests. Few studies meet symptom, pyuria, and urine culture criteria mentioned in existing research guidelines. 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 10(3) to 10(5) 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.
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