Laboratory investigation of UTI
Full colour PDF of the Laboratory Investigation of UTIs POEM.
Printer friendly PDF.Download a powerpoint presentation of the key points.
Key Messages
- Women with symptoms of uncomplicated UTI do not require a urine culture
- Screening for asymptomatic bacteriuria is not recommended except in pregnant women
- Chlamydia trachomatis urethritis can cause similar symptoms to a UTI
Introduction
This resource focuses on the diagnosis of infection in the urinary tract. In particular uncomplicated and complicated urinary tract infection (UTI), urethral infection with Chlamydia trachomatis and issues around the investigation of asymptomatic bacteriuria.
Urinary tract infections are common. Studies in the US have shown that approximately 50% of all women will have a urinary tract infection in their lifetime, of these 25% will have recurrent infections (Mehnert-Kay, 2005). Each year approximately 5% of women present to their GP with frequency and dysuria (Prodigy).
In 2005, almost 800 000 urine cultures were performed in New Zealand, at a cost of over $12.5 million (Laboratory claims data). Many women with UTI will have ‘uncomplicated’ infections that do not require urine culture. Streamlining the diagnostic process by only requesting urine culture when appropriate could improve patient satisfaction and decrease costs without compromising care.
Epidemiological data on Chlamydia trachomatis infection in New Zealand suggests we are well behind other OECD countries in the control of this infection (Perkins, 2004). When patients have symptoms of UTI, and sexual history indicating they may be at risk, Chlamydia trachomatis urethritis should be considered.
The occurrence of asymptomatic bacteriuria increases with age with up to 50% of elderly people having asymptomatic bacteriuria (Nicolle, 2005). There is no evidence to suggest this group of patients benefit from antibiotic treatment; while on the other hand, there is evidence of increased adverse effects, emergence of resistant organisms and cost associated with the use of antibiotics.
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