Envisioning Future Urinary Tract Infection Diagnostics

Abstract

Urinary tract infections (UTIs) are among the most common bacterial infections in the United States and are a major driver of antibiotic use, both appropriate and inappropriate, across healthcare settings. Novel UTI diagnostics are a strategy that might enable better UTI treatment. Members of the Antibacterial Resistance Leadership Group Laboratory Center and the Infectious Diseases Society of America Diagnostics Committee convened to envision ideal future UTI diagnostics, with a view towards improving delivery of healthcare, patient outcomes and experiences, and antibiotic use, addressing which types of UTI diagnostics are needed and how companies might approach development of novel UTI diagnostics.

Keywords: UTI; diagnostics; laboratory diagnosis; urinary tract infection.

Figure 1.

Trends in antimicrobial therapy for acute uncomplicated cystitis [47–49]. Widespread use of the β-lactams, amoxicillin, and cephalexin, as standard therapy for urinary tract infections in the 1970s and 1980s was followed by emergence of resistance and treatment failure. These were replaced by trimethoprim-sulfamethoxazole as the empiric therapy of choice in the 1980s, which was again followed by increasing antimicrobial resistance and treatment failure. Fluoroquinolones eventually replaced trimethoprim-sulfamethoxazole as the preferred empiric therapy in the 1990s, again followed by increasing antimicrobial resistance and treatment failure.