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Review
. 2023 Jun 27;10(7):ofad332.
doi: 10.1093/ofid/ofad332. eCollection 2023 Jul.

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

Manu P Bilsen  1 , Rosa M H Jongeneel  1 , Caroline Schneeberger  2 , Tamara N Platteel  3 , Cees van Nieuwkoop  4   5 , Lona Mody  6   7 , Jeffrey M Caterino  8 , Suzanne E Geerlings  9 , Bela Köves  10 , Florian Wagenlehner  11 , Simon P Conroy  12 , Leo G Visser  1 , Merel M C Lambregts  1
Affiliations
Review

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

Manu P Bilsen et al. Open Forum Infect Dis. .

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.

Keywords: complicated urinary tract infection; cystitis; definition; pyelonephritis; urinary tract infection.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart of the study selection process. Abbreviation: UTI, urinary tract infection.
See this image and copyright information in PMC

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