What is chronic urinary tract infection? A systematic review

Abstract

Objective: To define 'chronic' urinary tract infection (UTI) by reviewing current published research that employs this term.

Methods: We systematically searched Medline and Embase for studies covering all aspects of human UTI. For comparison, current urological and infectious disease guidelines were also reviewed.

Results: The electronic search yielded a total of 2175 articles, of which 154 were eventually included for data extraction. Of these, six studies presented a definition of chronic UTI within the text. The definitions were highly incongruent among studies and often identical to the current definition of 'recurrent' UTI.

Conclusion: Chronic UTI is an undefined term, which has nevertheless been increasingly used in the past 15 years. Chronic UTI does not represent a distinct clinical or microbiological condition that justifies its use as medical diagnosis.

Keywords: bladder infection; chronic urinary tract infection; disease definition; recalcitrant urinary tract infection; recurrent urinary tract infection; unresolved urinary tract infection; urinary tract infection; urological guidelines.

Fig. 1

Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) flow diagram for the systematic search.

Fig. 2

Summary of the use of the term ‘chronic UTI’ from 1948 to 2022, presented as accumulated publications per year. From 2009 to 2022 (blue shading), the use of ‘chronic UTI’ increased 4.1‐fold.