Journal List > Urogenit Tract Infect > v.11(3) > 1084211

Choi and Bae: How Do You Diagnose Recurrent Urinary Tract Infections and Confirm the Diagnosis?

Abstract

Recurrent urinary tract infections (UTIs) are the most prevalent conditions affected mainly by reinfection by the same bacteria in young women with no functional or anatomic problem. Recurrent UTIs present both storage (dysuria, irritative etc.) and voiding symptoms. For example, frequency subsequently followed by sexual intercourse is a powerful predictor of recurrent UTI. In patients with morbid situations or other factors, recurrent complicated infections or sepsis may be aggravated. Escherichia coli is the most common organism responsible for UTIs, but Pseudomonas, Proteus, Klebsiella, and other organisms are also frequent, particularly, in patients higher risk of complicated infections. Urine culture is not often needed to diagnose typical uncomplicated infection. Generally, urine culture with more than 10² colony-forming units/ml is used to diagnose UTIs in symptomatic patients. Recurrent UTIs could be managed with several techniques with the help of urine culture and by imaging studies when suspicious of anatomical abnormalities.

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Table 1.
Condition for further investigations of recurrent urinary tract infection
Bacterial persistence even antibiotics on the bases of culture test
Previous urologic surgery
Hematuria even after the infection resolved
Prior urologic stone
Main obstructive symptoms
Low peak flow on uroflowmetry or high residual urine volume
Urea-splitting pathogen like Proteus, Klebsiella
Abdominopelvic malignant disease
Immunocompromised condition
Fecaluria, pneumaturia, anaerobic bacteria or a history of diverticulitis
Recurrent pyelonephritis with fever, gastrointestinal symptom or costovertebral angle tenderness
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