Definitions

• Infection of the urinary tract is identified by growth of a significant number of organisms of a single specimen of urine, in the presence of symptoms

• UTI cannot be diagnosed by symptoms alone nor by culture of urine from a bag specimen.

• Definitive diagnosis by culture of urine obtained in a sterile fashion – Mid stream urine (MSU), supra –pubic aspiration (SPA), catheterized urine specimen (CSU)

• Colony count of >10⁵ /ml of a single species in a midstream clean catch sample OR

• Any growth from SPA urine OR

• Growth > 10⁴ cfu/ml from catheterized urine specimen (CSU)

Infection of the lower urinary tract (bladder) without fever

Infection of the upper (kidney) and lower urinary tract with fever

• UTI associated with sepsis or bacteraemia

• Concern regarding obstructive uropathy e.g. poor urine flow, abdominal or bladder mass

• Failure to respond to antibiotics within 48 hours

• Associated impaired renal function e.g. raised creatinine

• Infection with a non E. coli organism

• Two or more episodes of UTI

• One episode of febrile UTI and one or more episodes of cystitis

• Three or more episodes of cystitis

• Bacteriuria in the absence of pyuria without symptoms

• This is most often found in school aged and older girls, but can also occur in infancy

Presence of inflammatory cells/white cells on microscopy with negative culture