AJM onlineCommentary‘Urinary Tract Infection’ and the Microbiome
Section snippets
Diagnosis and Management of “UTI”
The ambiguous definition of “UTI” seems to promote antibiotic overuse. In one common usage, “urinary tract infection is defined as microbial infiltration of the normally sterile urinary tract.”3 With this definition, asymptomatic bacteriuria is a “UTI” and is often treated, even in patient groups where strong evidence shows lack of benefit.4 A second common definition, “significant bacteriuria in a patient with symptoms or signs attributable to the urinary tract and no alternate source”1 seems
Paradigm Shift?
With its various meanings, convenient diagnosis, long tradition, suggestive link to treatment, and uncritical acceptance by clinicians, patients, families, and insurers, “UTI” remains heavily embedded in practice; “one of the most common bacterial infections worldwide.”3 The paradigm provides tidy management for a patient with “UTI” who expects antibiotics. Further, the current paradigm does account for several findings. Standard bacteriuria is associated with pyuria, fever, and dysuria, for
Body-as-Battleground vs Human-as-Habitat
Costello et al10 outline a broader paradigm shift in the general approach to infection; “transitioning clinical practice from the Body-as-Battleground to the Human-as-Habitat perspective will require rethinking how one manages the human body.” To help in this transition, mindful language will be important. We suggest that authors use “UTI” only within quotation marks and that clinicians use the bimanual “air quotes” gesture in discussions. This small, repetitive annotation is intended to
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Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder
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Clin Infect Dis
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Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults
Clin Infect Dis
(2005) Urinary tract infections
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