Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC)

Enferm Infecc Microbiol Clin. 2017 May;35(5):314-320. doi: 10.1016/j.eimc.2016.11.005. Epub 2016 Dec 23.
[Article in English, Spanish]

Abstract

Most urinary tract infections (UTI) are uncomplicated infections occurring in young women. An extensive evaluation is not required in the majority of cases, and they can be safely managed as outpatients with oral antibiotics. Escherichia coli is by far the most common uropathogen, accounting for >80% of all cases. Other major clinical problems associated with UTI include asymptomatic bacteriuria, and patients with complicated UTI. Complicated UTIs are a heterogeneous group associated with conditions that increase the risk of acquiring infection or treatment failure. Distinguishing between complicated and uncomplicated UTI is important, as it influences the initial evaluation, choice, and duration of antimicrobial therapy. Diagnosis is especially challenging in the elderly and in patients with in-dwelling catheters. The increasing prevalence of resistant uropathogens, including extended-spectrum β-lactamases and carbapenemase-producing Enterobacteriaceae, and other multidrug-resistant Gram-negative organisms further compromises treatment of both complicated and uncomplicated UTIs. The aim of these Clinical Guidelines is to provide a set of recommendations for improving the diagnosis and treatment of UTI.

Keywords: Acute cystitis; Acute pyelonephritis; Asymptomatic bacteriuria; Bacteriuria asintomática; Catheter-associated urinary tract infection; Cistitis aguda; Infecciones del tracto urinario; Infecciones recurrentes del tracto urinario; Infecciones urinarias asociadas al sondaje vesical; Pielonefritis aguda; Recurrent urinary tract infections; Urinary tract infection.

Publication types

  • Practice Guideline

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis
  • Bacterial Load
  • Bacteriuria / microbiology
  • Catheter-Related Infections / diagnosis
  • Catheter-Related Infections / drug therapy
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Infectious Disease Medicine / organization & administration
  • Infectious Disease Medicine / standards
  • Male
  • Microbiology / organization & administration
  • Microbiology / standards
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / microbiology
  • Societies, Medical
  • Urinary Catheterization / adverse effects
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / prevention & control

Substances

  • Anti-Bacterial Agents