For women with uncomplicated UTIs, urinary frequency, urgency, dysuria, and the absence of vaginal discharge are strongly diagnostic of UTIs. ĭespite UTIs being so common, they present differently across various age groups, making their diagnosis difficult. When complicated by factors such as urinary stones, long-term catheters, and urinary tract surgeries, UTIs carry the risk of urosepsis, which can have a mortality rate of 20–40%. CAUTIs account for 40% of healthcare-associated infections. About 25% of hospitalized patients are catheterized, which puts them at the risk of acquiring a catheter-associated UTI (CAUTI). Around 7–9% of children will have had a UTI by age 19. UTIs account for 10–14% of all infections in the elderly and are also the second most common bacterial infection (after ear infections) affecting children. At least 50% of all women suffer from a UTI at least once in their lifetime, and 20–30% of women with UTIs will suffer from recurring episodes. Total healthcare costs for hospitalizations due to UTIs in 2011 in the USA were $2.8 billion. Urinary tract infections (UTIs) caused 10.5 million hospital visits in the USA in 2007, of which 2.2 million were emergency department visits. We also discuss several emerging technologies – microfluidics, biosensors, real-time microscopy systems, and sequence-based diagnostics – that show huge potential in delivering rapid results. Several groups have made progress in optimizing mass spectrometry methods for direct urine processing, and there are also new multiplex PCR panels that are specific for UTI pathogens and antibiotic resistance. Screening tools, such as flow cytometers and new dipstick assays, can help with rapidly identifying negative samples and improving workflow and reducing costs. An ideal new diagnostic technology will test clinical urine samples directly and identify the pathogen and determine its antibiotic susceptibilities within a few hours such that the patient can be prescribed the appropriate antibiotic treatment the same day. New technologies are urgently needed for improved patient care as well as to promote antibiotic stewardship. Present diagnostic practices take 2–3 days for pathogen identification and antibiotic susceptibility testing. Misdiagnoses and incorrect prescriptions are frequent in the treatment of urinary tract infections this also contributes to the increase in antibiotic resistance among pathogens. Urinary tract infections affect 150 million people worldwide, yet the diagnosis of this common infection is not straightforward.
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