Further aspects of UTIs
Appropriate sample collection and Mid-Stream Urine (MSU):
As the urethra is colonised with bacteria , it is important to minimise contamination with these bacteria when collecting urine for culture to avoid misinterpreting the result. This is done by cleaning the perineal region and discarding the first part of the urine to allow bacteria to be flushed out. The urine then collected is called midstream urine.
Significant bacteriuria:
The urethra contains bacteria so voided urine will contain some bacteria. When the number of bacteria is greater than 105/ml, it is a strong indicator that the bacteria are from the bladder not the urethra. This is termed significant bacteriuria.
Asymptomatic bacteriuria:
Significant bacteriuria in patients without symptoms. Commonly seen in older adults or pregnant women. This condition is to be treated in pregnant women but not in older adults.
Complicated UTI:
structurally abnormal urinary tract / upper UTI/ urosepsis
Uncomplicated UTI:
structurally normal urinary tract
Ascending UTI:
infection due to bacteria which colonise urethra and get introduced further up the urinary tract
Haematogenous UTI:
infection of renal parenchyma secondary to bloodstream infections e.g. infective endocarditis