Urine Trouble: Should We Think Differently About UTI?

Int Urogynecol J. 2018 Feb;29(2):205-210. doi: 10.1007/s00192-017-3528-8. Epub 2017 Dec 26.


Urinary tract infection (UTI) is clinically important, given that it is one of the most common bacterial infections in adult women. However, the current understanding of UTI remains based on a now disproven concept that the urinary bladder is sterile. Thus, current standards for UTI diagnosis have significant limitations that may reduce the opportunity to improve patient care. Using data from our work and numerous other peer-reviewed studies, we identified four major limitations to the contemporary UTI description: the language of UTI, UTI diagnostic testing, the Escherichia coli-centric view of UTI, and the colony-forming units (CFU) threshold-based diagnosis. Contemporary methods and technology, combined with continued rigorous clinical research can be used to correct these limitations.

Keywords: Diagnostics; Escherichia coli; Microbiome; Pathogens; Urinalysis; Urinary tract infection.

MeSH terms

  • Adult
  • Aged
  • Colony Count, Microbial / methods*
  • Escherichia coli / isolation & purification
  • Female
  • Humans
  • Middle Aged
  • Urinary Bladder / microbiology
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / microbiology
  • Urine / microbiology