Urinary tract infections in women
小结
定义
病史和体格检查
关键诊断因素
- dysuria
- urinary frequency
- hematuria
- back/flank pain
- costovertebral angle tenderness
- fever
其他诊断因素
- urinary urgency
- suprapubic pain and tenderness
危险因素
- sexual activity
- spermicide use
- postmenopause
- positive family history of UTIs
- history of recurrent UTI
- presence of a foreign body
- insulin-treated diabetes
- high lifetime number of UTIs
- recent antibiotic use
- poor bladder emptying
- increasing age
诊断性检查
首要检查
- urine dipstick
- urine microscopy
- urine culture and sensitivity
需考虑的检查
- postvoid residual (PVR)
- renal ultrasound
- abdominal/pelvic CT scan
- cystoscopy
治疗流程
uncomplicated
complicated suitable for outpatient therapy: not pregnant
complicated suitable for outpatient therapy: pregnant
complicated requiring inpatient therapy: not pregnant
complicated requiring inpatient therapy: pregnant
uncomplicated recurrent (3 or more in 12 months): related to sexual intercourse
uncomplicated recurrent (3 or more in 12 months): unrelated to sexual intercourse
撰稿人
作者
Una J. Lee, MD
Female Pelvic Medicine and Reconstructive Surgery
Section of Urology and Renal Transplantation
Virginia Mason Medical Center
Seattle
WA
利益声明
UJL declares that she has no competing interests.
鸣谢
Dr Una J. Lee would like to gratefully acknowledge Dr Elliot Blau for his contribution to this monograph, and Dr Bhavin N. Patel and Dr Howard B. Goldman, previous contributors to this topic.
利益声明
EB, BNP, and HBG declare that they have no competing interests.
同行评议者
Priyanka Sharma, MD
Associate Staff
Cleveland Clinic Foundation
Cleveland
OH
利益声明
PS declares that she has no competing interests.
Timothy J. Benton, MD
Associate Residency Director
Texas Tech University Health Sciences Center
Amarillo
TX
Disclosures
TJB declares that he has no competing interests.
Paul Little, BA (Oxon), MBBS, MRCP, MSc, FRCGP, MD
Professor of Primary Care Research
Community Clinical Sciences Division
University of Southampton
Southampton
UK
Disclosures
PL declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
European Association of Urology. EAU guidelines on urological infections. Mar 2025 [internet publication].Full text
Nicolle LE, Gupta K, Bradley SF, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019 Mar 21.Full text Abstract
Bent S, Nallamothu BK, Simel DL, et al. Does this woman have an acute uncomplicated urinary tract infection? JAMA. 2002 May 22-29;287(20):2701-10. Abstract
The American College of Obstetricians and Gynecologists. Urinary tract infections in pregnant individuals. Obstet Gynecol. 2023 Aug 1;142(2):435-45.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Asymptomatic bacteriuria
- Pyelonephritis
- Urinary tract stones
More DifferentialsGuidelines
- Guidelines on urological infections
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update
More GuidelinesPatient information
Cystitis
More Patient information
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