Urinary tract infections in women

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources

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Evidence last reviewed: 15 Mar 2026
Topic last updated: 10 Apr 2026

Summary

Definition

病史和体格检查

关键诊断因素

  • dysuria
  • urinary frequency
  • hematuria
  • back/flank pain
  • costovertebral angle tenderness
  • fever
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其他诊断因素

  • urinary urgency
  • suprapubic pain and tenderness
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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
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诊断性检查

首要检查

  • urine dipstick
  • urine microscopy
  • urine culture and sensitivity
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需考虑的检查

  • postvoid residual (PVR)
  • renal ultrasound
  • abdominal/pelvic CT scan
  • cystoscopy
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治疗流程

急症处理

confined to bladder without complicating factors

complicating factors present (nonpregnant): suitable for outpatient therapy

pregnant: suitable for outpatient therapy

complicating factors present (nonpregnant): requiring inpatient therapy

pregnant: requiring inpatient therapy

持续性治疗

recurrent confined to bladder (3 or more in 12 months): related to sexual intercourse

recurrent confined to bladder (3 or more in 12 months): unrelated to sexual intercourse

撰稿人

专家顾问

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 topic, 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

Bernard G. Jaar, MD, MPH

Clinical Director

Johns Hopkins School of Medicine

Division of Nephrology

Baltimore

MD

利益声明

BGJ declares that he has no competing interests.

Timothy J. Benton, MD

Associate Residency Director

Texas Tech University Health Sciences Center

Amarillo

TX

利益声明

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

利益声明

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.

参考文献

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关键文献

Trautner BW, Cortes-Penfield NW, Gupta K, et al. IDSA 2025 guideline update on complicated urinary tract infections. Jul 2025 [internet publication].全文

European Association of Urology. EAU guidelines on urological infections. Mar 2025 [internet publication].全文

American College of Obstetricians and Gynecologists. Urinary tract infections in pregnant individuals. Obstet Gynecol. 2023 Aug 1;142(2):435-45.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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