Scientific Calendar November 2022

Urinary tract infections: sensible use of antibiotics begins with proper diagnostics and includes antimicrobial susceptibility testing

What does the EAU guideline recommend for the diagnosis of an uncomplicated cystitis?

There may be more than one correct answer.

High probability of accurate diagnosis is achieved based on a focused history of lower urinary tract symptoms, as well as the absence of vaginal discharge.

Differential diagnosis of uncomplicated cystitis and asymptomatic bacteriuria is not relevant, as they are treated the same way.

Urine culture is recommended to increase the response rate to antimicrobial therapy.

Urine dipstick testing continues to be the most accurate laboratory diagnostic tool for UTI.

Urine culture is highly recommended in recurrent uncomplicated cystitis.


That's the correct answer!

Sorry! That´s not completely correct!

Please try again

Sorry! That's not the correct answer!

Please try again


Please select at least one answer

Sysmex’s contribution

Sysmex is developing innovative solutions for the fast diagnosis of UTI and the selection of the correct antibiotic drug in each case, by means of antimicrobial susceptibility testing (AST). The use of nanofluidics in the PA-100 AST system allows a reliable, fast detection of bacteriuria and performance of AST in a point-of-care setting. [6] This provides physicians with the necessary information to support their clinical decision immediately. [7]

Scientific background

Urinary tract infections (UTI) are among the most common bacterial infections and affect 150 million people per year worldwide. UTI are clinically classified as complicated or uncomplicated. [1]

Uncomplicated UTI are most common and affect otherwise healthy women who do not have any abnormalities in their urinary tract. They can affect the upper (pyelonephritis) or the lower (cystitis) urinary tract. The most relevant risk factors for cystitis are female gender, sexual activity, vaginal infections or a history of UTI. Most of these UTI are caused by E. coli, an inhabitant of the human intestine. [2,3]

Complicated UTI usually occur in individuals that suffer from host-related factors such as diabetes or immunosuppression and/or whose urinary tract has anatomical or functional abnormalities (lithiasis-related obstruction, catheterisation, etc.). UTI in men and pregnant women are also considered complicated.

Interestingly, many healthy women have an increased bacterial count in their lower urinary tract, which does not lead to the development of any UTI-related symptoms. This phenomenon, known as asymptomatic bacteriuria, is common and is not considered an infection, but rather a commensal colonisation.

Diagnosis and treatment

Uncomplicated UTI are commonly diagnosed at the GP setting. Due to their high incidence, they are an important cause for antibiotic prescription, if we consider non-hospital usage of antibiotics. [4] Partly due to the lack of fast diagnostic methods for the point of care, empiric treatment is standard in many settings. Empiric treatment refers to the prescription of drugs (i.e. antibiotics) based on a clinical evaluation of the patient’s symptoms, but without any diagnostic procedure that supports the selection of a drug.

Empiric treatment has important negative effects, namely the prescription of antibiotics in cases where no infection is present, or the selection of antibiotics to which the infecting bacteria are resistant (i.e. the drug is not effective against those bacteria).

Differential diagnosis and the use of proper diagnostics is key to ensure the correct use of antibiotic drugs. Failure to do so contributes to the spreading of antimicrobial resistance. [5]


[1] Flores-Mireles AL. (2015): Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, 13: 269–284.

[2] Bonkat G. (2021): EAU Guidelines on Urological Infections – European Association of Urology.

[3] Wagenlehner F. (2020): ): Epidemiology, definition and treatment of complicated urinary tract infections. Nature Reviews Urology, 17: 586–600.

[4] Yelin I. (2019): Personal clinical history predicts antibiotic resistance of urinary tract infections. Nature Medicine, 25 (7): 1143–1152.

[5] Sysmex Europe (2022): AMR page

[6] Baltekin Ö. (2017): Antibiotic susceptibility testing in less than 30 min using direct single-cell imaging. PNAS, 114 (34): 9170–9175.

[7] Sysmex Europe white paper (2022): How to perform real-time Antimicrobial Susceptibility Testing (AST)

Copyright © Sysmex Europe SE. All rights reserved.