Urine samples for cultural microbiological diagnostics need to be processed immediately.
Quantitative urine culture with species identification and susceptibility testing is an indispensable prerequisite for targeted therapy, especially in pyelonephritis and recurrent UTIs V. Urine flow cytometry is a laboratory-based method to standardize urine sediment analysis. The automated analyzers are capable to quantify for examples white blood counts WBC or bacteria.
While clinical performance with a sensitivity specificity of 0. For the diagnosis of acute pyelonephritis in healthy women without complicating factors, further diagnostic procedures are recommended to rule out complicating factors e. In women without recurrent UTI and without relevant comorbidities, routine cystoscopy ought not to be performed B, IIb.
In the case of non-specific symptoms, or inconsistent urine examination, including negative urine culture, other diagnoses, such as gynecological infections, like chlamydia or trichomonas infection, should be considered at an early stage V. The most common cause of uncomplicated UTIs is E.
Other pathogens are rare Ia. Enterococci are most commonly found in mixed infections. Therefore, their pathogenicity is uncertain in uncomplicated UTIs Ic. Figure 2 shows the clinical microbiological pathway for diagnosis and therapy of symptomatic patients. Clinical microbiological pathway for diagnosis and therapy of symptomatic patients. Adapted from the guideline version [ 6 ]. Uncomplicated UTIs are responsible for a large proportion of all antibiotic prescriptions and pathogen resistance is increasing worldwide.
This is a major challenge in health care and therefore requires a responsible and restricted handling of antibiotic prescriptions across all health care professions. Patient-reported symptom assessment is a key in the diagnostic evaluation of acute cystitis. The validated ACSS is an accurate tool for the diagnosis of acute uncomplicated cystitis in women. It may be considered in the patient follow-up for clinical outcome assessment and in the determination of the effect of therapy.
The performance of a differential diagnosis is important in cases of non-specific symptoms, or inconsistent urine examination, including negative urine culture, and other diagnoses, such as gynecological infections with chlamydia or trichomonas, should be considered at an early stage of patient examination. Other pathogens are rare. Urine analysis, including microbiology, is the gold standard for the diagnosis of UTI, including quantitative urine culture, with appropriate clinical examinations and typical symptom assessment. Nevertheless, performing urine culture in every patient is economically not feasible; therefore, in women who have no risk factors for complicated UTIs, complain of typical symptoms e.
In patients with recurrent UTIs, a urine culture and a single sonography should be performed. Urologie, Galenus, Hess. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor s. The publisher and the editor s disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Privacy Policy Terms of Use Imprint. Manage with MyKarger your orders simply and fast, save your favorite articles in your reading list, edit your newsletter profile and benefit from attractive discounts.
Your password must comply with the following rules: One number One special character e. We found an already existing MyKarger account with this e-mail address:. Your MyKarger account has been created. Please check your e-mails to validate your e-mail address. To reset your password, enter your e-mail address or your user ID you registered with. You will be sent an e-mail containing a link to reset your password. A link to reset your password has been sent to your e-mail address. Follow the instructions and try to log in again.
Urologia Internationalis. Download Fulltext PDF. Original Paper. Free Access. Wagenlehner chiru. Related Articles for " ". Urol Int ;— Abstract FullText PDF References Extras : 5 Abstract Objectives: We aimed to update the evidence- and consensus-based national clinical guideline on the diagnosis and management of uncomplicated urinary tract infections UTIs in adult patients.
Karger AG, Basel Background Uncomplicated, bacterial, community-acquired urinary tract infections UTIs , including cystitis and pyelonephritis, are among the most common infections in the outpatient setting.
Participating medical societies and working groups. Steps in the development of the guideline. Otherwise healthy, non-pregnant premenopausal women reference group.
Otherwise healthy pregnant women. Otherwise healthy postmenopausal women. Men with uncomplicated UTI. Patients with diabetes mellitus. Related Articles:. Rheinbach, Antiinfectives Intelligence, First-Page Preview. Library Recommendation. Karger AG, Basel. Company People Career Newsroom Contact.
Sign up for MyKarger. E-mail address. Set Your Password. Show password Password. Log in to MyKarger? Keep me logged in. Login Forgot password. Complete Your Name. So what about couples who live together but do not have children? You might presume that large cities attract more childless couples or flat-sharing groups, as well as single people. Yet the study reveals that the number of multi-person households without children in the 15 most populous German cities tends to be around the average. It is no secret that Germany has an ageing population. However, these are the exceptions, as older households are by and large underrepresented in the cities featured in our survey.
The proportion is particularly low in Frankfurt. While 50 to year-olds are more rarely found in the majority of the 15 cities included in this survey than elsewhere in the country, the proportion of 40 to year-olds barely diverges from the national average. The only exceptions here are Leipzig and Dresden. The picture is somewhat different with regard to younger age groups. The difference is even more extreme when it comes to the youngest households — those with a main earner aged under However, finding a dream place to call home is dependent on family ties and the labor market.
Those who choose to settle down in a city will find cultural offerings at every turn, excellent infrastructure and a varied lifestyle. But city life also has its downsides. Living in cramped conditions where you can constantly hear the neighbors, but without actually knowing them, can lead to illness. Moving to a quieter area can help — or keeping your distance from the chaos and confusion of city life now and again. Skip to main content. Families with children: least common in Leipzig What is the reason that some cities are home to more single-person households than families with children?
Living together without children: most common in Dresden So what about couples who live together but do not have children? The charts regarding 'German cities' can be downloaded here ca.
Focustopics Real or virtual: Car clinics in the method test Global challenges She buys, he buys Focustopics Marketing challenges: Decisive data Getting around in the future Bon appetit, Germany! The challenges facing the world Travel trends: We have lift off! Chic is a click away Economic outlook: mixed feelings in Europe Totally on trend — consumption in Germany What are our sources of entertainment?
Who does Europe trust? Get started with electric cars Trust rankings for retailers Values: Desire for security increases further. Focustopics Marketing Challenges: Stay competitive A mobile world — without mobile payments? Sustainability: More than a buzzword E-commerce for everyday consumables: a niche or growing market? Savoir-vivre in Europe — a comparison of attitudes to life The end of cash?