through the bloodstream. Table 1 captures the most important features of various types of UTIs. Disease Pathogen Signs and Transmission Diagnostic Tests Symptoms Cystitis Escherichia coli, Dysuria, pyuria, Nontransmissible; Urine dipstick, E. faecalis, hematuria, and opportunistic urine culture for St. agalactiae, bladder pain; most infections occur confirmation K. pneumoniae, common in females when fecal bacteria S. due to the shorter are introduced to saprophyticus, urethra and urinary tract or others abundant normal when normal vaginal microbiota urination or immune function is impaired Nongonococcal Chlamydia Mild or Transmitted Urethral swabs urethritis trachomatis, asymptomatic; may sexually or from and urine (NGU) Mycoplasma cause purulent mother to neonate culture, PCR genitalium, discharge and during birth Mycoplasma dysuria hominis, Ureaplasma urealyticum Pyelonephritis, E. coli, Proteus Back pain, fever, Nontransmissible; Urinalysis, urine spp., Klebsiella nausea, vomiting, infection spreads to culture, spp., blood in urine; kidneys from radioimaging of Streptococcus possible scarring of urinary tract or kidneys pyogenes, others the kidneys and through impaired kidney bloodstream function Laboratory diagnosis of urinary tract infections As previously mentioned, because noninvasive methods for collecting urine must rely on a specimen that has passed through a contaminated sites, quantitative cultures for the diagnosis of UTI are used to discriminate between contamination, colonization, and infection. SPECIMEN COLLECTION Clean external genitalia; begin voiding and after several mL Clean-catch midstream urine: have passed; collect midstream without stopping flow of urine. 2-3 mL must be collect (The first portion of the urine flow washes contaminants from the urethra, and the midstream
through the bloodstream. Table 1 captures the most important features of various types of UTIs. Disease Pathogen Signs and Symptoms Transmission Diagnostic Tests Cystitis Escherichia coli, E. faecalis, St. agalactiae, K. pneumoniae, S. saprophyticus, others Dysuria, pyuria, hematuria, and bladder pain; most common in females due to the shorter urethra and abundant normal vaginal microbiota Nontransmissible; opportunistic infections occur when fecal bacteria are introduced to urinary tract or when normal urination or immune function is impaired Urine dipstick, urine culture for confirmation Nongonococcal urethritis (NGU) Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum Mild or asymptomatic; may cause purulent discharge and dysuria Transmitted sexually or from mother to neonate during birth Urethral swabs and urine culture, PCR Pyelonephritis, E. coli, Proteus spp., Klebsiella spp., Streptococcus pyogenes, others Back pain, fever, nausea, vomiting, blood in urine; possible scarring of the kidneys and impaired kidney function Nontransmissible; infection spreads to kidneys from urinary tract or through bloodstream Urinalysis, urine culture, radioimaging of kidneys Laboratory diagnosis of urinary tract infections As previously mentioned, because noninvasive methods for collecting urine must rely on a specimen that has passed through a contaminated sites, quantitative cultures for the diagnosis of UTI are used to discriminate between contamination, colonization, and infection. SPECIMEN COLLECTION Clean-catch midstream urine: Clean external genitalia; begin voiding and after several mL have passed; collect midstream without stopping flow of urine. 2-3 mL must be collect (The first portion of the urine flow washes contaminants from the urethra, and the midstream