UTIs are challenging, not only because of the large number of infections that occur each year, but also because the diagnosis of UTI is not always straightforward. The annual cost to the health care system of the United States attributable to community-acquired UTI alone is estimated to be approximately $1.6 billion. UTIs have become the most common hospital-acquired infection, accounting for as many as 35% of nosocomial infections, and they are the second most common cause of bacteremia in hospitalized patients. It has been estimated that symptomatic UTIs result in as many as 7 million visits to outpatient clinics, 1 million visits to emergency departments, and 100,000 hospitalizations annually. Urinary tract infections (UTIs) are among the most common bacterial infections. Urine culture may not be necessary as part of the evaluation of outpatients with uncomplicated UTIs, but it is necessary for outpatients who have recurrent UTIs, experience treatment failures, or have complicated UTIs, as well as for inpatients who develop UTIs. Among the diagnostic tests, urinalysis is useful mainly for excluding bacteriuria. Physicians distinguish UTIs from other diseases that have similar clinical presentations with use of a small number of tests, none of which, if used individually, have adequate sensitivity and specificity. More important is the increase in resistance to some antimicrobial agents, particularly the resistance to trimethoprim-sulfamethoxazole seen in E. Enteric bacteria (in particular, Escherichia coli) remain the most frequent cause of UTIs, although the distribution of pathogens that cause UTIs is changing. Urinary tract infections (UTIs) are among the most common bacterial infections and account for a significant part of the workload in clinical microbiology laboratories.
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