The “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Urinary Tract Infection (UTI).

 

UTI-A: microbiologically confirmed symptomatic UTI:

  • patient has at least one of the following signs of symptoms with no other recognised cause: fever (> 38 °C), urgency, frequency, dysuria, or suprapubic tenderness

and

  • patient has a positive urine culture, that is, ≥ 105 microorganisms per ml of urine with no more than two species of microorganisms.

UTI-B: not microbiologically confirmed symptomatic UTI:

  • patient has at least two of the following with no other recognised cause: fever (> 38 °C), urgency, frequency, dysuria, or suprapubic tenderness,

and

  • at least one of the following:
    • positive dipstick for leukocyte esterase and/or nitrate;
    • pyuria urine specimen with ≥ 10 WBC/ml or ≥ 3 WBC/high-power field of unspun urine;
    • organisms seen on Gram stain of unspun urine;
    • at least two urine cultures with repeated isolation of the same uropathogen (gram-negative bacteria or S. saprophyticus) with ≥ 102 colonies/ml urine in nonvoided specimens;
    • ≤ 105 colonies/ml of a single uropathogen (gram-negative bacteria or S. saprophyticus) in a patient being treated with effective antimicrobial agent for a urinary infection;
    • physician diagnosis of a urinary tract infection;
    • physician institutes appropriate therapy for a urinary infection.

UTI-C: asymptomatic bacteriuria (they are excluded from surveillance)* :

  • Patient has no fever (> 38°C), urgency, frequency, dysuria, or suprapubic tenderness

and

either of the following criteria:

  • patient has had an indwelling urinary catheter within seven days before urine is cultured,

and

  • patient has a urine culture, that is, ≥ 105 microorganisms per ml of urine with no more than two species of microorganisms;
  • patient has not had an indwelling urinary catheter within seven days before the first positive culture;

and

  • patient has had at least two positive urine cultures ≥ 105 microorganisms per ml of urine with repeated isolation of the same microorganism and no more than two species of microorganisms.

Bloodstream infections secondary to asymptomatic bacteriuria must be reported  as BSI with source (origin) S-UTI.

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Link to European IC/HH Core Competencies

Area 3. Surveillance and investigation of healthcare associated infection (HAI)

 

References

http://www.ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf