Bermudez Tomas, Schmitz Jonathan E, Boswell Malcolm, Humphries Romney
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Independent MicroDx Consultancy Services, Tuson, Arizona, USA.
J Clin Microbiol. 2025 Feb 19;63(2):e0030624. doi: 10.1128/jcm.00306-24. Epub 2025 Jan 6.
Urinary tract infections (UTIs) impose a substantial burden on patient quality of life and urine testing accounts for the majority of workload in many clinical microbiology laboratories. Traditional UTI diagnosis relies on symptoms, urinalysis, and culture which are interpreted based on historical guidelines. This approach, while foundational, presents limitations, particularly in complex cases. Low-level bacteriuria and the presence of fastidious organisms are often overlooked or entirely missed in standard urine culture, stressing the need for novel diagnostic methods and technologies. This mini-review summarizes the existing state of UTI diagnostics in 2024 and covers current and upcoming technologies including rapid molecular-based pathogen identification, next-generation sequencing, and advanced antimicrobial susceptibility testing. However, these methods represent unique challenges, and as they are implemented, they will require the field to adapt to new concepts to avoid misdiagnosis and overtreatment.
尿路感染（UTIs）给患者的生活质量带来了沉重负担，尿液检测在许多临床微生物实验室的工作量中占比最大。传统的尿路感染诊断依赖于症状、尿液分析和培养，并根据既往指南进行解读。这种方法虽然是基础，但存在局限性，尤其是在复杂病例中。标准尿液培养中，低水平菌尿和苛养菌的存在常常被忽视或完全漏检，这凸显了新型诊断方法和技术的必要性。本综述总结了2024年尿路感染诊断的现状，涵盖了当前和即将出现的技术，包括基于分子的快速病原体鉴定、下一代测序和先进的抗菌药物敏感性测试。然而，这些方法也带来了独特的挑战，在实施过程中，该领域需要适应新的概念，以避免误诊和过度治疗。
