Skip to main content

Urinary Tract Infection — Follow-up Actions when Culture Results are Available — Clinical Pathway: All Settings

Urinary Tract Infection (UTI) Clinical Pathway — All Settings

Follow-up Actions when Culture Results are Available

Definition of a UTI

Symptoms of UTI + abnormal UA (e.g., pyuria, presence of nitrites) + growth of a
urinary pathogen with appropriate CFU

Specimen Definite Possible
Catheterization > 50, 000 cfu/mL > 10,000 cfu/mL
Clean-catch > 100,000 cfu/mL > 50,000 cfu/mL

Pathogens and Contaminants

Urine Pathogens Common Contaminants
  • E.coli
  • Klebsiella
  • Proteus
  • Enterococcus
  • Pseudomonas
  • S. aureus is unlikely to cause isolated UTI. If isolated from urine, consider blood cultures to evaluate for bacteremia.
  • Lactobacillus sp.
  • Corynebacterium sp.
  • Coagulase-negative staphylococci
  • Alpha-hemolytic streptococci

Urine Culture Follow-up

Empiric Treatment Prescribed Positive Culture
  • Review susceptibilities, change antibiotic as indicated
  • Assess if child is improving after 2 days of appropriate antibiotic
  • Educate family about future febrile illness
  • See Imaging and Prophylaxis Recommendations
Negative Culture
or Contaminant
  • Stop antibiotics
  • Inform family that the child did not have a UTI
No Empiric Treatment Prescribed Positive Culture
  • If CFU criteria met for definite or possible UTI, check child:
    • If still symptomatic and initial UA negative, repeat specimen or evaluate alternate causes
    • If symptomatic and initial UA positive or borderline, check susceptibilities and treat according to antibiotic recommendations
    • If no ongoing symptoms, no treatment (asymptomatic bacteriuria, spontaneous resolution)
Negative Culture
or Contaminant
No treatment

 

Jump back to top