Protocol for diagnosis of @entity293 : reconsidering the criterion for significant XXXX .

@entity1 @entity4658 @entity811 @entity2953 @entity6 @entity2335 @entity793 @entity8803 @entity3833 @entity158 @entity869 @entity2885 @entity365 @entity293 @entity526
The traditional criterion of 10(5) colony-forming units (CFU) per milliliter of urine to diagnose @entity293 was based on studies of pregnant and nonpregnant @entity1 with asymptomatic @entity793 or acute @entity2885 . Recent studies of symptomatic @entity1 revealed that urine cultures in approximately one third of those with confirmed @entity293 grew only 10(2) to 10(4) CFU/mL. The major causes of acute @entity3833 among such @entity1 are @entity293 , @entity2953 , and @entity365 . In most instances, it is possible to make the diagnosis based on clinical features. The major features of @entity293 are internal @entity3833 ; frequency, urgency, and voiding of small volumes; abrupt onset; @entity158 ; presence of @entity4658 . Presence of @entity811 which occurs in about 50 percent of @entity1 strongly suggests bacterial @entity2335 . Three to seven days of empiric antimicrobial therapy is indicated for these @entity1 , with selection of a first-line antimicrobial agent that offers efficacy against @entity526 or @entity8803 ; reasonable cost; few side effects. @entity869 is not recommended. Indications for culture include uncertain clinical features; history of previous infection within the past three weeks; duration of symptoms of more than seven days; recent hospitalization or catheterization; pregnancy; @entity6 . To maximize the sensitivity and specificity of the urine culture in acutely symptomatic @entity1 , it is necessary to request the laboratory to report 10(2) to 10(4) CFU/mL.
