Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance

The urine culture, the cornerstone for laboratory diagnosis of urinary tract infection (UTI), is associated with a high frequency of false-positive and false-negative results, and its diagnostic threshold is debated. Urine culture takes days to result, and antibiotics are often initiated while awaiting final culture readings. Further, asymptomatic bacteriuria-the presence of bacteria in urine in the absence of UTI symptoms-generally does not warrant treatment. The authors review current expert guidance on the use of urine culture, including approaches to ordering, processing, and reporting of urine cultures, with the goal of reducing unnecessary antibiotic use and misdiagnosis of UTI.