MSU - when an MSU is indicated
Urine microscopy, culture and sensitivity is required in patients (1) -
- with recurrent or complicated infections
- during pregnancy
- in suspected pyelonephritis (temp >=39.4; rigors; nausea; vomiting; diarrhoea; loin pain or tenderness)
- in men
- suspected UTI in children, any sick child and every young child with unexplained fever
- catheterised patients: Send sample only if features of systemic infection, as bacteriuria is usual
- abnormalities of genitourinary tract
- failed antibiotic treatment or persistent symptoms
- in elderly patients presence of two signs of infection (especially dysuria, fever >38 or new incontinence) is needed before taking a sample
- a bacterial count of >=10^5 is generally regarded as significant bacteriuria . The health protection agency has issued the following colony counts as diagnostic values:
- culture of single organisms >=10^4 colony forming units (CFUs)/mL + urinary symptom
- >=10^3 CFU/mL of Escherichia coli or Staphylococcus saprophyticus )
With respect to adults in primary care:
*Of note is that an MSU is indicated in ALL over 65 year olds if symptomatic and antibiotic given*
Reference:
- Public Health England. Urinary tract infection: diagnostic tools for primary care. A quick reference tool for primary care for consultation and local adaptation. Last updated May 2024. (online)
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