Hard-to-treat UTIs

Urinary tract infections are becoming increasingly drug-resistant and many require precise pathology

Judith is an 82-year-old woman from a low-level care facility.


Over the last week, she has developed new urinary incontinence and frequency.

She has a history of hypertension and osteoarthritis and is allergic to nitrofurantoin (rash).

Her GP requests a mid-stream urine sample prior to empirically starting cefalexin.

Subsequently, urine microscopy reveals a white blood cell count of 200x106/L (normal below 40x106/L) and cultures Escherichia coli, which is