Chronic UTIs and test flaws overlooked in ‘archaic’ guidelines: urologists

Definitions for positive culture have not been updated since the 1950s, Dr Ashani Couchman says.
Sarah Simpkins

UTI guidance is outdated and needs an overhaul to acknowledge chronic UTIs and the limits of culture assessments, urologists say.

Adelaide urological surgeon Dr Ashani Couchman says diagnosis criteria based on white cell counts and a bacteria count of 105 CFU/mL are “fixed and archaic”.

She says the definitions for a positive culture had been established in the 1950s based on “a study of about 70 people who had a kidney infection at the time”.

“That has not changed since, which is extraordinary,” says Dr Couchman, a Urological Society of Australia and New Zealand (USANZ) board member.