1st order laboratory parameters – obligatory laboratory tests.
- Urine sediment (urine examination) [leukocyturia (increased excretion of white blood cells in the urine); leukocyte cylinders are evidential of pyelonephritis (inflammation of the renal pelvis); nitrite-positive urine status (indicating Enterobacteriaceae), bacteriuria (excretion of bacteria with the urine); proteinuria (excretion of protein with the urine), if necessary].
- Isolated hematuria requires nephrological workup and follow-up.Caveat (Warning)! In (sub)total obstruction of the urinary tract may not be detectable leukocyturia.
- Urine culture (pathogen detection and resistogram, that is, testing of suitable antibiotics for sensitivity / resistance) from midstream urine or catheter urine.
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Small blood count – leukocytes
- CRP (C-reactive protein)
- Serum creatinine
Further notes
- In healthy, non-pregnant women in premenopause, neither screening for asymptomatic bacteriuria nor antibiotic therapy should be performed.For this purpose, a validated questionnaire “Acute Cystitis Symptom Score” (ACSS) is now available in German. With this questionnaire, the diagnosis of uncomplicated cystitis can be made with a high degree of certainty on the basis of clinical criteria. Furthermore, the severity of symptoms can be estimated and the course observed.
- In women with recurrent (recurrent) urinary tract infections in which the leukocyte count in the urine rises to > 150% of the baseline value can serve as an indication that the transition from a harmless bacteriuria to a symptomatic infection is present.
