biostudies-literatureBilsen MPNetherlands Organisation for Health Research and Development2070-2076https://www.ebi.ac.uk/biostudies/studies/S-EPMC10273372biostudies-literatureUnknown76(12)<h4>Background</h4>Pre-existing lower urinary tract symptoms (LUTS), cognitive impairment, and the high prevalence of asymptomatic bacteriuria (ASB) complicate the diagnosis of urinary tract infection (UTI) in older women. The presence of pyuria remains the cornerstone of UTI diagnosis. However, >90% of ASB patients have pyuria, prompting unnecessary treatment. We quantified pyuria by automated microscopy and flowcytometry to determine the diagnostic accuracy for UTI and to derive pyuria thresholds for UTI in older women.<h4>Methods</h4>Women ≥65 years with ≥2 new-onset LUTS and 1 uropathogen ≥104 colony-forming units (CFU)/mL were included in the UTI group. Controls were asymptomatic and classified as ASB (1 uropathogen ≥105 CFU/mL), negative culture, or mixed flora. Patients with an indwClinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaCurrent Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women.PMC1027337210150511910054van Andel Evan der Beek MTDelfos NMAantjes MJvan Nieuwkoop CNumans MEBilsen MPLeyten EMSStalenhoef JEMooijaart SPCobbaert CMSijbom MConroy SPLambregts MMCAchterberg WPVisser LGfalseCurrent Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women.<h4>Background</h4>Pre-existing lower urinary tract symptoms (LUTS), cognitive impairment, and the high prevalence of asymptomatic bacteriuria (ASB) complicate the diagnosis of urinary tract infection (UTI) in older women. The presence of pyuria remains the cornerstone of UTI diagnosis. However, >90% of ASB patients have pyuria, prompting unnecessary treatment. We quantified pyuria by automated microscopy and flowcytometry to determine the diagnostic accuracy for UTI and to derive pyuria thresholds for UTI in older women.<h4>Methods</h4>Women ≥65 years with ≥2 new-onset LUTS and 1 uropathogen ≥104 colony-forming units (CFU)/mL were included in the UTI group. Controls were asymptomatic and classified as ASB (1 uropathogen ≥105 CFU/mL), negative culture, or mixed flora. Patients with an indw2023-01-01T00:00:00Z2023 Jun2025-04-18T20:35:44.248Z2025-02-19T00:50:13.369ZS-EPMC102733723680658010.1093/cid/ciad099