MSU - when an MSU is indicated

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Urine microscopy, culture and sensitivity is required in patients (1,2) -
    • 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 (1)
  • a bacterial count of >=10^5 is generally regarded as significant bacteriuria (2). 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 (2)

With respect to adults in primary care more detailed guidance is now available (3):

*Of note is that an MSU is indicated in ALL over 65 year olds if symptomatic and antibiotic given*


Last edited 09/2019 and last reviewed 09/2019