Urinary Tract Infection, Complicated (UTI)

Michael Melia, M.D., James DeMaio, M.D.
Urinary Tract Infection, Complicated (UTI) is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

  • Among the most common, resistant strains frequently encountered:
    • Enterobacteriaceae
    • Pseudomonas aeruginosa 
    • Acinetobacterspp.
  • Less common:
    • MSSA or MRSA
      • Most due to invasion of urinary tract (secondary to catheters, stents)
      • Consider presentations of staphylococcal bacteremia with findings of S. aureus in urine.
    • Enterococcus spp. (including VRE)
    • Candida spp.
    • Fastidious organisms possible.
  • Infections may be polymicrobial, especially if chronic urinary catheter or stents are present.

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PATHOGENS

  • Among the most common, resistant strains frequently encountered:
    • Enterobacteriaceae
    • Pseudomonas aeruginosa 
    • Acinetobacterspp.
  • Less common:
    • MSSA or MRSA
      • Most due to invasion of urinary tract (secondary to catheters, stents)
      • Consider presentations of staphylococcal bacteremia with findings of S. aureus in urine.
    • Enterococcus spp. (including VRE)
    • Candida spp.
    • Fastidious organisms possible.
  • Infections may be polymicrobial, especially if chronic urinary catheter or stents are present.

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