A new study in the Journal of Clinical Microbiology poses troubling implications over the over-diagnosis of urinary tract infections (UTI). Both UTIs and sexually transmitted infections (STI) frequently are diagnosed in emergency room settings. Unfortunately, distinguishing between UTIs and STIs is often difficult because of the number of overlapping symptoms. The recent study sought to discover how often STIs are mistakenly diagnosed as UTIs, and, as a result, are treated with the wrong medication.
When bad bacteria, such as E. coli, enters the urethra, sometimes this causes an infection in the normally sterile urinary tract. On average about one out of every three women gets a UTI at least one time, causing almost seven million visits to the doctor per year.
As common as UTIs are, ERs often misdiagnose sexually transmitted infections as urinary tract infections due to the similarity of certain symptoms, such as pelvic pain, painful urination, and a constant need to pee. Unfortunately, these cases of misdiagnosis have led to millions of women being prescribed unnecessary antibiotics for UTIs that they don’t have. Women misdiagnosed with UTIs also have remained unaware of their STIs, meaning that they have potentially spread their STIs to their partners.
The recent study, under lead author Michelle Hecker, monitored 264 women who had gone to the emergency room in Ohio. Of those women, 175 were diagnosed with a urinary tract infection. Researchers evaluated the women’s urine samples using molecular tests to determine what infection, if any, that each woman had. Alarmingly, Hecker and her team found that less than 50% of the women who were diagnosed with a UTI actually had a UTI.
A common method of diagnosing a UTI is by running a urinalysis, which detects bacteria in the urinary tract. While urinalysis has the advantage of being instant, it is not the most accurate testing method. Urinalysis is often contaminated or comes back with abnormal results. The more thorough, but time-consuming, urine culture test is a much more accurate testing method.
The idea of many people walking around ignorant of their STIs because of a misdiagnosis of a UTI is not pleasant for several reasons. First of all, this increases the risk of unwittingly spreading STIs to countless other people. However, the other alarming aspect is the threat of antibiotic resistance. In recent years, researchers have become worried about the overuse of commonly prescribed antibiotics. The more people use antibiotics, the more resistant bacteria becomes to those drugs.
The solution for this problem is for ERs and doctors to reconsider how they test for UTIs and STIs. Using urine culture testing, rather than urinalysis, is a great way to start.
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