The absence of a consensus-based reference standard for urinary tract infection (UTI) research adversely affects the internal and external validity of diagnostic and therapeutic studies. This omission hinders the accumulation of evidence for a disease that imposes a substantial burden on patients and society, particularly in an era of increasing antimicrobial resistance. We did a three-round Delphi study involving an international, multidisciplinary panel of UTI experts (n=46) and achieved a high degree of consensus (94%) on the final reference standard. New-onset dysuria, urinary frequency, and urinary urgency were considered major symptoms, and non-specific symptoms in older patients were not deemed indicative of UTI. The reference standard distinguishes between UTI with and without systemic involvement, abandoning the term complicated UTI. Moreover, different levels of pyuria were incorporated in the reference standard, encouraging quantification of pyuria in studies done in all health-care settings. The traditional bacteriuria threshold (10 colony-forming units per mL) was lowered to 10 colony-forming units per mL. This new reference standard can be used for UTI research across many patient populations and has the potential to increase homogeneity between studies.

中文翻译：

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尿路感染研究的参考标准：多学科德尔菲共识研究


尿路感染（UTI）研究缺乏基于共识的参考标准，会对诊断和治疗研究的内部和外部有效性产生不利影响。这一遗漏阻碍了疾病证据的积累，给患者和社会带来了沉重负担，特别是在抗菌素耐药性日益增加的时代。我们进行了由国际多学科 UTI 专家小组 (n=46) 参与的三轮 Delphi 研究，并就最终参考标准达成了高度共识 (94%)。新发的排尿困难、尿频和尿急被认为是主要症状，老年患者的非特异性症状不被认为是尿路感染的征兆。该参考标准区分了有和没有全身受累的尿路感染，放弃了复杂性尿路感染这一术语。此外，不同水平的脓尿被纳入参考标准，鼓励在所有医疗机构进行的研究中对脓尿进行量化。传统菌尿阈值（每毫升 10 个菌落形成单位）降低至每毫升 10 个菌落形成单位。这一新的参考标准可用于许多患者群体的尿路感染研究，并有可能提高研究之间的同质性。