Urinary tract infections (UTIs) are among the most common bacterial infections and constitute for a considerable number of all antibiotic prescriptions. The surge of multi-resistant bacteria has significantly complicated empirical treatment leading to wide use of broad-spectrum antibiotics, further driving resistance development. New ways to detect and quantify host and bacterial molecules in urine promise opportunities to improve diagnostics of UTIs, which can translate to new approaches in treatment regimens. Areas covered: Limitations of traditional techniques like urine dipsticks and microscopy, biomarkers as potential aid in differentiating the different types of bacteriuria, limitations of traditional and alternative urine culture are discussed. Additionally, the strengths and limitations of modern bacterial detection and identification methods such as flow cytometry, mass spectrometry, near-infrared spectroscopy, nucleic acid based technologies, isothermal microcalorimetry, biosensors and modern test strips in the scope of UTIs are covered. Literature search was performed using Pubmed, focusing on recent publications about diagnostics and ABS/AMS in urinary tract infections. Expert commentary: We comment on the potential impact of new technologies with a focus on antibiotic stewardship and speculate how the abundance of technological methods may change the way UTIs are perceived and diagnosed in the future.
Keywords: Urinary tract infection; biomarkers; biosensors; flow cytometry; nucleic acid amplification; point of care diagnostic; urine diagnostic; uropathogen detection.