What are the recommended initial investigations for a patient presenting with symptoms of a urinary tract infection (UTI)?

Recommended initial investigations for a patient presenting with symptoms of a urinary tract infection (UTI) include:

• Obtain a urine sample for dipstick testing to detect leukocyte esterase and nitrites, which are indicative of infection. If both are negative, a UTI is unlikely and further testing or antibiotics may not be necessary.
• If dipstick testing is positive for leukocyte esterase or nitrites, send a urine sample for culture and sensitivity testing to identify the causative organism and guide antibiotic treatment.
• In children and young people, use dipstick testing as a first step; if positive, send urine for culture and start antibiotics. In babies under 3 months or those with high risk of serious illness, send urine for urgent microscopy and culture immediately.
• Collect urine samples using clean catch methods where possible; if not feasible, use non-invasive methods such as urine collection pads, or catheter samples/suprapubic aspiration if necessary.
• For patients with indwelling catheters, send a catheter urine sample for culture and susceptibility testing before starting antibiotics.

These investigations help confirm the diagnosis, identify the pathogen, and guide appropriate antibiotic therapy.

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