Table 1

Medians for 11 quality indicators (QI) and accompanying standards focusing on the diagnostic process of urinary tract infections (UTIs)

Rationale behind QIsDefinition of QIs
(numerator:denominator)		Standards (%)Median, range 1–9
Patients with suspected UTI
 QI1: No urinalysis when lack of symptomsPatients* without symptoms†‡ who had urinary dipstick and/or microscopy and/or urine culture: patients* without symptoms†‡0–109§
Patients with lower UTI
 QI2: UTI is defined by symptoms and bacteriuriaPatients¶ with ≥1 symptom† and a positive urinary dipstick (nitrite and leucocytes) and/or a positive microscopy: patients¶80–1009§
 QI3: The diagnosis of UTI presupposes symptomsPatients¶ with ≥1 symptom†: patients¶90–1009§
 QI4: Urine culture and susceptibility testing when complicated UTIPatients** who had urine culture and susceptibility testing: patients**90–1009§
Patients with pyelonephritis
 QI5: Pyelonephritis is defined by symptoms and bacteriuriaPatients†† with ≥1 symptom‡ and a positive urinary dipstick (nitrite and leucocytes) and/or a positive microscopy: patients††90–1009§
 QI6: Urine culture and susceptibility testing when pyelonephritisPatients‡‡ with ≥1 symptom‡ who had urine culture and susceptibility testing: patients‡‡80–1009§
 QI7: CRP testing can support the diagnosis of pyelonephritisPatients†† examined with a CRP test: patients††80–1009§
 QI8: Often markedly elevated CRP when pyelonephritisPatients†† with a CRP test <20 mg/L: patients†† examined with a CRP test0–108§
Patients with catheter and UTI
 QI9: Other symptoms in catheter users with UTIPatients§§ with ≥1 symptom‡: patients§§90–1007§
 QI10: Urine culture and susceptibility testing for catheter users with UTIPatients§§ who had urine culture and susceptibility testing: patients§§90–1009§
Patients with pregnancy and UTI
 QI11: Urine culture and susceptibility testing for pregnant women with UTIPatients¶¶ who had urine culture and susceptibility testing: patients¶¶90–1009§

  • Catheter: Chronic indwelling urethral or suprapubic catheter.

  • Unresolved: Continued suspicion of UTI, but, for example, awaiting a urine culture result.

  • *Patients with suspected UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’, ‘pyelonephritis’, ‘unresolved’ and ‘other, not UTI’).

  • †Symptoms of lower UTI: dysuria, frequency, urgency, new-onset incontinence, suprapubic pain.

  • ‡Symptoms of pyelonephritis: fever, shivering, flank pain, systemically unwell.

  • §Consensus of appropriateness after second round.

  • ¶Patients diagnosed with lower UTI (the diagnosis: ‘complicated lower UTI’ and ‘uncomplicated lower UTI’).

  • **Patients diagnosed with complicated lower UTI (the diagnosis: ‘complicated lower UTI’) including catheter users and pregnant women.

  • ††Patients diagnosed with pyelonephritis (the diagnosis: ‘pyelonephritis’).

  • ‡‡Patients with suspected pyelonephritis (the diagnosis: ‘pyelonephritis’ and ‘unresolved’).

  • §§Catheter users with suspected UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’, ‘pyelonephritis’ and ‘unresolved’).

  • ¶¶Pregnant women with suspected UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’, ‘pyelonephritis’ and ‘unresolved’).

  • CRP, C reactive protein.