Wishahi M, Badawy M. Letter to the Editor: Urinary infection in European guidelines 2025 vs microbiology culture results in the management of urinary infection. World J Exp Med 2026; 16(2): 115894 [DOI: 10.5493/wjem.v16.i2.115894]
Corresponding Author of This Article
Mohamed Wishahi, MD, PhD, Full Professor, Department of Urology, Theodor Bilharz Research Institute, Embaba, Giza, Cairo 12411, Egypt. moh.weshahy@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
letter
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Wishahi M, Badawy M. Letter to the Editor: Urinary infection in European guidelines 2025 vs microbiology culture results in the management of urinary infection. World J Exp Med 2026; 16(2): 115894 [DOI: 10.5493/wjem.v16.i2.115894]
World J Exp Med. Jun 20, 2026; 16(2): 115894 Published online Jun 20, 2026. doi: 10.5493/wjem.v16.i2.115894
Letter to the Editor: Urinary infection in European guidelines 2025 vs microbiology culture results in the management of urinary infection
Mohamed Wishahi, Mohamed Badawy
Mohamed Wishahi, Mohamed Badawy, Department of Urology, Theodor Bilharz Research Institute, Cairo 12411, Egypt
Author contributions: Wishahi M and Badawy M designed the research study; performed the research; contributed to analyzing the data, wrote the manuscript; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Mohamed Wishahi, MD, PhD, Full Professor, Department of Urology, Theodor Bilharz Research Institute, Embaba, Giza, Cairo 12411, Egypt. moh.weshahy@gmail.com
Received: October 29, 2025 Revised: November 11, 2025 Accepted: January 21, 2026 Published online: June 20, 2026 Processing time: 231 Days and 12.3 Hours
Abstract
We read with great interest the study by Yadav et al published in the World Journal of Experimental Medicine, which postulated a nomogram including patient’s critical factors, other than urine sample. European Association of Urology (EAU) published the guidelines on urological infection 2025. The EAU guidelines 2025 of urinary infections (UIs) has classified in two distanced categories: Localized UTs and systemic UTs according to specific patient’s symptoms and clinical signs, this new practical classification replaced previous concept of non-complicated urinary tract infection (UTI) against complicated UTI. The new EAU classification categorizes UIs as either localized or systemic, according to the presence of specific clinical signs and symptoms, this new practical classification replaced previous concept of non-complicated UTI against complicated UTI, irrespective of the results of bacteriological findings. In the new classification of UIs, the classification is based on clinical set-up on which the practitioner or urologist will manage the patient. Management of UIs is crucial to consider the urinary and gut microbiota. It was established recently that antibiotic use affects microbiota homeostasis in the gut and urinary tract that will initiate dysbiosis.
Core Tip: The European Association of Urology guidelines 2025 for urinary infections (UIs) published new classification describing localized and systemic UIs. Patient’s Symptoms, clinical examinations, laboratory, and imaging investigation are required to set up the diagnosis. Localized UIs could be treated on an ambulatory basis, while systemic infection indicates hospitalization and monitoring. Urine culture would not reveal all bacterial community in urine. Second generation sequencing reveals bacterial community including dysbiosis and helper microbiota. Implementing the new guidelines would lead to personalized medicine, minimizing antibiotics use, avoid antibiotic resistance, and considering probiotics in treatment of localized infections.
