Revolutionizing Urinary Tract Infection Management: Nanotechnology for Improved Diagnosis and Targeted Treatment

Urinary tract infections (UTIs), primarily caused by uropathogenic Escherichia coli (UPEC) using virulence factors like adhesins, toxins and biofilms, are common bacterial infections with significant clinical and economic impact; rising antibiotic resistance demands new diagnostic and therapeutic approaches. This review uniquely integrates UTI-specific pathogenesis, diagnostic challenges and therapeutic nanotechnology strategies, while critically evaluating translational barriers. Current diagnostic techniques, including dipstick urinalysis, microscopic urinalysis and urine culture, have limited sensitivities, specificities and turnaround times. Nanotechnology offers promising advancements in UTI diagnosis and treatment with higher therapeutic efficacy than traditional methods. Nanoparticle-based biosensors and point-of-care devices facilitate rapid, sensitive and specific detection of uropathogens and biomarkers. The delivery of antimicrobials using nanoparticles, such as silver, copper, zinc oxide and selenium nanoparticles, enhances their effectiveness against resistant strains and biofilms, while reducing off-target effects. Additionally, organic nanoparticles, nanodiamonds and green-synthesized nanoparticles exhibit antibacterial properties and improved drug delivery efficiency. Key challenges remain in nanoparticle characterization, manufacturing scalability, regulation of drug-device combinations and rigorous renal-focused toxicology and pharmacokinetics. Overall, nanotechnology offers credible pathways for a faster diagnosis and more effective targeted UTI treatment. However, clinical translation requires a standardized evaluation, elucidation of the mechanism and safety-by-design development.