UNIT V Urinary Tract Infection Urinary Tract Infection

UNIT V Urinary Tract Infection

Urinary Tract Infection

URINARY TRACT INFECTION • Broadly classified as – Upper UTI – Lower UTI • patient may have both at a time • Frequency- varies with age and sex – may be acute or chronic

• Upper urinary tract Infections: – Kidney infection or Pyelonephritis • Lower urinary tract infections – Bladder infection or Cystitis (“traditional” UTI) – Urethritis (often sexually-transmitted) – Prostatitis

• Positive Urine Culture = >105 CFU/m. L • Most common pathogen for cystitis, prostatitis, pyelonephritis: – – – Escherichia coli Staphylococcus saprophyticus Proteus mirabilis Klebsiella Enterococcus • Most common pathogen for urethritis • Chlamydia trachomatis • Neisseria Gonorrhea

Risk Factors For Urinary Tract Infection • Inability or failure to empty the bladder completely • Obstructed urinary flow: – – – – from congenital anomalies, from urethral strictures contracture of the bladder neck, bladder tumors calculi in ureters or kidneys compression of ureters neurologic abnormalities

• Contributing conditions as: » Diabetes mellitus » Pregnancy » Neurologic disorders » Gout » Urinary stasis • Inflammations or abrasions in the urethral mucosa • Instrumentations of the urinary tract • Immunosuppressant's

Urinary Tract Infection • Urethrovesical Reflux “back flow of urine “ with: » Coughing » Sneezing » Straining • Routes of infection: » Ascending infection e. g. Because the female urethra is short, Unhygienic sexual intercourse is the major precipitating factor of UTI in women

Clinical Manifestations of UTI • Urgency • Dysuria • Increased frequency • Hematuria • Fever • Nausea/Vomiting (pyelonephritis) • Flank pain (pyelonephritis) • Bacteriuria and positive urine cultures as basis for diagnosing lower urinary tract infections

Complications • Permanent kidney damage • In pregnant women- low birth weight baby or premature infant • Urethral narrowing • Sepsis – life threatening complication

Diagnostic findings of UTI • Urine cultures • Testing – Leukocyte esterase test is positive – STD sexual transmitted disease may be present • Computerized Tomography ”C. T. ” to detect pyelonephritis, abscess • Ultrasonography to detect obstruction, abscess, tumors, cysts. • Intravenous pyelography to detect strictures or stones.