Urinary Track Infection

8/4/2019 Urinary Track Infection

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Paired kidney

UretersUrinary bladder

Urethra


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Cystitis and urethritis, the two

forms of lower urinary track

infection (UTI), are nearly ten

times more common in femalesthan in males. Lower UTI is also

a prevalent bacterial disease in

children, with girls also most

commonly affected.


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In men and in children of either sex,

lower UTIs are usually related toanatomic or physiologic

abnormalities and therefore require

extremely close evaluation. UTIstypically respond readily to

treatment, but recurrence and

resistant bacterial flare-up during

therapy are possible..


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Ascending infection by a singlegram negative enteric

bacterium ( ESCHERIA COLI,KLEBSIELLA,PROTEUS,ENTERO

BACTER,PSEUDONOMAS, OR

SERRATIA)

Simultaneous infection with

multiple pathogens.


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Benign prostatic hyperplasiaBowel incontinence

CatheterizationCystoscopy

DiabetesHistory of analgesic or reflux

nephropathy


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Immobility or decreased

mobility Incomplete emptying of the

bladder (in elderly patients)

Indwelling urinary catheter

Lack of adequate fluids

Pregnancy

Prostatitis

Urethral strictures


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Abdominal pain or tenderness overthe bladder area.

Chills

Cramps or bladder spasm Dysuria Feeling o f warmth during

urination Fever, flank pain

Hematuria


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Itching

Low back painMalaise

Nausea, vomitting

Nocturia

Urethral discharge in males

Urinary frequency and

urgency


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Characteristic signs and symptoms andmicroscopic urinalysis showing redblood cell and white blood cell counts

greater than 10 high power fieldsuggest lower UTI. A clean catch, midstream urine

specimen revealing a bacterial count ofmore than 100,000/ml confirms thediagnosis. Lower counts don't necessarilyrule out infection,


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Especially if the patient is voiding

frequently, because bacteria require

30 to 45 minutes to reproduce in

urine. Careful midstream, clean

catch collection is preferred tocatheterization, which can reinfect

the bladder with urethral bacteria.

Sensitivity testing determines theappropriate therapeutic

antimicrobial agent.


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Sensitivity testing determines the

appropriate therapeutic

antimicrobial agent.

Voiding cystoureterography or

excretory urography maydisclose congenital anomalies

that predispose the patient torecurrent UTIs.


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Appropriate antimicrobials are thetreatment of choice for most initial

lower UTIs. a 7 to 10 day course of

antibiotic therapy is standard, but

recent studies suggest that a single

dose of an antibiotic or a 3 to 5 dayantibiotic regimen may be sufficient

to render the urine sterile.


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After 3 days of urine antibiotic

therapy, urine culture should

show no organisms.

If the urine isnt sterile after 3

days of antibiotic therapy,

bacterial resistance has probably

occurred, making the use ofdifferent antimicrobial necessary.


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Single dose antibiotic therapy

with amoxicillin or cotrimoxazole

may be effective in females with

an acute, uncomplicated UTI. A

urine culture taken 1 to 2 weekslater indicates whether the

infection has been eradicated


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Teach the female patient how toclean the perineum properly and

keep the labia separated during

voiding to collect a clean-catch,

midstream urine specimen. Explain

that an uncontaminated midstreamspecimen is essential for accurate

diagnosis.


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Watch for GI disturbances from

antimicrobial therapy.Teach the patient how to

prevent and treat UTIs.

Collect all urine samples for

culture sensitivity testing

carefully and promptly..


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Paracetamol

AmpicillinGentamicin sulfate

Bacillus clausil

Urinary Track Infection

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