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    Urinary Tract Infection

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    SANDYTHYA
    This document discusses urinary tract infections (UTIs). It describes the anatomy, clinical presentations, microbiology, diagnosis and treatment of various types of UTIs, including cystitis, urethritis, pyelonephritis, and renal abscesses. The most common bacteria that cause uncomplicated UTIs is E. coli. Complicated UTIs can be caused by a wider range of bacteria including E. coli, enterococci, and Pseudomonas. Diagnosis involves urinalysis and urine culture. Treatment depends on the type and severity of the UTI but commonly involves antibiotics like trimethoprim-sulfamethoxazole or fluoroquinolones.

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    Urinary Tract Infection

    Uploaded by

    SANDYTHYA
    64 views2 pages
    This document discusses urinary tract infections (UTIs). It describes the anatomy, clinical presentations, microbiology, diagnosis and treatment of various types of UTIs, including cystitis, urethritis, pyelonephritis, and renal abscesses. The most common bacteria that cause uncomplicated UTIs is E. coli. Complicated UTIs can be caused by a wider range of bacteria including E. coli, enterococci, and Pseudomonas. Diagnosis involves urinalysis and urine culture. Treatment depends on the type and severity of the UTI but commonly involves antibiotics like trimethoprim-sulfamethoxazole or fluoroquinolones.

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    This document discusses urinary tract infections (UTIs). It describes the anatomy, clinical presentations, microbiology, diagnosis and treatment of various types of UTIs, including cystitis, urethritis, pyelonephritis, and renal abscesses. The most common bacteria that cause uncomplicated UTIs is E. coli. Complicated UTIs can be caused by a wider range of bacteria including E. coli, enterococci, and Pseudomonas. Diagnosis involves urinalysis and urine culture. Treatment depends on the type and severity of the UTI but commonly involves antibiotics like trimethoprim-sulfamethoxazole or fluoroquinolones.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    64 views2 pages

    Urinary Tract Infection

    Uploaded by

    SANDYTHYA
    This document discusses urinary tract infections (UTIs). It describes the anatomy, clinical presentations, microbiology, diagnosis and treatment of various types of UTIs, including cystitis, urethritis, pyelonephritis, and renal abscesses. The most common bacteria that cause uncomplicated UTIs is E. coli. Complicated UTIs can be caused by a wider range of bacteria including E. coli, enterococci, and Pseudomonas. Diagnosis involves urinalysis and urine culture. Treatment depends on the type and severity of the UTI but commonly involves antibiotics like trimethoprim-sulfamethoxazole or fluoroquinolones.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    Urinary tract infections

    (UTI guideline)

    Anatomic Lower: urethritis, cystitis (superficial infection of bladder), prostatitis Upper: pyelonephritis (inflammatory process of the renal parenchyma), renal abscess Clinical Uncomplicated: cystitis in nonpregnant women without underlying structural or neurological disease Complicated: upper tract infection or any UTI in men or pregnant women or UTI with underlying structural or neurological disease (obstruction, reflux, azotemia, transplant, catheter-related) Microbiology Uncomplicated UTI: E.coli(80%), Proteus, Klebsiella, enterococci Complicated UTI: E,coli(30%), enterococci(20%), Pseudomonas(20%) , S.epidermidis(15%), other GNR Catheter-associated UTI: yeast(30%) , E.coli(25%), other GNR, enterococci, S.epidermidis Urethritis: Chlamydia trachomatis, Neisseria gonorrhoeae Clinical Manifestations Cystitis: dysuria, urgency, frequency, in urine color/odor, suprapubic pain; fever generally absent Urethritis: may be identical to cystitis except for urethral discharge Pyelonephritis: fever, shaking chills, flank or back pain, nausea, vomiting, diarrhea Renal abscess( intrarenal or perinephric): identical to pyelonephritis except persistent fever despite appropriate antibiotics Diagnostic studies Urinalysis: pyuria+ bacteriuria +/-hematuria Significant bacterial counts: > 105 CFU/ ml in asymptomatic women, > 103 CFU/ml in men, > 102 CFU/ml in symptomatic or catheterized patients Sterile pyuria urethritis, renal tuberculosis, foreign body Urine gram stain and culture ( from clean-catch midstream or straight-catheterized specimen) in pregnant women and in patients undergoing urologic surgery-screen for symptomatic bacteriuria blood cultures: consider in complicated UTIs First-void and midstream urine specimens Abdominal CT to rule-out abscess in patients with pyelonephritis who fail to defervesce after 72h Urologic workup (KUB, renal U/S, abdominal CT, voiding cystography)

    Treatment of UTIs Clinical scenario Cystitis

    Urethritis

    Clinical scenario TMP-SMX or FQ x 3d or x 10-14 d(complicated) Asymptomatic bacteriuria in pregnant women or Treat for both Neisseria and Chlamydia Neisseria: ceftriaxone 125 mg IM x1 or ofloxacin 400 mg POx1 Outpatient: FQ or amoxicillin/clavulanate or 1st gen.ceph.PO x 14d Inpatient: [ampicillin IV+gentamicin] or ampicillin/sulbactam or FQ or P Ceph 3 or AP Pen X 14 d(IVPO when patient improved Drainage + antibiotics as for pyelonephritis

    Pyelonephritis

    Renal abcess

    Reference: 1.Harrisons Principles of Internal Medicine,15ed, P1620-1626 2.The Washington Manual of Medical Therapeutics 30 ed, P310-312 3.The Massachusetts General Hospital Handbook of Internal Medicine P6-3 4.The Stanford Guide To Antimicrobial Therapy,2004,P23

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