Urinary Tract Infection

Urinary Tract Infection

• Most common bacterial infection in women
• May be caused by a variety of disorders
  • Bacterial infection most common
• Bladder and its contents are free of bacteria in majority of healthy people
• Minority of healthy individuals have some bacteria colonizing in bladder
  • Called asymptomatic bacteriuria and does not justify treatment
• Escherichia coli  (E. coli) most common pathogen
• Other causes of UTIs
  • Enterococcus
  • Klebsiella
  • Enterobacter
  • Proteus
  • Pseudomonas
  • Staphylococcus
  • Serratia
  • Candida albicans
• Counts of 105 CFU/mL or more indicate significant UTI
• Counts as low as 102 CFU/mL in a person with signs/symptoms are indicative of UTI
• Fungal and parasitic infections may cause UTIs
• Patients at risk
  • Immunosuppressed
  • Diabetic
  • Have kidney problems
  • Have undergone multiple antibiotic courses
  • Have traveled to developing countries
• Classification of UTI
  • Upper versus lower
    • Upper urinary tract
      • Renal parenchyma, pelvis, and ureters
      • Typically causes fever, chills, flank pain
      • Example
        • Pyelonephritis: inflammation of renal parenchyma and collecting system
    • Lower urinary tract
      • Usually no systemic manifestations
      • Examples
        • Cystitis: inflammation of bladder
        • Urethritis: inflammation of urethra
    • Urosepsis
      • UTI that has spread systemically
      • Life-threatening condition requiring emergent treatment
  • Complicated versus uncomplicated
    • Complicated UTI
      • Coexists with presence of
        • Obstruction or stones
        • Catheters
        • Abnormal GU tract
        • Diabetes/neurologic disease
        • Resistance to antibiotics
        • immunocompromised
        • Pregnancy-induced changes
        • Recurrent infection