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

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