A detail information on urinary tract infection with its epidemiology, etiology and pathophysiology, signs and symptoms with its types and causes and a detail information on management of urinary tract infection with both pharmacological treatment and non-pharmacological treatment.

1. URINARY TRACT
INFECTIONS
• INTRODUCTION
• EPIDEMIOLOGY
• ETIOLOGY
• TYPES OF UTI
• PATHOGENESIS OF UTI
• CAUSES OF UTI
• SIGNS AND SYMPTOMS OF UTI
• TREATMENT OF UTI

3. INTRODUCTION
• A URINARY TRACT INFECTION (UTI) IS AN INFECTION IN ANY PART OF THE URINARY SYSTEM.
• THE URINARY SYSYTEM INCLUDES THE KIDNEYS, URETERS, BALDDER NAD THE URETHRA.
• MOST OF THE INFECTIONS INVOLVE THE LOWER URINARY TRACT – THE BLADDER AND THE
URETHRA.
• WOMEN ARE THE GREATER RISK OF DEVELOPING A UTI THAN A MEN. IF AN INFECTION IS
LIMITED TO THE BLADDER, IT CAN BE PAINFUL AND ANNOYING. AMONG ADULTS AGED 20-
50YEARS, UTI’S ARE ABOUT 50-FOLD MORE COMMOM IN WOMEN.

4. URINARY TRACT
KIDNEYS :- KIDNEYS ARE THE SMALL, BEAN-SHAPED
ORGANS ON THE BACK OF YOUR BODY, ABOVE THE
HIPS. MOST PEOPLE HAVE TWO KIDNEYS. THEY FILTER
WATER AND WASTE PRODUCTS FROM YOUR BLOOD,
WHICH BECOMES URINE. COMMON WASTES INCLUDE
UREA, CREATININE.
URETERS :- URETERS ARE THE THIN TUBES THAT CARRY
URINE FROM YOUR KIDNEYS TO THE BLADDER.
BLADDER :- BLADDER IS A BALLON- LIKE ORGAN THAT
STORES URINE BEFORE IT LEAVES YOUR BODY.
URETHRA :- THE URETHRA IS A TUBE THAT CARRIES
URINE FROM YOUR BLADDER TO THE OUTSIDE OF

5. EPIDEMIOLOGY
• URINARY TRACT INFECTIONS ARE MUCH MORE COMMON IN ADULTS THAN IN
CHILDREN, BUT ABOUT 1%-2% OF CHILDREN DO GET URINARY TRACT INFECTION.
• URINARY TRACT INFECTIONS IN CHILDREN, ARE MORE LIKELY TO BE SERIOUS THAN
THOSE IN ADULTS AND SHOULD NOT BE IGNORED (ESPECIALLY) IN YOUNGER
CHILDREN.
• THESE INFECTIONS ARE COMMON IN GIRLS AND WOMEN THAE KIDNEYS N IN BOYS
AND MEN YOUNGER THAN 50 YEARS OF AGE.
• THE LIFETIME RISK OF A WOMAN HAVING A UTI IS OVER 50%. THEY ARE ESPECIALLY
PRONE DUE TO ANATOMICAL REASONS; A WOMAN’S URETHRA IS SHORTER THAN A
MAN’S , ANS IS SITUATED CLOSER THAN THE ANUS, MAKING IT QUICKER FOR BACTERIA
TO ENTER THE BLADDER.
• ABOUT 40% OF WOMEN AND 12% OF MEN HAVE A URINARY TRACT INFECTION AT

6. ETIOLOGY
• THE MOST COMMON CAUSE OF UNCOMPLICATED UTI’S IS E.COLI , ACCOUNTING FOR MORE THAN 80%
TO 90% OF COMMUNITY- ACQUIRED INFECTIONS. ADDITIONAL CAUSATIVE ORGANISMS ARE
STAPHYLOCOCCUS SAPROPHYTICUS (COAGULASE-NEGATIVE STAPHYLOCOCCUS). KLEBSIELLA
PNEUMONIAE; PROTEUS SPP.., PSEUDOMONAS AERUGINOSA, AND ENTEROCOCCUS SPP..,
• THE URINARY PATHOGENS IN COMPLICATED OR NOSOCOMIAL INFECTIONS MAY INCLUDE ;E.COLI, WHICH
ACCOUNTS FOR LESS THAN 50% OF THESE INFECTIONS, PROTEUS SPP.., K.PNEUMONIAE, ENTEROBACTER
SPP.., P.AERUGINOSA, STAPHYLOCOCCI, AND ENTEROCOCCI.
• ENTEROCOCCI REPRESENT THE SECOND MOST FREQUENTLY ISOLATED
ORGANISMS IN HOSPITALIZED PATIENTS.
• MOST UTI’S ARE CAUSED BY A SINGLE ORGANISM; HOWEVER, IN
PATIENTS WITH STONES, INDWELLING URINARY CATHETERS, OR
CHRONIC RENAL ABSCESSSES, MULTIPLE ORGANISMS MAY BE ISOLATED.

7. TYPES OF UTI
• UTI’S ARE CAUSED BY MICRO-ORGANISMS OR GERMS, USUALLY BACTERIA. THE DIFFERENT
TYPES OF UTI CAN INCLUDE:-
CYSTITIS
• INFECTION OF
THE BLADDER.
• CYSTITIS IS THE
MOST COMMON
LOWER URINARY
INFECTION.
URETHRITIS
• INFECTION
OF THE
URETHRA.
PYLELONEPHRITIS
• INFECTION
OF THE
KIDNEYS.

9. PATHOPHYSIOLOGY:-
4 ROUTES OF BACTERIAL ENTRY TO URINARY
TRACT:-
1. ASCENDING INFECTION.
2. BLOOD BORNE SPREAD.
3. LYMPHATOGENOUS SPREAD.
4. DIRECT EXTENSION FROM
OTHER ORGANS.

10. ASCENDING INFECTION
• MOST COMMON ROUTE.
• ORGANISMS ASCEND THROUGH URETHRA INTO THE BLADDER.
ORGANISM COLONIZE IN
PERINEAL AND
PERIURETHRAL AREAS.
ASCEND TO THE
BLADDER AND THEN
ENTERS THE
KIDNEYS.
UTI

11. HEMATOGENOUS
SPREAD:
• BLOOD BORNE
SPREAD TO KIDNEYS.
• OCCURS IN
BACTERAEMIA
MOSTLY S.AUREUS.

12. LYMPHATOGENOUS SPREAD
• MEN- THROUGH RECTAL AND COLONIC
LYMPHATIC VESSELS TO PROSTRATE AND
BLADDER.
• WOMEN- THROUGH PERIUTERINE
LYMPHATICS TO URINARY TRACT.

13. DIRECT EXTENSION
FROM OTHER ORGANS:
• PELVIC INFLAMMATORY
DISEASES.
• GENITO-URINARY TRACT
FISTULAS.

14. CAUSES OF UTI :
UTI’S MOST COMMONLY OCCUR DUE TO THE FOLLOWING BACTERIA:
• ESCHERICHIA COLI
• PROTUS MIRABILIS
• ENTEROCOCCUS FAECALIS
• STAPHYLOCOCCUS SAPROPHYTICUS
• KLEBSIELLA PNEUMONIAE

15. THE FOLLOWING FACTORS CAN INCREASE THE LIVELIHOOD
OF DEVELOPING A UTI :
• HAVING DIFFICULTY FULLY EMPTYING THE BLADDER.
• HAVING A CONDITION THAT CAUSES A BLOCKAGE IN THE URINARY TRACT, SUCH AS KIDNEY
STONES.
• HAVING DIABETES MELLITUS.
• HAVING HAD A PREVIOUS UTI.
• HAVING POOR HYGIENCE.
• INADEQUATE WATER INTAKE.
• HAVING RECENTLY USED A CATHETER.

17. SIGNS AND
SYMPTOMS OF UTI :
• BURNING WITH URINATION.
• INCREASED FREQUENCY OF URINATION
WITHOUT PASSING MUCH URINE.
• INCREASED URGENCY OF URINATION.
• BLOODY URINE.
• CLOUDY URINE.
• PAIN AND TENDERNESS IN THE UPPER
BACK AND SIDES.
• CHILLS.
• FEVER.

18. RISK FACTORS OF
UTI :
1. AGING :-
• DIABETES MELLITUS
• URINE RETENTION
• IMPARIED IMMUNE SYSTEM
2. FEMALES :-
• SHORTER URETHRA
• INCOMPLETE BLADDER EMPTYING
WITH AGE
• PREGNANCY
3. MALES :-
• PROSTATIC HYPERTROPHY

19. DIAGNOSIS :
1. URINALYSIS :- THIS TEST WILL EXAMINE FOR RED BLOOD
CELLS, WHITE BLOOD CELLS AND BACTERIA. THE NUMBER
OF WHITE AND RED BLOOD CELLS FOUND IN YOUR URINE
CAN ACTUALLY INDICATE AN INFECTION.
2. URINE CULTIURE :- A URINE CULTURE IS USED TO
DETERMINE THE TYPE OF BACTERIA IN YOUR URINE. THIS IS
IMPORTANT TEST BECAUSE IT HELPS DETERMINE THE
APPROPRIATE TREATMENT.
3. ULTRASOUND :- IN THIS TEST, SOUND WAVES CREATE AN
IMAGE OF THE INTERNAL ORGANS. THIS TEST IS DONE ON
TOP OF YOUR SKIN, IS PAINLESS AND DOES NOT TYPICALLY
NEED ANY PREPARATION.
4. CYSTOSCOPY :- THIS TEST USES A SPECIAL INSTRUMENT
FITTED WITH A LENS AND A LIGHT SOURCE ( CYSTOSCOPE )
TO SEE INSIDE THE BLADDER FROM THE URETHRA.

20. TREATMENT OF UTI

21. DRUG NAME
(ORAL THERAPY)
BRAND NAME ADVERSE DRUG
REACTIONS
MONITORING
PARAMETERS
TRIMETHOPRIM-
SULFAMETHOXAZOLE
BACTRIM, SEPTRA RASH, STEVENS-
JOHNSON SYNDROME,
RENAL FAILURE,
PHOTOSENSITIVITY.
SERUM CREATININE,
BUN, ELECTROLYTES,
SIGNS OF RASH AND
CBC.
NITROFURANTOIN MACROBID GI INTOLERANCE,
NEUROPATHIES AND
PULMONARY
REACTIONS.
BASELINE SERUM
CREATININE AND
BUN.
FOSFOMYCIN MONUROL DIARRHEA,
HAEDACHE, AND
ANGIOEDEMA.
NO ROUTINE TESTS
RECOMMENDED.
FLUROQUINOLONES
CIPROFLOXACIN
LEVOFLOXACIN
CIPRO
LEVAQUIN
HYPERSENSITIVITY,
PHOTOSENSITIVITY,
GI SYMPTOMS,
DIZZINESS,
CONFUSIONS AND
TENDONITIS.
CBC, BASELINE SERUM
CREATININE, AND
BUN.
PENICILLINS
AMOXICILLIN- AUGMENTIN
HYPERSENSITIVITY
(RASH,
ANAPHYLAXIS),
CBC, SIGNS OF RASH
(OR)
HYPERSENSITIVITY.

22. DRUG NAME BRAND NAME ADVERSE DRUG
REACTIONS
MONITORING
PARAMETERS
CEPHALOSPORINS
CEFDNIR
CEFPODOXIME-
PROXETIL
OMNICEF
VANTIN
HYPERSENSITIVITY
(RASH, ANAPHYLAXIS),
DIARRHEA,
SUPERINFECTIONS AND
SEIZURES.
CBC, SIGNS OF RASH
(OR)
HYPERSENSITIVITY.
PARENTERAL THERAPY
AMINOGLYCOSIDES
GENTAMICIN
TOBRAMYCIN
AMIKACIN
GARAMYCIN
NEBCIN
AMIKIN
OTOTOXICITY,
NEPHROTOXICITY.
SERUM CREATININE,
AND BUN, SERUM
DRUG
CONCENTRATIONS
AND INDIVIDUAL
PHARMACOKINETIC
MONITORING.
PENICILLINS
AMPICILLIN-
SULBACTAM
UNASYN
ZOSYN
HYPERSENSITIVITY
(RASH, ANAPHYLAXIS),
DIARRHEA,
CBC, SIGNS OF RASH
(OR)
HYPERSENSITIVITY.

23. DRUG NAME BRAND NAME ADVERSE DRUG
REACTIONS
MONITOR
PARAMETERS
CEPHALOSPORINS
CEFTRIAXONE
CEFTAZIDIME
CEFEPIME
ROCEPHIN
FORTAZ
MAXIPIME
HYPERSENSITIVITY
(RASH, ANAPHYLAXIS),
DIARRHEA,
SUPERINFECTIONS AND
SEIZURES.
CBC, SIGNS OF RASH
(OR)
HYPERSENSITIVITY.
CARBAPENEMS/
MONOBACTAMS
IMPIPENEM-
CILISTATIN
MEROPENEM
DORIPENEM
ERTAPENEM
AZTREONAM
PRIMAXIN
MERREM
DORIBAX
INVANZ
AZACTAM
HYPERSENSITIVITY
(RASH, ANAPHYLAXIS),
DIARRHEA,
SUPERINFECTIONS AND
SEIZURES.
CBC, SIGNS OF RASH
(OR)
HYPERSENSITIVITY.
FLUROQUINOLONES
CIPROFLOXACIN CIPRO
HYPERSENSITIVITY,
PHOTOSENSITIVITY, GI
SYMPTOMS, DIZZINESS,
CBC, BASELINE SERUM
CREATININE, AND BUN.

24. INDICATIONS
LOWER TRACT
INFECTION
ANTIBIOTICS DOSE INTERVAL DURATION
UNCOMPLICATE
D
TRIMETHOPRIM-
SULFAMETHOXAZOLE
NITROFURANTOIN
MONOHYDRATE
FOSOMYCIN
CIPROFLOXACIN
LEVOFLOXACIN
AMOXICILLIN-
CLAVULANATE
1 DS TAB
100 mg
3 g
250 mg
250 mg
500 mg
TWICE A DAY
TWICE A DAY
SINGLE DOSE
TWICE A DAY
ONCE A DAY
EVERY 8 HOURS
3 DAYS
5 DAYS
1 DAY
3 DAYS
3 DAYS
5-7 DAYS
COMPLICATED TRIMETHOPRIM-
SULFAMETHOXAZOLE
CIPROFLOXACIN
LEVOFLOXACIN
AMOXICILLIN-
CLAVULANATE
1 DS TAB
250-500
mg
250 mg
750 mg
500 mg
TWICE A DAY
TWICE A DAY
ONCE A DAY
ONCE A DAY
EVERY 8 HOURS
7-10 DAYS
7-10 DAYS
10 DAYS
5 DAYS
7-10 DAYS

25. INDICATIONS ANTIBIOTICS DOSE INTERVAL DURATION
RECURRENT
INFECTIONS
NITROFURANTOIN
TRIMETHOPRIM-
SULFAMETHOXAZOLE
50mg
1/2 SS
TABLET
ONCE A DAY
ONCE A DAY
6 MONTHS
6 MONTHS
ACUTE
PYELONEPHRITHI
S
TRIMETHOPRIM-
SULFAMETHOXAZOLE
CIPROFLOXACIN
LEVOFLOXACIN
AMOXICILLIN-
CLAVULANATE
1 DS TABLET
500 mg
1000 mg ER
250 mg
750 mg
500 mg
TWICE A DAY
TWICE A DAY
ONCE A DAY
ONCE A DAY
ONCE A DAY
EVERY 8 HOURS
14 DAYS
14 DAYS
7 DAYS
10 DAYS
5 DAYS
14 DAYS

26. PREVENTION OF UTI

27. DRINK PLENTY OF WATER AND OTHER FLUIDS TO FLUSH THE URINARY
SYSTEM.
TREAT VAGINAL INFECTIONS SUCH AS THRUSH QUICKLY.
CLEANING VAGINAL AND RECTAL AREAS DAILY.
TAKING SHOWERS INSTEAD OF BATHS.
URINATE AS SOON AS, FEEL THE NEED RATHER THAN HOLDING ON.
URINATE SHORTLY AFTER SEX, TO FLUSH AWAY BACTERIA THAT MIGHT
HAVE ENTERED IN THE URETHRA DURING SEX.
TAKE VITAMIN-C (OR) CRANBERRY JUICE, BECAUSE THESE ARE SAID TO
BE URINARY ANTI-SEPTICS.

28. THANK
YOU