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URINARY TRACT INFCTION
PRESENTED BY:
DR. CHITRANJAN DAS
M.D. SCHOLAR (DRAVYAGUNA)
GACH PATNA
GUIDEDBY :
DR. (PROF.)MAHENDRA PRASAD SINGH
M.D.(AY.)DRAVYAGUNA
HOD. DEPT. OF DRAVYAGUNA
GACH PATNA
CO-GUIDEDBY :
DR. SHREEBHAGWANSINGH
M.D.(AY.) DRAVYAGUNA
ASSOCIATEPROF. DEPT .OF DRAVYAGUNA
GACH PATNA
INTRODUCTION :-
Urinary tract infection is one
of the most common bacterial
infection.
A urinary tract infection, or
UTI, is an infection in any part
of your urinary system, which
includes your kidneys,
bladder, ureters, and urethra.
It is managed in general
medical practice .
DEFINITION
UTI is an inflammatory response
of the urothelium to bacterial
invention that is usually
associated with bacteriuria and
pyuria.
CAUSATIVE PATHOGENS
Most UTIs are caused by
a single bacterial
species.
At least 80% of the
uncomplicatedcystitis
and pyelonephritisare
due to E.coli.
Other Less common
pathogens includes
klebsiella , proteus and
Enterobacterand
enterococci.
• In hospitalacquired UTIs , a wider variety of
causativeorganism is found , including
pseudomonas and staphylococcus .
• UTI uncommon in male except over the age
of 60 yr. when urinary tract obstructiondue
to prostatic hypertrophy may occur.
• Symptomaticpresence of micro organism
within the urinary tract i.e. kidney ureters
bladder and urethra.
• Associatedwith inflammationof urinary
tract.
COMMON MICROORGANISM CAUSING UTI
Escherichia coli Enterococcus Klebsiella Proteus Pseudomonas Staphylococcus
Candida
albicans
PREDISPOSING FACTOR TO UTI
FACTOR INCREASING URINARY STASIS
Intrinsic obstruction due to stone or tumour in urinary tract
Extrinsic obstruction due to tumour and fibrosis
Urinary retention including neurogenic bladder
Renal impairment
2. FOREIGN BODY
•Urinary tract calculi
•Catheter
•Urinary tract instrumentation
3. ANATOMICAL FACTOR
Congenital defect in genital tract leading to obstruction
Fistula
Shorter female urethra
obesity
4. FACTOR COMPROMISING IMMUNE RESPONSE
Ageing
HIV
Diabetes mellitus
5. FUNCTIONAL DISORDER
•Constipation
•Voiding dysfunction
6. OTHER
Pregnancy
Multiple sex partner
Poor personal hygiene
CLASSIFICATION OF UTI
UPPER
UTI
•Acute pyelonephritis
•Chronic pyelonephritis
•Interstitial pyelonephritis
•Renal abscess
•Prerenal abscess
LOWER
UTI
•Cystitis
•Prostatitis
•Urethritis
•Both upper and lower
UTI are further divided in
to complicated and
uncomplicated .
RISK FACTORS
1. AGEING
•Diabetes
mellitus
•Urine retention
•Impaired
immune system
2. FEMALE
•Shorter urethra
•Poor hygiene
3. MALE
•Prostatic
hypertrophy
•bacterial
prostatitis
PATHOPHYSIOLOGY
In most of the cases infection ascends through urethra and reach to
urinary bladder
Infection of urethra is known as urethritis and in bladder is known as
cystitis
In severe case this infection can ascends to the pelvis and kidney
through ureter. It is called pyelonephritis.
Urinary stasis because of any reason helps in the growth and
multiplication of bacteria.
CLINICAL FEATURE
In lower UTI there is burningsensation during micturition (dysuria)and increasefrequencyof micturition
In severecasethere may be –
Fever
Suprapubicpain
Urgency
Hesitancy
Haematuria
Continue………………….
When infection reaches to upper urinary tract then –
High grade fever with chills and rigor is the prominent symptoms
Nausea and vomiting
Flank pain
Renal angle tenderness (characteristic feature of pyelonephritis )
Most important clinical feature is UTI may present with only fever
In some case like diabetic mellitus severe UTI develops without any sign and symptoms and patient developed
septicaemia and septic shock and renal failuremay occur
2. Age of
patient
1. Site of
infection
Clinical manifestation
depend on –
1. SITE OF INFECTION
• Discomfort in voiding
• Dysuria
• Urgency
• Frequency
URETHRITIS
• Dysuria , urgency and
• frequent urination
• Abdominal pain
• pyuria
CYSTITIS
• Suprapubic tenderness
• Fever and chills
• White blood cell caste in urine
• Loin pain
• Nausea and vomiting
PYELONEPHRITIS
• Sepsis ,
• septic shock
• death
COMPLICATIONS
2. DEPENDING ON AGE
BABIES
AND
INFANTS-
Fever
Diarrhoea
CHILDREN
:-
Dysuria
urgency
frequency
haematuria
acute
abdominal pain
vomiting
ADULTS
LOWER UTI :-
frequency ,
urgency , dysuria
,haematuria
• UPPER UTI :- fever,
rigor, and loin pain
and symptoms of
lower UTI.
ELDERLY
PATIENTS :-
mostly
asymptomatic
INVESTIGATION
Microscopic examination of urine Urine for culture and sensitivity
Imaging studies of urinary tract (e. g. cystoscopy)
LABORATORY FINDING
• Uncontaminated , mid stream urine to used sample
LABORATORY FINDING
NORMALFINDING ABNORMALFINDING
PH 4.6 -8.0 ALKALINE(INCREASE)
APPEARENCE STRAW CLOUDY
COLOUR PALE AMBER YELLOW
ODOUR AROMATIC FOULSMELLING
BLOOD NONE MAY BE PRESENT
WBC ABSENT PRESENT
BACTERIA ABSENT PRESENT
PREVENTION OF UTI
Maintain
hygiene
Wash
hand
before
using
toilets
Wipe
front and
back after
urination
or
defecation
Clean
urethral
meatus
first while
bathing
Use wash
cloths to
clean the
perinium
Use liquid
soap in
stand of bar
soap to
prevent
colonization
Urinate
before and
after
intercourse
Wear
comfortable
and clean
clothing
Consume
healthy diet
TREATMENT
MUTRAL
DRUGS
ADEQUATE
FLUID INTAKE
AYURVEDIC
MEDICIENS
CONSULTING
ABOUT RISK OF
RECURRENCE
AND
REDUCTION
RISK FACTORS
GOKSHUR
(Tribulus
Terrestris)
PUNARNAVA
(Boerhaavia
diffusa)
VARUN
(Crataeva
nurvala)
Urinary tract infaction

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