2. • DEFINATION
• THE UTI IS BACTERIA IN THE URINARY TRACT SEEN EITHER BY WET PREPARATION OR IDENTIFICATION VIA BACTERIAL CULTURE, THAT DOES NOT REPRESENT CONTAMINATION
• UTI ARE CLASSIFIED AS LOWER TRACT OR UPPER TRACT UTI INFRCTION
• AN EXAMPLES FOR LOWER TRACT UTI INFECTION IS CYSTITIS
• CYSTITIS- IT IS A SYNDROME ASSOCIATED WITH UTI INVOLVING DYSURIA , FREQUENCY , URGENCY AND OCCASIONAL
SUPRAPUBIC TENDERNESS
• AN EXAMPLE FOR UPPER URINARY TRACT DISEASE IS PYELONEPHRITIS
• PYELONEPHRITIS – IT IS AN INFLAMMATION OF THE KIDNEY DUE TO INFECTION
3. • EPIDEMIOLOGY
• Privalance of uti varies by age and gender
• Girls more affected than boys
• UTI 30% in women between age of 20- 40. But 30 times more in men at this age
• It is believed that upward of 40-50% of female will experience a symptomatic uti
in their life time
4. • ETIOLOGY
• The frequency of causative organisms changes depending on weather the setting is
complicated or uncomplicated
• Complicated UTI refers to structural and functional abnormalities is in UTI
• Patients with complicated UTI need longer treatment than the complicated UTI
• 85% of cases the causative organisms is Escherichia coli
• Other organisms included staphylococcus ,saprophyticus and enterococcus sepcis and all
gram positive bacterias
• Garam negetive species such as pseudomonas aeruginosa, klebsiella pneumonia, Proteus
species ,entero bacteria species
5. • PATHOPHYSIOLOGY
• There are three potential way for bacteria enters into urinary tract and cause the infection
• Ascending pathway –
• The ascending pathway occurs when bacteria colonizing in urethra subsequently traveled
upwards the urethra to bladder and causing the cystitis
• Ascending route helps to explain uti more in womens due to short urethra
• These bacteria may ascending continuously towards the urinary tract via ureters that may
cause more complicated infection such as pyelonephritis
6. • HEMATOGENOUS PATHWAY
• It may occurs through the seeding of the urinary tract with pathogens carried by
the blood supply
• Staphylococcus aureus bacterium causes renal abscesses via hematogenous route
7. • LYMPHATIC PATHWAY
• It can connect the bladder to the kidney and may represent a way for bacteria to
be transported and subsequently cause infection
• Ascension – bacterial toxins may also play a role by inhibiting peristalsis
• Pyelonephritis- while infection to the renal parenchyma is usually the bacterial
Ascension ,it occurs form hematogenous spread
8.
9. • RISK FACTORS
• In women – sexual intercourse
. Use of diaphragm
Seprmicidal jellies
. During pregnancy
• In men’s – older age
• prostatic hyperplasia
• Both – urological instrumentation , urinary tract obstruction
10. • SIGNS AND SYMPTOMS
LOWER UTI
• Dysuria
• Suprapubic heaviness
• Gross hematuria
• Nocturia
11. • SIGNS AND SYMPTOMS
UPPER UTI
• Flank pain
• Malaise
• Fever
• Vomiting
12. • DIAGNOSIS
• Urinalysis should show
• Pyuria is>10 WBCs / mm3 urine
• Nitrites are present
• Leukocyte esters are present
13. • TREATMENT
PHARMCOLOCIGCAL TREATMENT
• Uncomplicated UTI –
• Ciprofloxacin 250mg will take twice a day with in 3 day of treatment
• Cotriamoxizole twice a day with in 3 days
• Norfloxacin 400mg twice a day with in 3 days
• Fosfomycin 3 gm single dose with in 1 day
14. • COMPLICATED UTI
• Gatifloxacin 400 mg once a day with in 7- 10 day of treatment
• Levofloxacin 250 mg once a day required 7 days
• Amoxicillin and clavulanate 500mg for 8 th hourly with in 7- 10 days
• Recurrent infection
• Co trimaxizol once a day with in 6 months of treatment
• Acute pyelonephritis
• Enoxacin 400mg once a day required 14 days of treatment
17. • NON PHARMCOLOCIGCAL TREATMENT
• Drink plenty of liquids especially water
• Take cranberry juice
• Wipe for front to back
• Empty your bladder every intercourse
• Change the birth control methods
