Infección del tracto urinario

1. INFECCIÓN DE TRACTO
URINARIO COMPLICADO
MR. DR LUIS ALBERO TORREZ MAMANI

2. Definición
 Invasión bacteriana de parénquima renal y o sus vías de excreción

3. Infección del tracto urinario
No complicado
 Mujeres
 Sin alteración anatómica y
funcional
Complicada
 Hombres
 Inmunosuprimidos
 Enfermedad renal
Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

4. https://google.com/slideshrecdn.infeccion
tractourinario//3-320.jpg

5. Patogénesis
Colonizacion del introito
vaginal- o meato uretral
Seguido de un ascenso a travez
de la uretra- vejiga
Pielonefritis – patogénesis
asciende hacia los riñones.
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

6. Pielonefritis
 Deterioro de los riñones debido a
bacteremia
Ascendente
Hematógena
linfática
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

7. Terminología
ITU aguda complicada
que se extiende más
allá de la vejiga
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

8. Sintomatología
disuria
Urgencia
urinaria
Frecuencia
urinaria
dolor
suprapúbico Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

9. Síntomas de
cistitis:
1. Uretritis
Cistitis
intersticial/síndrome
de dolor de vejiga
Vaginitis
Enfermedad
inflamatoria pélvica
prostatitis bacteriana Hiperplasia prostática
benigna
Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

10. Síntomas de
pielonefritis:
Dolor de
costado
Fiebre
Náuseas
vómitos
Dolor en el
ángulo
costovertebral
nefrolitiasis Infección de herpes
Infarto renal
Procesos
intraabdominales:
ApendicitisColecistitis/
cólico
biliar
Pancreatitis
Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

11.  Nefroditiasis
estenosis
afecciones inmunocomprometidas
diabetes mellitus mal controlada
PACIENTES CON MAYOR RIESGO
Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

12. E .coli Pseudomona Estafilococos
Klepsiela. SPP Enterococos s. aureus sensible a la
meticilina
Protius Resistente a la meticilina
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

13. Terapia antimicrobiana empírica
Debe iniciarse de inmediato
teniendo en cuenta los
factores de riesgo de
resistencia a los
medicamentos incluidos el
uso previo de antimicrobianos
y resultados de los cultivos
recientes  Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

14. Indicaciones de hospitalización
1. Paciente sépticos o en estado crítico
2. Fiebre alta persistente
3. Dolor debilidad marcada o incapacidad tolerancia
oral 2
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

15. Enfermedad crítica y obstrucción del
tracto urinario
1. Imipemen 500 mg por diente intravenosa cada 6 horas
2. Meropenem un gramo intravenoso cada 8 horas
BLEE
1. VANCOMICINA PARA CUBRIR E. AUREUS RESISTENTE A METICILINA
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

16. No hay factores de riesgo de infección por un
organismo verdad negativo resistente a
múltiples fármacos
 Ceftriaxona un gramo intravenoso una vez al día
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

17. Sin resistencia a las fluoroquinolonas
 Ciprofloxacina o levofloxacina
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

18. Un factor de riesgo de infección por un
organismo gran negativo multirresistente
 Piperacilina tazobactam 3. 375 gramos
intravenoso cada 6 horas
 Imipenem 500 mg intravenoso cada 6 horas
o meropemen un gramo intravenoso cada 8
horas
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

19. Enterococcus
 Amoxicilina 500 mg por vía oral cada 8
horas o 875 mg dos veces al día
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

20. Estafilococos
 Trimetoprim sulfametoxazol una tableta de
doble concentración 160 mg / 800 mg por
vía oral dos veces al día
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

21. Duración
 Varía entre 5 a 10 días dependiendo de la rapidez
de la respuesta clínica y del antimicrobiano
elegido para completar el tratamiento
 Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-based epidemiologic analysis of acute pyelonephritis. Clin Infect Dis 2007; 45:273.
 Nicolle LE. A practical guide to antimicrobial management of complicated urinary tract infection. Drugs Aging 2001; 18:243.
 Linsenmeyer K, Strymish J, Gupta K. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.
Antimicrob Agents Chemother 2015; 59:7593.

22. bibliografia
https://google.com/slideshrecdn.infeccion tractourinario//3-320.jpg.