The document provides a detailed overview of urinary tract infections (UTIs), including their classification, etiology, pathophysiology, clinical manifestations, diagnosis, and management. It highlights that UTIs are more prevalent in women and outlines common symptoms and diagnostic methods. Management includes antibiotic therapy for symptomatic infections, while asymptomatic cases may not require treatment, though concerns about antibiotic resistance are noted.

1. BY PINKY RATHEE
M.Sc. Nursing
URINARY TRACT
INFECTION

2. CONTENT
• Introduction
• Classification of UTI
• Etiology & Risk factors
• Pathophysiology
• Clinical manifestation
• Diagnosis
• Medical management
• Conclusion

3. INTRODUCTION
Symptomatic presence of micro-
organisms within the urinary tract i.e.,
kidney, ureters, bladder and urethra.
• Associated with inflammation of
urinary tract.

4. Significant bacteriuria
Asymptomatic bacteriuria : bacteriuria with no
symptoms.
• Urethritis: infection of anterior urethral tract -
dysuria, urgency and frequency of urination.
• Cystitis: infection to urinary bladder -dysuria,
frequency and urgency, pyuria and haematuria.

5. • Acute pyelonephritis: infection of
one/both kidneys; sometimes lower tract
also-pyuria, fever, painful micturition
• Chronic pyelonephritis: particular
type of pathology of kidney; may/may
not be due to infection.

6. Acute pyleonephritis
Chronic pyleonephriitis
Interstitial pyleonephritis
Renal abscess
CystitiS
Urethritis
UTI
UPPER LOWER

7. Etiology and risk factors
• Urethra-verticular reflux(from urethra to bladder)
• Uretero-vesical or vesico-urethral reflux-flowing urine
from the bladder and into one or both ureters.
• Feceal contamination of urethral meatus.
• Sexual intercourse
• Instrumentation of urinary tract
• Stasis of urine
• Obstruction of urinary flow.
• Prevalence is 8 times higher in the females then males.

8. 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

9. • ASCENDING INFECTION:
organism
Colonize in
perineal and
periurethral
areas
UTI
Ascend to
bladder,
kidneys

10. HEMATOGENOUS SPREAD:
Blood borne
spread to
kidneys.
Occurs in
bacteraemia
UTI

11. • Pelvic inflammatory
diseases
• Genito-urinary tract
fistulas
• Men- through rectal
and colonic lymphatic
vessels to prostrate
and bladder.
• Women- through
periuterine lymphatics
to urinary tract.
Lymphatogenous
spread:
Direct extension
from other organs:

12. LOWER URINARY TRACT INFECTION
(CYSTITIS)
• Frequent pain and burning on urination.
• Spasms in the region of bladder and
suprapubic area.
• Hematuria and back pain.
CLINICAL MANIFESTATIONS OF URINARY
TRACT INFECTION

13. UPPER URINARY TRACT INFECTION
(PYELONEPHRITIS)
• Fever, chills, flank pain, painful
urination, pain and tenderness in the
area of costovertebrae (CVA).
• Renal failure at late stage can occur,
sign and symptoms can be –nausea,
vomiting, pruritus, weight loss, edema,
fatigue.

14. SIGN AND SYMPTOMS-
Urgency, frequency, burning, pain on urination, nocturia.
Pain and spasms in the region of bladder.
Pyuria (WBC in urine).
Haematuria, bacterial colony count increases.

15. DIAGNOSTIC TESTS OF URINARY TRACT
INFECTION
Colony-count – at least 1,00,000 colonies per millilitre of urine on
clean catch urine.
Cellular finding, microscopic hematuria, WBC increased
Urine culture, E.coli.
Test for sexually transmitted disease.
Other tests- intravenous urogram (IVU), intravenous pyelography
(IVP), ultrasound.
Cystitis (LUTI) - inflammation of urinary bladder and most often
caused by ascending infection from the urethra occurs more in
women.

16. UTI - MANAGEMENT
• Symptomatic UTI- antibiotic therapy
• Asymptomatic UTI- no treatment required
except in special situations.
• Non- specific therapy:
more water intake.
Maintaining acidity of urine by fluids like
canberry juice.

17. ANTI-MICROBIAL THERAPY
Goals of therapy:
• Elimination of infection
• Relief of acute symptoms
• Prevention of recurrence and long
Antibacterial agents- common medicines
include ampicillin, trimethoprim.

18. CONCLUSION
• Urinary tract infections are the 2nd most common
bacterial infections.
• Women are the most infected subjects in the
population.
• Development of resistance to antibiotics by the
bacteria result in problems during the treatment
and lead to relapse or recurrence.
• Recent advances such as development of
immunologicals like intranasal vaccines may result
in life time cure of the infection in future.

19. NURSING CONSIDERATION
Reducing pain- antimicrobial therapy, antispasmodics, hot tube
bath.
Maintain adequate elimination pattern is encourage lot of fluids,
avoid the cause.
Give knowledge- perineal hygiene, void every 2-3 hours/day, if
cause is sexual intercourse void immediately and take anti-
microbial, avoid indwelling catheter.
Assess vital signs.