Urinary tract infection (UTI)
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Urinary system is composed of kidney, ureters, urinary bladder, and urethra. Infection of any part or the urinary system is known as urinary tract infection. 95% women are at the risk of developing a urinary tract infection. Latest research shows that almost all women will develop a urinary tract infection at some point during their lives, and many will experience more than one.
Urinary tract infection may be classified as uncomplicated (normal urinary tract and function), or complicated (male patients, abnormal renal tract, impaired renal function).A recurrent UTI is further infection with a new organism and a replace with the same organism.
What are the risk factors for UTI?
Some people appear to be more likely than are others to develop urinary tract infections. Risk factors include:
- Female sex
- Sexual active
- using diaphragm contraceptive
- vaginal spermicidal
- Diabetes mellitus
- Immunosuppressant people
- During pregnancy ,
- during menopause
- Urinary tract obstruction ( kidney stone , or tumor)
- instrumentation of urinary tract
- malformation of urinary tract
- unhygienic
What are the organisms that cause the urinary tract infection?
Bacteria are the main causes of UTI.
- Bacteria includes: E.coli is the most common (>70% in the community), staphylococcus saprophyticus, Enterococcus faecalis, proteus mirabilis, Klebsiella, Pseudomonas aeruginosa and serratia marascens.
- Virus : Simplex herpes virus type 2
- Fungal : yeast infections
- Parasites : chistosomiasis
What are the symptoms of UTI?
Symptoms depend on which part of the urinary tract is infected.
- Cystitis (infection of Urinary bladder): Frequency, dysuria (painful urination), urgency, strangury, haematuria, lower abdominal pain, low grade fever.
- Acute pyelonephritis (infection of kidney): high grade fever, rigors, chills, nausea, vomiting, loin pain.
- urethritis( infection of urethra) : Burning urination
- Prostatitis (infection of prostate gland, only in man): flu like symptoms, lower back pain, swollen, low grade fever.
How UTI is diagnosed?
Diagnosis relies on patient’s history, normal urinary analysis (a pure growth of >108 colony forming units (CFU/L) is diagnostic) , and urine culture .some complicated cases Total blood count, blood culture , CRP , X-ray KUB and ultrasound may required.
How is UTI treated?
Patient is advice to drink plenty of water, urinate frequently, maintain hygiene, and post intercourse urination. In simple urinary tract infections antibiotic like Amoxicillin, Nitrofurantion, ofloxiacin, Co-trimoxazole is giving for 7-11 days. Severely ill patients with kidney infections may be hospitalized and give intravenous antibiotic according urine culture and sensitivity until they can take fluids and needed drugs on their own.
What is the prevention?
Antibiotic prophylaxis, either continuous or post coital, decreases infection rates in women with recurrent UTIs. Self treatment with a single antibiotic dose as symptoms start is an option. Effects of cranberry juice have not been fully assessed but this long term established alternative remedy may inhibit adherent of E.coli to bladder cells.
What to prevent UTI?
In the simple urinary traction infection prognosis is excellent.
References:
- Sabiston textbook of surgery 18th edition
- Bailey and love, surgery 25th edition
- The Washington manual of surgery, 5th edition.
- emedicine.medscape.com
Filed Under: Urology
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