Urinary Tract Infection

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Urinary Tract Infection Urinary tract infection (UTI) is an infection that affects any part of the urinary tract. The urinary system consists of the kidneys, ureters, bladder, and urethra. Bladder infection or cystitis is the most common type of UTI. If the infection affects the kidney, it is called pyelonephritis which is a more serious infection. Background 1. Bacterial infections of urinary tract are a very common reason to seek health services 2. Common in young females and uncommon in males under age 50 3. Common causative organisms  a. Escherichia coli (gram-negative enteral bacteria) causes most community acquired infections  b. Staphylococcus saprophyticus, gram-positive organism causes 10 – 15%  c. Catheter-associated UTI’s caused by gram-negative bacteria: Proteus, Klebsiella, Seratia, Pseudomonas Normal mechanisms that maintain sterility of urine  a. Adequate urine volume  b. Free-flow from kidneys through urinary meatus  c. Complete bladder emptying  d. Normal acidity of urine  e. Peristaltic activity of ureters and competent ureterovesical junction  f. Increased intravesicular pressure preventing reflux  g. In males, antibacterial effect of zinc in prostatic fluid Pathophysiology 1. Pathogens which have colonized urethra, vagina, or perineal area enter urinary tract by ascending mucous membranes of perineal area into lower urinary tract 2. Bacteria can ascend from bladder to infect the kidneys 3. Classifications of infections  a. Lower urinary tract infections: urethritis, prostatitis, cystitis  b. Upper urinary tract infection: pyelonephritis (inflammation of kidney and renal pelvis) Risk Factors 1. Aging  a. Increased incidence of diabetes mellitus  b. Increased risk of urinary stasis  c. Impaired immune response 2. Females: short urethra, having sexual intercourse, use of contraceptives that alter

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