urinary track infection
TRANSCRIPT
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Paired kidney
UretersUrinary bladder
Urethra
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Cystitis and urethritis, the two
forms of lower urinary track
infection (UTI), are nearly ten
times more common in femalesthan in males. Lower UTI is also
a prevalent bacterial disease in
children, with girls also most
commonly affected.
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In men and in children of either sex,
lower UTIs are usually related toanatomic or physiologic
abnormalities and therefore require
extremely close evaluation. UTIstypically respond readily to
treatment, but recurrence and
resistant bacterial flare-up during
therapy are possible..
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Ascending infection by a singlegram negative enteric
bacterium ( ESCHERIA COLI,KLEBSIELLA,PROTEUS,ENTERO
BACTER,PSEUDONOMAS, OR
SERRATIA)
Simultaneous infection with
multiple pathogens.
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Benign prostatic hyperplasiaBowel incontinence
CatheterizationCystoscopy
DiabetesHistory of analgesic or reflux
nephropathy
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Immobility or decreased
mobility Incomplete emptying of the
bladder (in elderly patients)
Indwelling urinary catheter
Lack of adequate fluids
Pregnancy
Prostatitis
Urethral strictures
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Abdominal pain or tenderness overthe bladder area.
Chills
Cramps or bladder spasm Dysuria Feeling o f warmth during
urination Fever, flank pain
Hematuria
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Itching
Low back painMalaise
Nausea, vomitting
Nocturia
Urethral discharge in males
Urinary frequency and
urgency
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Characteristic signs and symptoms andmicroscopic urinalysis showing redblood cell and white blood cell counts
greater than 10 high power fieldsuggest lower UTI. A clean catch, midstream urine
specimen revealing a bacterial count ofmore than 100,000/ml confirms thediagnosis. Lower counts don't necessarilyrule out infection,
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Especially if the patient is voiding
frequently, because bacteria require
30 to 45 minutes to reproduce in
urine. Careful midstream, clean
catch collection is preferred tocatheterization, which can reinfect
the bladder with urethral bacteria.
Sensitivity testing determines theappropriate therapeutic
antimicrobial agent.
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Sensitivity testing determines the
appropriate therapeutic
antimicrobial agent.
Voiding cystoureterography or
excretory urography maydisclose congenital anomalies
that predispose the patient torecurrent UTIs.
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Appropriate antimicrobials are thetreatment of choice for most initial
lower UTIs. a 7 to 10 day course of
antibiotic therapy is standard, but
recent studies suggest that a single
dose of an antibiotic or a 3 to 5 dayantibiotic regimen may be sufficient
to render the urine sterile.
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After 3 days of urine antibiotic
therapy, urine culture should
show no organisms.
If the urine isnt sterile after 3
days of antibiotic therapy,
bacterial resistance has probably
occurred, making the use ofdifferent antimicrobial necessary.
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Single dose antibiotic therapy
with amoxicillin or cotrimoxazole
may be effective in females with
an acute, uncomplicated UTI. A
urine culture taken 1 to 2 weekslater indicates whether the
infection has been eradicated
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Teach the female patient how toclean the perineum properly and
keep the labia separated during
voiding to collect a clean-catch,
midstream urine specimen. Explain
that an uncontaminated midstreamspecimen is essential for accurate
diagnosis.
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Watch for GI disturbances from
antimicrobial therapy.Teach the patient how to
prevent and treat UTIs.
Collect all urine samples for
culture sensitivity testing
carefully and promptly..
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Paracetamol
AmpicillinGentamicin sulfate
Bacillus clausil