Urinary Tract Infections (UTI)

Definition
• Urinary tract infection (UTI) is a condition
where germs or microbes grow and multiply in
the urinary tract in significant quantities
 Classification
• Anatomy
a. Lower urinary tract infection
1). Women (for example: Cystitis)
2). man
Cystitis, prostatitis, epidymidis and urethritis.
b. Upper urinary tract infection
based on the time it is divided into 2 namely:
1). Acute pyelonephritis (PNA)
2). Chronic pyelonephritis (PNK)
• Clinical
a. Simple UTI (uncomplicated)
b. UTI complicated
 Epidemiology
• UTI is the second most common cause of fever
after ARI in children <2 years
• Incidence in preterm neonates (3%), term
neonates (1%)
• In children aged <10 years, the incidence in
girls (3.5%), boys (1.1%)
• As we get older, the incidence of UTIs is more
common in women than in men because the
urethra of women is shorter than in men
 Etiology
• caused by bacteria, viruses and fungi but
bacteria are often the cause.
• inhabit the intestine and will rise to the
urinary system including Escherichia coli,
Proteus sp, Klebsiella, Enterobacter
 Pathophysiology
• almost all UTIs are caused by invasion of asending
microorganisms from the urethra into the
bladder.
• Microorganime invasion can reach the kidneys
made easy with vesicoureter reflux.
• In women the germs from anal colonize at first
vulva, then enter the bladder through the urethra
short spontaneously or mechanically due to
relationships sexual and possibly changes in pH
and deep vulva flora menstrual cycle
 Clinical symptoms
• in lower UTI, patient complaints are usually in
the form of pain or burning sensation in the
urethra while urinating with small amounts of
urine and discomfort in the suprapubic region
• In upper UTI symptoms can be found
headaches, malaise, nausea, vomiting, fever,
chills, discomfort, or pain in the waist.
Supporting diagnosis and examination
1. History
2. Physical examination
Fever, Costovertebral angle (CVA),
suprasymphysis tenderness, External genital
abnormalities (phimosis, vulvar sinechia,
hypospadias, epispadia, spina bifida)
3. Supporting examination
 Supporting investigation
• Urinalysis (Proteinuria, Leukosituria
(Leukocytes> 5 / LPB), Hematuria
(Erythrocytes> 5 / LPB))
• urine culture
growing colonies> 105 colonies / ml of urine:
positive UTI
 Governance
UTI below
- a lot of fluid
- adequate antibiotics
- symptomatic therapy for alkalinization of urine:
nearly 80% of patients respond 48 hours after a
single antibiotic: ampicillin 3gr, trimethropin 200mg.
if the infection persists with urinalysis is required
conventional therapy for 5-10 days.
px microscopic urine and urine culture are not
required when
all symptoms disappear and without leukosiuria
UTI Above
PNA requires hospitalization to maintain
hydration status and parenteral antibiotic
therapy for at least 48 hours