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Urinary tract infection

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Pinky Rathee

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

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BY PINKY RATHEE M.Sc. Nursing URINARY TRACT INFECTION
CONTENT • Introduction • Classification of UTI • Etiology & Risk factors • Pathophysiology • Clinical manifestation • Diagnosis • Medical management • Conclusion
INTRODUCTION Symptomatic presence of micro- organisms within the urinary tract i.e., kidney, ureters, bladder and urethra. • Associated with inflammation of urinary tract.
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.
• 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.
Acute pyleonephritis Chronic pyleonephriitis Interstitial pyleonephritis Renal abscess CystitiS Urethritis UTI UPPER LOWER
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.
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
• ASCENDING INFECTION: organism Colonize in perineal and periurethral areas UTI Ascend to bladder, kidneys
HEMATOGENOUS SPREAD: Blood borne spread to kidneys. Occurs in bacteraemia UTI
• 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:
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
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.
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.
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.
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.
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.
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.
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.
Urinary tract infection

More Related Content

Urinary tract infection

  • 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.