UTIs-Definition.ppt

UTIs-Definition Infectious diseases of the urinary tract: cystitis (bladder) pyelonephritis (kidney) prostatitis (prostate) Etiology Usually Acute Majority due to a single pathogen Usually an Enterobacteriaceae 90% of all UTI gram negative bacilli common intestinal flora Escherichia coli most commonly isolated pathogen ~80% of all UTI Gram staining Organisms: Gram -ve Cause 90-95% of UTI’s most often, E. coli. Others include: Proteus mirabilis and Klebsiella. Gram +ve pathogens include: Staph saprophyticus, Staph aureus, group A beta hemolytic streptococci and enterococci. Features of UTI Common affliction to seek medical attention. Infancy to old age Bacturia: bacteria in urine does not necessarily imply infection Features of UTI Pyuria Presence of WBCs in urine Evidence of inflammatory response to infection. Epidemiology Populations with increased incidences: School age girls Young womenmen 50% have a UTI during their lifetime 10% per year have a UTI Pregnant women Elderly of both sexes Diabetes Abnormal urine flow Who to screen for UTI? Children with recurrent infection Monitoring antibiotic therapy High risk individual How do we screen for UTIs? Collect midstream urine use fresh or refrigerate. Pour about 10 ml in tube and dipstick. Microscopy Culture Chemical Analysis Dip-stick testing Quick Efficient Inexpensive Large number of substances Chemical Analysis Chemical Analysis Chemical Analysis Urinalysis Dipstick findings: leukocyte esterase + with pyuria nitrite + with Enterobacteriaceae alkaline pH with urea splitting bacteria, e.g., Proteus mirabilis high specific gravity if patient is volume depleted protein often + blood may be + What are the most useful test? Leukocyte Esterase Enzyme found WBCs More reliable than microscopic analysis for WBCs Positive results indicate inflammation in the path taken by urine. Includes urethra, prostate, cervix and vagina Occur in 90 to 95% of symptomatic UTI Less sensitive asymptomatic UTI in elderly a