Ana’am HunotTowfik houry课件.pptVIP

Done by : Ana’am Hunot Towfik Khoury Supervised by Dr. Yossef Matane UTI Microbial invasion of the upper lower urinary tract . Some Definitions : Bacteriuria : bacteria in the urine . Uncomplicated UTI : infection in a patient with a structurally functionally normal tract . Complicated : structural functional abnormality . Reinfection : recurrent infection with different bacteria (bcoz the mechanism of infection is still present) . Relapse : recurrent UTI by the same organism . Classifications of UTI - first infection . - unresolved infection .(bacterial resistance, two different bacterial species, azotemia, papillary necrosis, giant staghorn calculi ) - bacterial persistence ( stone, fistula, FB, medullary sponge kidney, scarred atrophied kidney ) - reinfection . - Recurrent UTI . Predisposing factors for UTI Colonization of the perineum . Ascent of organisms up the urethra : catheter, lower UT surgery, sexual intercourse, vaginal prolapse . Stagnation of urine in the bladder ( V-U reflux, impaired neurologic control, diverticula, infrequent micturition . Organisms infecting the UT Ascending infection ( the commonest ) Gram –ve - E- coli - proteus - klebsiella - citrobacter - serratia - pseudomonas ( common when there is a UT pathology or instrumentations ) . Fungi - candida . Gram +ve cocci - staph. Aureus - staph epidermidis - strep. Feacalis . Hematogenous infection (rare) : Bacteria : salmonella, mycobacteria . Parasites : schistosoma haematobium . Fungi : histoplasma duboisii Viruses : CMV, adenovirus type 11 . Sterile pyuria High urine WBC’s with –ve culture . - TB . - chlamydia . Carcinoma in situ . Staghorn calculi . Antimicrobials . If patient pre