肾内科课件 uti教学材料.pptVIP

2.urethral syndrome: exhibit irritative voiding symptom no significant bacteriuria Infective urethral syndrome: caused by other pathogens such as virus, mycoplasms, chlamydia. Urinalysis show pyuria. Non- Infective urethral syndrome: no WBC is seen with urinalysis. Probably it is because of psychological problems. treatment Antibiotics G—Bacillus （ sulfonamide, quinolones, β-lactam drug semisythetic penicillins , cephalosporins ） After the drug sensitivity test for offending organisms is available, then antibiotics are given according to the test. Urinary Tract Infection( U T I ) Ling Pan Etiology and pathogenesis Pathogen： gram-negative bacteria （ Specifically coliform bacteria, proteus bacteria ） Pyocyanic infection is frequently seen in patients with instrumentation. Proteus bacteria is often seen in patients with calculus. Bacterial virulence factors A high degree of bacterial adherence, which is mediated by the bacterial fimbriae. Some bacteria can produce hemolysin which can resist the body’s defense system . Drug resistance strains Host defense mechanisms Efficient emptying of the bladder with voiding . A protective glycosaminoglycan layer. The high osmolality and extremes of pH . IgG, IgA and organic acid secreted by urinary tract mucosa. Host susceptibility factors urinary tract Obstruction such as calculus, vesicoureteral reflux or intrarenal reflux. (the presence of UTI with structurally or functionally abnormal urinary tract is called complicated UTI) The deformity of urinary system Instrumentation of the urinary tract Host defense system get weak, for instance, diabetes mellitus Pregnancy,gender neurogenic?bladder Genetic?factor Infection route The ascending route: periurethral tissues → urethra → bladder → ureter →renal pelvis→renal medulla The hematogenous route Lymphogenous spread Direct extension from other organs may occur Clinical manifestation cystitis Irritati