Urinary Tract Infection(尿路感染全英文).ppt

Urinary Tract InfectionWu YitaiDepartment of NephrologyTongji Hospital, Tongji University ;Content;Definition of UTI;Anatomic Lower UTI: urethritis cystitis (mucosal infection) Upper UTI: pyelonephritis prostatitis intrarenal and perinephric abscesses (tissue invasion);Classification of UTIs（2）;Classification of UTIs（3）;Epidemiology;Etiology（1） ;Etiology（2） ;CASE 1 32 year-old woman; Dysuria and frequency; Pyuria in the urine sediment; Gram negative bacilli. Escherichia coli (E. coli) . ;CASE 3 18 year-old woman Dysuria and frequency; Pyuria; Gram positive cocci; Staphylococcus.;Route of Infection;Pathogenesis;Pathogenesis（1）;Pathogenesis （2）;Conditions affecting pathogenesis;Conditions affecting pathogenesis（1）;Conditions affecting pathogenesis（2）;Conditions affecting pathogenesis（3）;Conditions affecting pathogenesis（4）;Conditions affecting pathogenesis（5）;Conditions affecting pathogenesis（6）;Conditions affecting pathogenesis（7）;Conditions affecting pathogenesis;Pathology;Pathology;Pathology;Pathology;Clinical Presentation;Clinical presentation（1）;Clinical presentation（2）;Clinical presentation（3）;Clinical presentation（4）;How is it diagnosed?;Microscopic Examination;Diagnosis Dipstick Methods;Clean urine culture: bacterial counts > 105 /ml Suprapubic puncture, catheter collected urine > 102/ml Significant bacteriuria Microscopic bacteriuria ;Localization of UTI;Treatments for different types of UTIs;Acute uncomplicated cystitisPathogens;Single-dose therapy is less effective Especially with β-lactams 3-day course recommended TMP-SMX, fluoroquinolone, nitrofurantoin NOT appropriate for male patients and complicated UTIs 7-day course: Diabetes , age > 65 years, Males If untreated: may lead to acute uncomplicated pyelonephritis treatment;Acute uncomplicated pyelonephritisPathogens;Mild or moderate symptoms: Outpatient treatment ( 7–14 days) Oral treatment: Fluoroquinolone, TMP/SMX, third generat