内科学教学课件：英文班尿路感染.pptVIP

Urinary Tract Infection Definition UTI is the urinary infective disease which is causing by many different microorganisms growing and breeding in urinary tract often occur in old man ,worst immune, urinary deformity and woman in child-bearing period Classification 1 Infection of the urinary tract can be subdivided into two general anatomic categories: lower tract infection (cystitis) and upper tract infection (pyelonephritis). 2 Acute or chronic UTI 3 complicated infection or not- complicated infection complicated UTI is the UTI with abnormality of the structure and function, such as impeded urinary drainage, stone, urinary deformity, tubal bladder backflow, and occurred on the basis of chronic renal parenchyma diseases . Etiology The most common agents are the gram-negative bacilli. Escherichia coli cause 70% of acute infection in patients without catheters, urologic abnormalities, or calculi. P. Aeruginosa infect after instrument examination. Klebsiella and proteus happen in urolithiasis. Coagulase-negative Staphylococcus occur among the woman with active sexual life. Mechanism Sources of infection 1)Ascending infection. Enteric gram-negative organisms residing in the bowel colonize the bladder, the ureter, the urethral skin, and distal urethra. 2) Hematogenous infection, occur in serious urinary obstruction or worst immune. Blood poisoning of S.Aureus 3) Direct infection 4) Lympy infection Human resistance bacteria placed are rapidly cleared, the antibacterial properties of urine and the bladder mucosa , high urea concentration and high osmolarity . Precipitating factors 1)Impeded urinary drainage : urine-tumor, stricture, stone, or prostatic hypertrophy-result 2) tubal bladder backflow 3)Bad immune 4) neurogenic bladder 5）pregnancy 6)gender and sex activity 7)Use instruments 8)structural abnomalities 9)Genetic factors Bacterial pathogenicity  细菌特殊菌毛对尿路上皮的吸附能力 Clinical presentation Clinical Manifestation 1: Cystitis: