Pathophysiology:
Causative Organism:
Epidemiology:
- More common in females than males. (Female:
anal & vaginal opening are close to urethral
opening)
- Symptomatic infection, most common in
young women after the onset of sexual activity
(20 to 50 years of age)
Risk Factors:
- Obstruction of urinary tube (e.g. kidney stones)
- Female (A woman has a shorter urethra than a
man does, which shortens the distance that
bacteria must travel to reach the bladder.)
- Pregnancy
- Sexual Intercourse
- Bladder catheterization (the longer its used, the
more infection)
- Diabetes Mellitus (Diabetes and other diseases
that impair the immune system the body's
defense against germs can increase the risk of
UTIs.)
- Genitourinary malformation (Babies born with
urinary tract abnormalities that don't allow urine
to leave the body normally or cause urine to
back up in the urethra have an increased risk of
UTIs.)
- Prostatic hypertrophy
- Common organisms: E. coli (85%), Staphylococcus
saprophyticus (5-15%), klebsiella, proteus, pseudomonas (5-
15%)
- Enterobacter, Enterococcus, Candida
Urinary Tract Infection
Treatment:
- Antibiotics (Metronidazole, TMP-SMX, Tetracycline)
- Women who uses oral contraceptive should use barrier
contraceptives (some antibiotics interfere with the effectiveness
of oral contraceptives)
- Surgery: Correct underlying structural abnormalities, relieve
obstruction, drain abscesses.
- Bacterial entry into the urinary tract can
occur through one or more of the following
routes:
Ascending from urethra (mainly from the
GIT; the easiest in treatment)
Mainly for females as the urethra is only
3cm long, so organisms are spread from
perineal skin, particularly during intercourse,
or not washing the perineal are properly.
- Usually the bladder is flushed by urine, but
for some reason there is bladder stasis (e.g.
immobility, dehydration), bacteria can easily
multiply.
Through blood stream
Through lymphatic system
During bladder catheterization
Types of UTI:
UTI can be classified according to the section
of urinary tract affected into:
Lower UTI: Cystitis (bladder) - Urethritis
(urethra) - Epididymitis (epididymis)
Upper UTI: Pyelonephritis (kidney & renal
pelvis), more serious
UTI is also classified into:
Uncomplicated UTI - affects mainly
healthy females of age 15-45 years
Complicated UTI - UTIs that are associated
with metabolic disorders and anatomic or
functional abnormalities that impair
urinary tract drainage.