Description, causative agent, s/s, transmission, diagnosis, treatment & prevention

URINARY SYSTEM

BACTERIAL Diseases

1. Cystitis
o Common inflammation of the urinary bladder in females
o Can be caused by Escherichia coli and the
coagulase-negative Staphylococcus saprophyticus
o Symptoms often include dysuria (difficult, painful, urgent urination) and pyuria.
o The female urethra is less than 2 inches long, and microorganisms traverse it readily. It’s also closer than
the male urethra to the anal opening and its contaminating intestinal bacteria.
o A urine sample with more than 100 colony forming units (CFU) per milliliter of potential pathogens (such
as coliforms) from a female patient with cystitis is considered significant.
o The diagnosis should also include a positive urine test for leukocyte esterase (LE)
o an enzyme produced by neutrophils
o indicates an active infection.

o Trimethoprimsulfamethoxazole
o usually clears cases of cystitis quickly.
o Fluoroquinolone antibiotics or ampicillin
o often successful if drug resistance is encountered.

2. Pyelonephritis
o Inflammation of one or both kidneys.
o The causative agent in about 75% of the cases is E. coli
o Symptoms are fever and flank or back pain.
o In females, it’s often a complication of lower urinary tract infections.
o A urine sample of more than 10,000 CFUs/ml and a positive LE test indicate pyelonephritis.
o Treatment usually begins with intravenous, extended term administration of a

broad-spectrum antibiotic, such as a second- or third-generation cephalosporin.

3. Leptospirosis
o Primarily a disease of domestic or wild animals, but it can be passed to humans and sometimes causes
severe kidney or liver disease.
o The causative agent is the spirochete Leptospira interrogans
o Has the following characteristics:
 an exceedingly fine spiral
 about 0.1 μm in diameter
 wound so tightly that it is barely discernible under a darkfield microscope
 Obligate aerobe that can be grown in a variety of artificial media supplemented with
rabbit serum.
o After an incubation period of 1 to 2 weeks, headaches, muscular aches, chills, and fever abruptly appear.
o Several days later, the acute symptoms disappear, and the temperature returns to normal.
 o A few days later, a second episode of fever may occur.
o It’s uncertain how the pathogens enter host cells, but they use this as a mechanism to
spread to target organs and evade the immune system.
o Serological test is usually done to test whether the person has leptospirosis or by sampling
blood, urine, or other fluids for the organism or its DNA.
o Doxycyline (a tetracycline) is the recommended antibiotic for treatment

SUMMARY OF BACTERIAL DISEASES IN THE URINARY SYSTEM