1. 8/14/2015

2.  Urinary tract infections (UTIs) are caused by pathogenic microorganisms in the urinary tract (the normal urinary tract is sterile above the urethra).  UTIs are generally classified as infections involving  the upper or lower urinary tract 8/14/2015

4.  Lower UTIs include bacterial cystitis (inflammation of the urinary bladder), bacterial prostatitis (inflammation of the prostate gland), and bacterial urethritis (inflammation of the urethra).  Upper UTIs are much less common and include acute or chronic pyelonephritis (inflammation of the renal pelvis), interstitial nephritis (inflammation of the kidney), and renal abscesses. 8/14/2015

5.  For infection to occur, bacteria must gain access to the bladder, attach to and colonize the epithelium of the urinary tract to avoid being washed out with voiding, evade host defense mechanisms, and initiate inflammation. Most UTIs result from fecal organisms that ascend from the perineum to the urethra and the bladder and then adhere to the mucosal surfaces. 8/14/2015

6.  Ascending infection  E.Coli ---> 86%  In men, obstructive abnormalitites  UTI ---> sepsis and nosocmila infections  Upper UTI ---> recurrent bladder infection 8/14/2015

7.  Dysuria, frequency, urgency, nocturia  Suprapubic pain or discomofort  Microscopic or gross hematuria 8/14/2015

8.  Urine microscopy  Urine culture  Patients with indwelling catheter---> asypmtomatic 8/14/2015

9.  Antibiotic therapy( follow up culture) 3-7-10 8/14/2015

10.  Pyelonephritis  hematogeneuos spread leading to sepsis 8/14/2015

11.  History of recurrent UTI?  Voiding habits?  Suprapubic pain or tenderness? 8/14/2015

12.  Acute pain R/T inflammation of the bladder mucosa  Deficient knowledge R/T prevention of recurrent UTI 8/14/2015