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Urinary Tract Infections

Published on Nov 23, 2015

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PRESENTATION OUTLINE

URINARY TRACT INFECTIONS

A BRIEF OVERVIEW

INCIDENCE

  • The second most common infection
  • 10% of women have one each year
  • Under 60's: more common in women
  • Over 60's: more common in men

VARIANTS AND BASIC SYMPTOMS

  • Cystitis affects the urethra and bladder
  • Pyelonephritis affects the kidneys
  • Dysuria: Painful urination
  • Hematuria: Blood in the urine

SYMPTOMS

  • Cystitis: Dysuria, Frequency, Urgency and Hematuria
  • Pyelonephritis: Sudden severe loin pain, pyrexia, rigor, nausea and vomiting
  • Confusion, although this is caused by the bodys reaction to infection due to
  • An increase in temperature, inflammation and dehydration

MEDICAL MANAGMENT

  • MSU (midstream specimen of urine)
  • Urinalysis
  • FBC, U+E's
  • Antibiotic

PATHOPHYSIOLOGY

  • Visico-ureteric reflux
  • Obstruction
  • Fistulae
  • Sexual trauma
  • Iatrogenic factors

PREGNANCY

  • Hydroureter: Distension of the ureter with urine
  • Hydronephrosis: Distension of the kidney pelvis
  • Caused by relaxation of muscles due to high progesterone levels
  • Also caused by obstruction of the ureters by the uterus
  • 40-50% UTI's in pregnancy develop into pylonephritis

RISK FACTORS

  • Female (under 60) male (over 60)
  • Pregnancy
  • Catheter, especially long term
  • Sexually active (in women)
  • Diabetes

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TREATMENT FOR CYSTITIS

  • Nitrofurantoin
  • Trimethoprim
  • Both shown to be equally as effective
  • Trimethoprim resistance is said to be 20-30%

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QUICK FACTS

  • Cranberry has yet to be proven as an effective treatment
  • Women with uncomplicated will be prescribed antibiotics regardless of urinalysis results
  • It is therefore not necessary for GP's to perform a urinalysis