Urinary Tract Infection Compiled

1.   Ask #TeamGenesis  
By: Muhammad Halmii
FB: Muhammad Helmi
WhatsApp:0163626470
Twitter:@ChaldeaPrince

2. HYDRONEPHROSIS 101

3. PATHOLOGY OF UTI
By: Muhammad Halmii
FB: Muhammad Helmi
WhatsApp:0163626470
Twitter:@ChaldeaPrince

4. • DEFINE
• CAUSE (Etiology)
• RISK FACTORS
• DIAGNOSIS
• TYPES
• PATHOGENESIS
• EFFECT
• CLINICAL MENIFESTATIONS (SIGNS & SYMPTOMS)

6. DEFINE
Infection of the urinary tract by :
Bacteria
Parasite
Fungus
Virus
Bacteriuria: the presence of bacteria in the urine
Significant bacteriuria: 105 organism or more per milliliter
Pyuria: the presence of white blood cells in urine
Pyuria with 5 or more cells per microscopic high-power field: reliable indicator of UTI The absence of such pyuria
does not reliably exclude UTI

7. The Culprit
 Community-Acquired
 E. Coli—85%
 Proteus
 Klebsiella
 E. faecalis
 Staph. Saprophyticus (10% of young sexually active females)
 Enterococcus Proteus
 K.pneumoniae
 Nosocomial
 E. Coli—50%
 Klebsiella
 Enterobacter
 Citrobacter
 Serratia
 Pseudomonas
 S. epidermitis

9. Shistosoma
Blastomycves
Hemophilus

10. Male Risk Factors Female Risk Factors
Urinary Tract Obstruction {Stasis}
Instrumentation (Catheter, Surgery, Tampon, Birth Control Stuffs)
Congenital Anomaly / Genetics
Neurogenic Bladder
(Neurogenic bladder is a problem in which a person lacks bladder control due to a brain, spinal cord, or nerve
condition.)
{Stasis Of Urine}
Sexual Relationship
Not Circumcised Oestrogen Deficiency
Pregnancy
Short Urethra

12. Low Vaginal pH Flushing Mechanism Tamm-Horsefall Protein Antibody & WBC’s

15. UTI VIRULENCE FACTORS
1. fimbriae
(Acts as adhesion)
2. resistance to serum bactericidal activity ; increased amounts of capsular K antigen activity
(The presence of K antigens is associated with upper urinary tract
infections, and antibody to the K antigen has been shown to afford some degree of protection in experimental
infections. The K antigens of E. coli are "capsular" antigens that may be composed of proteinaceous organelles
associated with colonization (e.g., CFA antigens), or made of polysaccharides. Regardless of their
chemistry, these capsules may be able to promote bacterial virulence by decreasing the ability of antibodies and/or
complement to bind to the bacteria surface, and the ability of phagocytes to recognize and engulf the bacterial cells. )
3. toxin production
(Cellular Damage)
4. production of urease enzyme (Proteus sp) {Metabolizes urea}

16. PATHOGENESIS
• Bacterial adherence
The process of bacterial cell adhesion is the key to urinary tract infection
Bacterial adhesions produced by pili on the bacterial surface are important in
pathogenesis, (for example, the P fimbriae possessed by E coli).
Adhesions of bacteria to epithelium is followed by proliferation, invasion, and
initiation of the inflammatory process.

17. Might not invoke
pyrogenic activity
(Might not be true for
Upper UTI)
Primary &
Secondary can also
be used to classify
UTI
Uncomplicated:
Healthy patient
with normal
urinary tract.
Complicated:
compromised
patient or one
with a functional
or structural
abnormality.

19. CLINICAL MANIFESTATION
• Cystitis (Bladder)
• Dysuria,
• urinary frequency, urgency
• Also nocturia, hesitancy,
• suprapubic discomfort,
• gross hematuria may be present.
• Unilateral flank or back pain indicates upper urinary tract involvement
• Fever indicates involvement of kidney / prostate.
• Pyelonephritis (Kidney)
• High rise, spiking fever with rigor {A sudden feeling of cold with shivering accompanied by a rise in temperature, often
with copious sweating, especially at the onset or height of a fever.},
• nausea, vomiting,
• flank and/or loin pain [Low grade fever in mild cases ]
• Rapid rise in creatinine may indicate papillary necrosis.
• Intraparenchymal abscess to be suspected when patient has continued fever and/or bacteremia despite antibacterial
therapy

20. CLINICAL MANIFESTATION
• Urethritis (Urethra)
• painful urination and burning
• Cloudiness in urine
• Blood in urine
• Micro organism counts: +
• Prostatitis (Prostate)
• generalized malaise and fever.
• pain in the perineum and suprapubic areas with frequency and urgency of micturition.
• Direct Examination shows tender prostate