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Urinary Tract Infection PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Urinary tract infection” by Dr. Mai Banakhar.

This medical PowerPoint presentation is about urinary tract infection (UTI), an infection that affects any part of the urinary system, including the kidneys, ureters, bladder, and urethra. It is most commonly caused by bacteria, such as Escherichia coli (E. coli), which normally live in the bowel. UTIs can affect people of all ages, but they are more common in women than men.

Treatment for a UTI usually involves a course of antibiotics to kill the bacteria causing the infection. Drinking plenty of fluids can also help flush out the bacteria from the urinary tract. In some cases, pain relievers may be recommended to relieve discomfort during urination.

If left untreated, a UTI can lead to more serious complications, such as kidney damage or sepsis. It is important to see a healthcare provider if you suspect you have a UTI, especially if you have a fever or other signs of a more severe infection.

Tags : Urinary tract infection, urinary system, kidneys, ureters, bladder, urethra, Nephrology, Nephrology PowerPoint presentation

Published on : Jun 07, 2023 | Views : 878 | Downloads : 1

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Slide 1-

Urinary tract infection Dr. Mai Banakhar
Slide 2-

UTI inflammatory response of urothelium to bacterial invasion.
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Bacteriuria : bacteria in urine Asymptomatic or symptomatic Bacteriuria + pyuria= infection Bacteriuria NO pyuria = colonization
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Pyuria : WBCs in urine. Infection T.B Bladder stone.
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Complicated VS uncomplicated Un complicated UTI: UTI structurally & functionally normal urinary tract. Female. Respond to short course of antibiotic Complicated UTI: Anatomical or funtional abnormality. Male. Longer time to respond to ttt
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Isolated UTI: 6 months between infections.
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Recurrent UTI:>2 infections in 6 months 3 UTI in 12 months. Reinfection by different bacteria. Persistence : same organism from focus within the urinary tract. Struvate stone. Bacterial prostatitis. Fistula Urethral diverticulum. atrophic infected kidney.
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Unresolved infection: in adequate therapy , bacterial resistance to ttt.
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Risk factors to bacteriuria Female Age Low estrogen ( menopause) Pregnancy. D.M Previous UTI. FC Stone GU malignancy. Obstruction. Voiding dysfunction. Institutionalized elderly
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Microbiology Faecal-drived bacteria Uncomplicated UTI E.Coli, G-ve baccillus, (85%- 50%) Staph saprophyticus Enterococ faecalis Proteus Klebsiella. Complicated UTI E.coli 505 Enterococ faecalis. Staph aureus Staph epidermidis Pseudomonas aeruginosa
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Route of infection Ascending Short urethra Reflux Impair urteric peristalisis. Pregnancy Obstruction G-ve , Edotoxins Organism P pili
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Route of infection Haematogenous: Uncommon. Staph aureus. Candida fungemia. T.B Lymphatics: Rarely in inflammatory bowel disease, reteroperitoneal abscess
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Increase UTI risk Increase bacterial virulence Protect against UTI Host defences
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Factors increasing bacterial virulence Adhesion factors Toxins Enzyme production. Avoidance of host defense mechanisms
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Factors increasing bacterial virulence Adhesion factors G-ve bacteria, Pili Attachment to host urothelial cells. Single type or different types e.x E.coli Defined functionally be mediating hemagglutination (HA) of specific erythrocytes Mannose –sensitive (type 1) Produced by all strains E.coli Certain pathogenic types of E.coli mannose resistant pili ( pyelonephritis)
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Factors increasing bacterial virulence Avoidance of host defense mechanisms E.coli Extracellular capsule Immunogenisity phagocytosis M.Tuberculosis reisit phagocytosis by preventing phagolysosome fusion Toxins: E.coli cytokines, pathogenic effect on host tissues Enzyme production: Proteus ureases Ammonia struvite stone formation
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Host defences Protective Mechanical (flushing of urine) antegrade flow of urine Tamm-Horsfall protein (mucopolysaccharide coating bladder prevent bacterial attachment) chemical : Low Urine PH & high osmolality Urinary Immunoglobulin I gA inhibit adherence
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Lower UTI Cystitis: infection& inflammation of the bladder Frequency, samll volumes, dysuria, urgency, offensive urine SP pain, haematuria, fever & incontinence.
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Investigation Dipstick of MSU WBC ( pyuria ) 75 -95% sensitivity infection False –ve False +ve Other causes of pyuria Nitrite testing: Bacteriuria. Specificity >90% Sensitivity 35- 85% + test ------- infection - --------infection
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Investigation Microscopy : Bacteria : False –ve low bacterial count False +ve contamination (lactobacilli & corynebacteria ) epithelial cells RBCs & pyuria
Slide 21-

Investigation Indications for further investigations in LUTI. Symptoms of Upper UTI. Recurrent UTI. Pregnancy Unusal infecting organism ( proteus suggest infection stone) KUB Ultrasound IVU cystoscopy
Slide 22-

DD Non-infective cystitis: radiation cystitis Drud cystitis ( cyclophosphamide ) Haemorrhagic cystitis Urethritis
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Treatment Aim : Eliminate bacterial growth from urine. Empirical ttt before culture & sensitivity for the most likely organism. Adgusted according to the culture & sensitivity. Resistance : Intrinsic (proteus) Genetically transferred between bacteria by R plasmids.
Slide 24-

Recurrent UTI >2 in 6 months or 3 within 12 months Reinfection Bacterial persistence
Slide 25-

Recurrent UTI Reinfection ( different bacteria) After prolonged interval with adifferent organism Reinfection in females No anatomical nor functional pathology In males BOO, urethral stricture Bacterial persistance ( same organism from a focus within tract) within short interval Functional or anatomical problem. The underlying problem should be treated
Slide 26-

Management Reinfection UTI Females KUB, Ultrasound, cystoscopy Simple Reinfection TTT Avoid spermicides Estrogen replacement therapy Low dose antibiotic prophylaxis
Slide 27-

Female recurrent reinfection Prophylactic antibiotic: Reduce infection 90% at bed time 6-12 months Symptomatic reinfection Trimethoprim Nitrofurantoin Cephalexin Fluoroquinolones
Slide 28-

Female recurrent reinfection Natural youghart Post-intercourse antibiotic prophylactic Self-started therapy
Slide 29-

Management of bacteria persistance Investigations: Kub, renal ultrasound. C.T, IVU Cystoscopy Treatment : For the functional or anatomical anomaly
Slide 30-

Antibiotics Empirical therapy. Definitive therapy. Bacterial resistance to drug therapy.
Slide 31-

Acute pyelonephritis Clinical Dx: Flank pain Fever. Elevated WBCs DD: acute cholecystitis. Pancreatitis.
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Acute pyelonephritis Risk factors: VUR UTO Spinal cord injury D.M Malformation pregnancy FC
Slide 33-

Acute pyelonephritis Pathogenisis : Initially patchy Inflammatory bands from renal papilla to cortex. 80% E.coli, others klebsiella, proteus& pseudomonas.
Slide 34-

Acute pyelonephritis Urine analysis & culture. CBC , U&E KUB & ultrasoundif no response with I.V antibiotic for 3 days go for CTU
Slide 35-

Perinephric abscess Pathogenesis. Suspected?? C.T, ultrasound PC drainage . Open surgical
Slide 36-

Pyonephrosis Infected hydronephrosis. Pus accumulation Causes Ultrasound. C.T Management: PCN, I.V antibiotic, I.V fluids.
Slide 37-

Emphysematous pyelonephritis Severe form of acute pyelonephritis Gas forming organism Fever, abdominal pain with radiographic evidence of gas within the kidney. D.M Urinary obstruction. High glucose level-------fermentation,CO2 production
Slide 38-

Emphysematous pyelonephritis Presentation: sever acute pyelonephritis High fever & systemic upset E.coli, commonly, Klebsiella & proteus less frequent
Slide 39-

Management KUB Ultrasound, C.T Patients are unwell Mortality is high
Slide 40-

Management Conservative ? I.V antibiotic , IVF PC drainage Control D.M Sepsis is poorly controlled Nephrectomy
Slide 41-

Xanthogranulomatous pyelonephritis Severe renal infection Renal calculi & obstruction. Result in non-functioning kidney E.coli & proteus common. Macrophage full of fat deposit around the abscess Kidney, perinephric fat
Slide 42-

Xanthogranulomatous pyelonephritis Acute flank pain Fever & tender flank mass C.T , Ultrasound Stone , mass ?? RCC
Slide 43-

Xanthogranulomatous pyelonephritis IV antibiotic , Nephrectomy
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