urinary trac infectionby rodman

8/21/2019 Urinary Trac Infectionby Rodman

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URINARY TRACT INFECTION

dr.RODMAN TARIGAN, SpA.,MKes

UTI is the common term for conditions in

which there is growth of bacteria within theurinary tract

Bacteriuria is presence of bacteria in

bladder urine Growth of > 100.000 colony forming units

significant


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AETIOLOGY

Escherichia coli (80-90% acute UTI)

(70-80% recurrent UTI)

Proteus, Staphylococcus epidermidis &

aureus, Enterococcus, Pseudomonas,

Klebsiella.


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CLASSIFICATION

1. Clinical Problem

-Non complicated UTI (Non obstructive)

-Compilcated UTI (Obstructive)

- Abnormality urinary tract

- Abnormality immunology system - Renal impairment


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With or without symptom

- Symptomatic

Frequent syndrome

Acute pyelonephritis

Acute prostatitis

-Asymptomatic


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PATHOGENESIS

1. Ascenderen (95%)

2. Hematogen (3%)

3. Lymphogen


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LABORATORY

PYURIA A. urine sedimen, leucocytes 5/HPF

B. urine leucocytes (non centrifuge) 2. BACTERIA IN URINE (non

centrifuge)2 bact/10 HPF or 5 bact/HPF

3. CHEMICAL TESTa. Nitrite testb. Methylen blue reductase test


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URINE SAMPLE LABORATORY

1. Perineal bag steril

2. Urine mid stream

3. Catheterization

4. Suprapubic aspiration


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INTERPRETATION OF THE RESULT URINE

CULTURE

Sample Colony Culture UTI

Midstream >100.000 1 80%

>100.000 2 96% Catheterization >100.000 1 95%

Supra pubic > 1 bact Gr - 1 99%

> 1000 bact Gr+ 1 99%


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DIAGNOSIS

- SYMPTOMS

- PYURIA

- TRUE BACTERIURIA


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CLINICAL PRESENTATIONS

- The symptoms of children with UTI

depend on the level of the infections as

well as the age of child

- Neonatal : anorexia, lethargy, feeding

difficults, body tenderness, hypothermia

- Infants : non toxic

- Childhood : classical symptoms


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Management of Acute

Symtomatic 1. Eliminate infection

2. Establish clinical and microbiological

survailence to ensure

3. Prevent further infection


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ANTI BACTERIAL

TREATMENT Depend : culture & resistensi test

1. Bactericid & Bacteriostatic

2. No side effect

3.After treatment increase therapeutic level 4. Easy

5. No resistance


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COMPLICATION

- Evaluate ---- Anomaly. VUR

and other obstruction

ren & CRF damage

If +1. Prophylactic antibiotic

a. Complicated UTI, recurrence 3 X or

more in one year ( 1-2 years)


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B. Uncomplicated UTI recurrence 3X or

more in one year (3-6 months)

Drugs : Nitrofurantoin, cotrimoxazol

Radiology : PIV, MSU, USG, Cyntigrahpy,

Cistography, Tomography computer, after4-6 weeks no infections.

Urology intervention

urinary trac infectionby rodman

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