Urinary tract infections and their importance (original) (raw)
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Urinary Tract Infection (UTI, 2020
A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. Women are at greater risk of developing a UTI than are men. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.
Urinary Tract Infection (UTI) Still a Force to be Reckoned with
Journal of Biomedical Engineering and Medical Imaging
Burning pain ,frequent urge to urinate is the first sign of a UTI. It is due to bacteria in the urethra or bladder. Frequent urination is another red flag for an infection. Urine produces peculiar even foul odor and smoky, cloudy. Urine appears pinkish or reddish due to the presence of blood.Young women are commonly infected.Prostate hypertrophy is linked to male disease. It is affecting almost 4 million people in US alone. The chance of UTI is more in women.In females, it affects the bladder and urethra. Women who use diaphragms, spermicidal agents are more at risk. Menopause women are more vulnerable to infection. Infection of upper urinary tract,consisting of the kidney and pelvis ,is known as pyelonephritis.Infection of the lower tract may involve the bladder (Cystitis),urethra (Urethritis) or prostate (Prostatitis) Intercourse is common association of UTI. Catheters increase the risk.Obstruction of urinary flow increase the risk.Bacterial adherence favors persistence.Fever is usually absent.Enterobacteriaceae and gram positive bacteria appear with complications.Back and perirectal pain are the signs of UTI.Pyuria suggests UTI but not specific.Chronic disease is the source of cystitis.Kidney infection results in permanent kidney damage. Take plenty of water/fluids to flush out bacteria.Wipe front to back. This helps the spread of bacteria from the anus into the bladder. Decreased estrogen levels during menopause cause changes that make the urinary tract more susceptible to bacteria. Most patients with UTI have uncomplicated cystitis, which is one of the most common infections in the United States, especially in sexually active women. Escherichia coli is the most common cause of urinary tract infection. Staphylococcus saprophyticus is a frequent cause of cystitis in women, probably related to its occurrence as a part of normal vaginal flora. Klebsiella, Enterobacter, Proteus, and Serratia are the primary opportunistic and often nosocomial pathogens. Pseudomonas aeruginosa is an opportunistic pathogen and a major cause of hospital-acquired infections.
Epidemiology of urinary tract infections: incidence, morbidity, and economic costs
The American Journal of Medicine, 2002
accounted for nearly 7 million office visits and 1 million emergency department visits, resulting in 100,000 hospitalizations. Nevertheless, it is difficult to accurately assess the incidence of UTIs, because they are not reportable diseases in the United States. This situation is further complicated by the fact that accurate diagnosis depends on both the presence of symptoms and a positive urine culture, although in most outpatient settings this diagnosis is made without the benefit of culture. Women are significantly more likely to experience UT1 than men. Nearly 1 in 3 women will have had at least 1 episode of UT1 requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience 1 UT1 during their lifetime. Specific subpopulations at increased risk of UT1 include infants, pregnant women, the elderly, patients with spinal cord injuries and/or catheters, patients with diabetes or multiple sclerosis, patients with acquired immunodeficiency disease syndrome/human immunodeficiency virus, and patients with underlying urologic abnormalities. Catheter-associated UT1 is the most common nosocomial infection, accounting for >l million cases in hospitals and nursing homes. The risk of UT1
Epidemiology, definition and treatment of complicated urinary tract infections
Nature Reviews Urology, 2020
UTIs are amongst the most frequent bacterial infections in the community, as well as in health-care systems in general, and they are seen in many specialties, such as internal medicine, gynaecology, urology and intensive care medicine 1. The clinical spectrum of UTI ranges from benign to life-threatening infections 2-5. For decades, UTIs have therefore been classified into uncomplicated UTIs and complicated UTIs (cUTIs), with the aim of distinguishing infections with a benign course from those with a higher probability of recurrence or progression to severe infection. However, the classification systems employed by regulatory authorities, scientific societies or guideline groups are not unified and UTI classification is continuously evolving and developing 6. Traditionally, uncomplicated UTIs referred to infections in non-pregnant, healthy women that resolve with antibiotic treatment, whereas all other UTIs were referred to as complicated, including cystitis in men. Some more recent definitions focus more on the relevance of complicating factors to cause a more complicated course of the infection and group healthy postmenopausal women or women with well-controlled diabetes mellitus amongst those with uncomplicated UTI. Infections can occur in any part of the urinary tract, including the urethra (urethritis), the bladder (cystitis), the ureters and the kidneys (pyelonephritis). Without treatment or in cases that are not resolved with antibiotics, in some patients with lower UTIs the infection can ascend and cause pyelonephritis or male genital infections, such as prostatitis or epididymo-orchitis, or can progress to severe, life-threatening urosepsis. Incidence and prevalence rates vary substantially according to the UTI location, the medical specialist dealing with the patient, and patient sex and comorbidities, amongst others. Self-reported incidence rates for cystitis were 12.6% per year for women and 3.0% for men in the USA in the 2000 (ref. 7). In 2000, hospitalization rates for pyelonephritis were 11.7 per 10,000 women and 2.4 per 10,000 men in the USA 8. The Global Prevalence Study on Infections in Urology (GPIU) estimates that 1,866 of 19,756 (9.4%) urological patients hospitalized between 2005 and 2017 developed a cUTI during their hospital stay 9. A wide variety of important medical aspects are intimately linked with UTIs, such as morbidity, mortality, long-term sequelae, antimicrobial administration and antimicrobial resistance, and costs. Morbidity rates for recurrent cystitis were assessed in the GESPRIT study 10 , which reported a mean of
Economic burden of uncomplicated urinary tract infections: direct, indirect and intangible costs
Expert Review of Pharmacoeconomics & Outcomes Research, 2005
A better understanding of how antimicrobial therapies affect the total cost of lower uncomplicated urinary tract infection, including direct (e.g., doctor visits), indirect (e.g., productivity) and intangible (e.g., pain) costs would facilitate selection of an optimal therapeutic approach. The results of this literature review indicate that the there is a considerable societal burden from uncomplicated urinary tract infection, with approximately US$1 billion in indirect and over $600 million in direct costs in 1995. However, no single identified study incorporated all three cost components, there are gaps in the knowledge concerning the current extent of these costs, and there are no comparative assessments based on total cost. Research is needed to provide current insights on the burden of uncomplicated urinary tract infection in terms of direct, indirect and intangible costs.
UTIs in Chronic Health Situations
2019
UTIs are a severe public health problem and are caused by a range of pathogens, but most commonly by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. High recurrence rates and increasing antimicrobial resistance among uropathogens threaten to greatly increase the economic burden of these infections. UTIs typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. If left untreated, a urinary tract infection can have serious consequences. Adult women are 30 times more likely than men to develop a UTI, with almost half of them experiencing at least one episode of UTI during their lifetime. Uncomplicated lower UTI remains one of the most commonly treated infections in primary care. A complicated UTI is an infection associated with a condition, such as a structu...
Primary Care, 2003
Urinary tract infection (UTI) is among the most frequently encountered bacterial infections in the office setting. In addition, UTI is a major cause of hospital admissions, is responsible for significant morbidity and mortality, and has a large associated economic burden, with estimated annual costs in the United States ranging from 1.6to1.6 to 1.6to2.5 billion . The spectrum of severity ranges from asymptomatic bacteriuria to septic shock with multiorgan system failure. Because UTI occurs so frequently and can cause serious sequelae or lead to unnecessary testing and antimicrobial exposure if managed inappropriately, all practicing physicians should be able to diagnose and manage different types of UTI properly. This review addresses the clinical spectrum of UTI; the etiology, microbiology, diagnosis, and treatment of various UTI syndromes; and the areas of uncertainty in the field. Prostatitis, a related topic, is reviewed elsewhere .
Urinary Tract Infection in Adults
Brenner and Rector's The Kidney, 2012
Urinary tract infections (UTIs) are a frequent problem worldwide which are caused by microbial invasion to different tissues of the urinary tract. Urine is normally sterile, that is, free of bacteria, viruses, and fungi. A urinary tract infection is a condition in which one or more parts of the urinary system (the kidneys, ureters, bladder, and urethra) become infected. UTIs are one of the most common bacterial infections in the general population, with an estimated overall incidence rate of 18 per 1000 person per year. It is the most frequent bacterial infection recorded in older people [1]. In addition, UTIs are a major cause of hospital admissions and are associated with significant morbidity and mortality as well as a high economic burden [2]. In a study performed by Sammon et al. 10.8 million patients in the United States visited an Emergency Department (ED) for the treatment of a UTI between 2006 and 2009. The economic burden of utilizing the ED for the treatment of UTIs is estimated to be $2 billion US dollars annually [3]. UTIs can manifest in a wide clinical range from bacteriuria with limited clinical symptoms to sepsis [4].
Contemporary Management of Uncomplicated Urinary Tract Infections
Drugs, 2008
across the entire age spectrum, with mean annual incidences of approximately 15% and 10% in those aged 15-39 and 40-79 years, respectively. By definition, UTIs in males or pregnant females and those associated with risk factors known to increase the risk of infection or treatment failure (e.g. acquisition in a hospital setting, presence of an indwelling urinary catheter, urinary tract instrumentation/ interventions, diabetes mellitus or immunosuppression) are not considered herein. The majority of uUTIs are caused by Escherichia coli (70-95%), with Proteus mirabilis, Klebsiella spp. and Staphylococcus saprophyticus accounting for 1-2%, 1-2% and 5-10% of infections, respectively. If clinical signs and symptoms consistent with uUTI are present (e.g. dysuria, frequency, back pain or 128. O'Connor PJ, Solberg LI, Christianson J, et al. Mechanism of action and impact of a cystitis clinical practice guideline on
Treatment Considerations in Urological Tract Infection (UTI
Asymptomatic bacteriuria or candiduria is not considered as infection and may be considered as colonization [1]. Do not treat asymptomatic bacteriuria or candiduria with antibiotics unless the patient is pregnant or about to undergo invasion urological procedure. In these cases, asymptomatic bacteriuria or candiduria can develop into symptomatic UTI [1]. Symptomatic UTI defined as those with clinical signs and symptoms listed below as well as verified presence of pathogen by culture, microscopy, dipstick or PCR techniques [1]. Severity of UTI and risks factors for complications along with pathogen virulence and antibiotic availability and side effects can guide antibiotic treatment. Severity of the clinical presentation is the foremost consideration in treatment planning. Accompanied risk factors for each patient may modify the severity of each clinical presentation [1]. Severity of UTI ranges from cystitis, pyelonephritis, urosepsis to uroseptic shock [1]. Mild to moderate pyelonephritis can be treated in an outpatient setting with oral antibiotics while more severe infections with systematic symptoms such as nausea and vomiting require parental therapy and hospitalization. The concept pathogen virulence has garnered discussion of its place in clinical practice however its specific application is unclear [1]. Risk factors such as extra-urogenital (eg pregnancy, uncontrolled diabetes or male gender), urogenital (eg ureteral stone obstruction, transient urinary catheter insertion or well-controlled urogenic bladder disturbances), or neuropathic (eg renal disease) increase the patient's chance for more severe outcomes and may require more aggressive antibiotic treatment [1]. Patients with no known risk factors (eg otherwise healthy premanpausal women) and patients at increased chance of recurrent UTIs with no risk of more severe outcomes (eg hormonal deficiency in menopause and well-controlled diabetes mellitus) require less aggress antibiotic treatment [1].