Diagnosis, Treatment, and Prevention of Urinary Tract Infection

Abstract

UTI may involve the lower or upper urinary tract and may be uncomplicated or complicated. The emphasis of this chapter is uncomplicated UTI. The diagnosis of uncomplicated cystitis (bladder infection) and pyelonephritis (kidney infection) is usually easily made based on the clinical presentation, whereas the diagnosis in patients with complicated UTI is often more complex. Thus uncomplicated cystitis is usually manifested by dysuria, frequency and/or urgency without fever, and pyelonephritis is usually manifested by fever and back pain/costovertebral angle tenderness. However, pyuria is usually present with UTI, regardless of location, and its absence suggests that another condition may be causing the patient's symptoms. Treatment of cystitis is usually straightforward with one of several effective short-course antimicrobial regimens, although antimicrobial resistance continues to increase and can complicate treatment choices in certain areas. Likewise, antimicrobial resistance has complicated our management of uncomplicated pyelonephritis since resistance of uropathogens to the fluoroquinolone class, the mainstay of oral treatment for pyelonephritis, is increasing worldwide, and some of the other agents used for cystitis are not recommended for pyelonephritis due to low tissue levels. The goal of prevention of recurrent cystitis is to minimize the use of antimicrobials and there are several research efforts in progress to develop effective and safe antimicrobial-sparing preventive approaches for this common condition.

Features of urinary Escherichia coli isolated from children with complicated and uncomplicated urinary tract infections in Mexico

“…UTIs are clinically classified as either uncomplicated or complicated. Uncomplicated UTIs (uUTIs) affect healthy individuals without structural or neurological abnormalities in the urinary tract; uUTIs are commonly known as cystitis (lower urinary tract) or pyelonephritis (upper urinary tract) and are mainly acquired in the community [ 2 ]. Complicated UTIs (cUTIs) have been associated with factors related to urinary tract dysfunction (urinary obstruction, urinary retention, and renal failure), host defense (immunosuppression, renal transplantation and pregnancy), and foreign bodies (calculi and catheters or other drainage devices) [ 3 – 6 ].…”

Role of semiology in cystitis and acute pyelonephritis: analysis in Internal Medicine patients of the Hospital de Clínicas, Paraguay

“…En segundo lugar destaca la polaquiria (46%), tenesmo (26%) y urgencia miccional (13%). Estos hallazgos están (22) referidos con detalles en una publicación de Pietrucha y Hooton .…”

Treatment of urinary tract infections in condition of growing antibiotic resistance: Antimicrobial Stewardship program

“…Інфекції сечової системи (ІСС) займають провідні позиції структурі інфекційних захворювань, поступаючись лише респіраторним інфекціям. Щорічно в світі реєструється близько 150 мільйонів випадків ІСС, на лікування яких витрачається приблизно 6 мільярдів доларів на рік [1,2,3,4]. В Україні розповсюдженість ІСС складає близько 40%, серед яких домінуючою ІСС є пієлонефрит (ПН).…”

“…• Зміну способу життя та запобігання факторам ризику (1) • Не антимікробні заходи (2) • Антимікробна профілактика (3) (1) Запобігання факторам ризику (представлені в таблиці 3), коли це можливо. Урологічні фактори ризику повинні бути розглянуті й усунені, наскільки це можливо.…”