Urinary Tract Infections

Question 1

What are the predisposing factors of UTI?

Answer 1

• Female sex (short urethra, close approximation to anus, wiping from back to front)
• congenital anomalies of urinary tract
• neuropathic bladder with incomplete emptying or detrusor-bladder dyssynergia
• obstructive uropathy
• DM
• voiding dysfx
• constipation
• immunosuppression
• malnutrition
• inadequate/ improper toilet training
• iatrogenic: frequent instrumentation, catheterization

Question 2

What is the etiology of UTIs?

Answer 2

• most commonly by bacterial infections
• commonest: E. Coli
• bacterial: most by gram -ve bacilli that are normal inhabitant of intestinal tract (E. Coli, Proteus mirabilis, Enterobacter agglomerans, Citrbacter freundii, Klebsiella pneumoniae, Pseudomonas)
• viral: Adenovirus may cause cystitis with gross hematuria
• fungal: Candida is most common in immunosuppression

Question 3

What is the classification of UTIs?

Answer 3

1) Depending upon the site of involvement:
a) Upper UTI: pyelonephritis, nephronia (focal pyelonephritis) and renal abscess
b) Lower UTI: cystitis & urethritis

2) depending upon clinical manifestations:
a) asymptomatic bacteriuria (most common, +ve blood culture w/o any manifestations)
b) cystitis (dysuria, urgency, frequency and suprapubic pain)
c)