URINARY TRACT INFECTION

UTI is the common term for conditions in

which there is growth of bacteria within the
urinary tract
Bacteriuria is presence of bacteria in
bladder urine
Growth of > 100.000 colony forming units
significant
 AETIOLOGY
Escherichia coli (80-90% acute UTI)
(70-80% recurrent UTI)
Proteus, Staphylococcus epidermidis &
aureus, Enterococcus, Pseudomonas,
Klebsiella.
 CLASSIFICATION
1. Clinical Problem
-Non complicated UTI (Non obstructive)
-Compilcated UTI (Obstructive)
- Abnormality urinary tract
- Abnormality immunology system
- Renal impairment
 With or without symptom
- Symptomatic
Frequent syndrome
Acute pyelonephritis
Acute prostatitis
-Asymptomatic
 PATHOGENESIS
1. Ascenderen (95%)
2. Hematogen (3%)
3. Lymphogen
 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 TEST
a. Nitrite test
b. Methylen blue reductase test
 URINE SAMPLE LABORATORY

1. Perineal bag steril

2. Urine mid stream

3. Catheterization

4. Suprapubic aspiration
 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%
 DIAGNOSIS
- SYMPTOMS

- PYURIA

- TRUE BACTERIURIA
 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
 Management of Acute
Symtomatic
1. Eliminate infection
2. Establish clinical and microbiological
survailence to ensure
3. Prevent further infection
 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
 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)
 B. Uncomplicated UTI recurrence 3X or
more in one year (3-6 months)

Drugs : Nitrofurantoin, cotrimoxazol

Radiology : PIV, MSU, USG, Cyntigrahpy,
Cistography, Tomography computer, after 4-
6 weeks no infections.
Urology intervention