Pathogens

 • Escherichia coli is the main organism.

• Staphylococcus saprophyticus and Proteus mirabilis are other causes.

 Epidemiology

 • extremely common. • ~60% of women will have a UTI at some point in their life.

Transmission

 • ascending spread of endogenous gut bacteria into the urethra.

 • The shorter urethra of women and its closer proximity to the anus are thought to be the main reason why females are more susceptible.

 Risk factors

 • Female gender, sexual intercourse, pregnancy, diabetes, catheterization, urinary tract obstruction, or malformation.

Pathogenesis

 • Pathogenic strains of E. coli have pili which allow them to bind to galactose- containing receptors on the surface of urothelial cells.

• Other important virulence factors include haemolysin which allows invasion of tissues and the K antigen which protects the organism from neutrophil phagocytosis.

Presentation

• Bladder infection (cystitis) causes frequency, urgency, dysuria, haematuria, and suprapubic pain.

 • ascending spread into the kidneys (acute pyelonephritis) causes a more severe illness with fever, rigors, vomiting, and loin pain.

 * May present with acute confusion in the elderly.

Diagnosis

• Urinalysis showing leucocytes or nitrites is a useful quick screening test.

• The gold standard is microbiological culture of a correctly collected midstream urine specimen. a pure growth of >105 organisms/ ml of urine is considered diagnostic.

مواضيع ذات صلة

Genitourinary malformations

Diabetic Foot Ulcers

Kidney transplantation

C3 glomerulopathy

Membranous glomerulonephritis

Focal segmental glomerulosclerosis

Diabetic nephropathy

Hypertensive nephropathy

Reflux nephropathy

Acute tubulointerstitial nephritis

Acute tubular injury

فرط نشاط جارات الدرق البدئي (PHPT) Primary hyperparathyroidism