In the name of God Tara Mottaghi Habibollah Amini Bacterial infections of Urinary tract Mazandaran University of Medical Sciences – Ramsar International Branch

Quick View  UTI Definition Imaging Treatment Recurrent UTI Approach to acute Cystitis  Renal Infections Acute Pyelonephritis Chronic Pyelonephritis Emphysematous Pyelonephritis Xanthogranulomatous Pyelonephritis Renal Abscess  Prostatitis  UTI during pregnancy TI in children

Urinary Tract Infection

Definition Random urine samples Wbc > 10 U/A

Definition Random urine samples Mid stream urine samples + Dysuria & Frequency Wbc > 10 Colony count > 10 ² U/A U/C

Definition Random urine samples Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Wbc > 10 Colony count > 10 ² Colony count > 10 5 U/A U/C

Definition Random urine samples Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Urine samples obtained by catheter Wbc > 10 Colony count > 10 ² Colony count > 10 5 Colony count > 10² U/A U/C

Definition Random urine samples Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Urine samples obtained by catheter Urine samples obtained through suprapubic aspiration Wbc > 10 Colony count > 10 ² Colony count > 10 5 Colony count > 10 ² A number of gram- negative bacteria U/A U/C

Definition Random urine samples Mid stream urine samples + Dysuria & Frequency Mid stream urine samples + Asymptomatic urinary tract Urine samples obtained by catheter Urine samples obtained through suprapubic aspiration Wbc > 10 Colony count > 10 ² Colony count > 10 5 Colony count > 10 ² A number of gram-negative bacteria A few gram-positive bacteria U/A U/C

Imaging KUB IVP Sonography CT Scan

Treatment Treatment for 7 days Simple uncomplicated UTI in women Treatment for 3-5 days Thesigns and symptoms been persist for more than a week Age > 65 yrs History of diabetes Cystitis in pregnant Recent UTI

Recurrent UTI Reinfection Persistant Unresolved Causes Chronic protatitis Urinary fistulas Infectious stones Congenital anomalies of the urinary Chronic pyelonephritis Foreign body Diverticulitis urethra Ureteral stump after nephrectomy Bacterial resistance to antibiotics used The creation of resistant strains during treatment Renal failure Renal abscess Staghorn renal calculi Obstruction in the urinary tract Inadequate dose treatment Inadequate treatment period

Staghorn renal calculi

Approach to acute Cystitis  در افراد دارای Risk factor مانند سنگ،آنومالی و دیابت اول U/C و سپس شروع AB

Approach to recurrent UTI Tab co-trimoxazole, ½, Qhs Tab nitrofurantoin, mg, Qhs Tab nalidixic acid, mg, Qhs Tab cephalexin 250mg, Qhs

Pyelonephritis

Pyelonephritis Acute pyelonephritis Chronic pyelonephritis Emphysematous Pyelonephritis Xanthogranulomatous Pyelonephritis Common sign & symptom : (Except chronic pyelonephritis) Fever Shaking chills Flank pain Nausea & vomiting

Acute pyelonephritis  Signs & symptoms : Fever Shaking chills Flank pain Dysuria Frequency Cloudy urine Vomiting  Laboratory tests results : Pyuria Hematuria high ESR and CRP levels Leukocytosis  The most common cause : Ecoli

Approach to Acute Pyelonephritis

Chronic pyelonephritis