Urinary tract infections in female
Presented by: Aseel kamel shaker
INTRODUCTION:
A urinary tract infection (UTI) is a condition where one or more parts of the urinary system (the kidneys, ureters, bladder, and urethra) become infected. UTIs are the most common of all bacterial infections and can occur at any time in the life of an individual. Almost 95% of cases of UTIs are caused by bacteria that typically multiply at the opening of the urethra and travel up to the bladder. Much less often, bacteria spread to the kidney from the blood stream
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Urine is normally sterile, that is, free of bacteria, viruses, and fungi.
n healthy women, the vagina is colonized by lactobacilli, beneficial microorganisms that maintain a highly
acidic environment (low pH) that is hostile to other bacteria. Lactobacilli also produce hydrogen peroxide,
which helps eliminate bacteria and reduces the ability of Escherichia coli (E. coli) to adhere to vaginal cells. (E. coli is the major bacterial culprit in urinary tract infections.
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UTI is established by counting the bacteria in urine. The bacterial count in excess of 100,000/ml of urine is indicative of UTI. Chronic infection can lead to distortion and scarring of the kidneys
In women, the urethra is short and close to the vagina and rectum, offering little protection against entry of microorganisms into the bladder. The incidence of these infections in the 15- to 24-year-old age group,
suggesting that hormonal and anatomic changes associated with puberty and sexual activity contribute to UTIs.
Women are more prone to urinary tract infections than men, and these infections tend to recur. One reason is that the urethra (the tube that carries urine away from the bladder) is shorter in women than in men.
When women reach menopause, the loss of estrogen thins the lining of the urinary tract, which increases susceptibility to bacterial infections.
Because bacteriuria may occur as an asymptomatic condition in pregnant women, it is recommends that a urine culture be obtained at the first prenatal visit. A repeat culture should be obtained during the third trimester.
Women with bacteriuria should be followed up closely, and infections should be properly treated to prevent complications.
The choice of antimicrobial agent should address the common infecting organisms and should be safe for the woman and fetus
Signs and symptoms
The most common symptoms of a bladder infection are burning with urination (dysuria), frequency of urination, an urge to urinate, significant pain. An upper urinary tract infection may additionally present with fever. Discomfort or pressure in the lower abdomen. The abdomen can feel bloated.
Pain in the pelvic area or back.
The symptoms of urinary tract infections may vary with age and the part of the urinary system that was affected. urinary tract infection symptoms may include diarrhea, loss of appetite, nausea and vomiting, fever, abdominal pain, or incontinence.
Lower urinary tract infections in adults may manifest with symptoms including hematuria (blood in the urine )
Diagnosis:
If a patient is susceptive with UTI then its mid stream urine is collected for urine routine examination.
This sample is now cultured for the causative agent (pathogen) and checked for the sensitivity of different antibiotics.
Causes
Staphylococcus saprophyticus accounts for 5 - 15% of UTIs, mostly in younger women
Klebsiella aerogenes, Alcaligenes feacalis, Enterococci bacteria, Pseudomonas aeruginosa and Proteus mirabilis account for most of remaining bacterial organisms that cause UTIs. They are generally found in UTIs in older women.
Treatment
A variety of antibiotics are available, and choices depend on many factors, including whether the infection is complicated or uncomplicated or primary or recurren
Treatment decisions are also based on the type of patient (man or woman, a pregnant or non-pregnant woman, child, hospitalized or non-hospitalized patient, person with diabetes).