Urinary tract infection
1.What is urinary tract infection
2.Syndrome
3.Diagnosis
4.treatment
The urinary system is made up of two kidneys connected to the urinary bladder by ureter. The urinary bladder is emptied by the urethra. In men, the prostate gland is located around the urethra and next to the bladder.
Urinary infection is classified into two groups:
1.Upper organ infection: that is, in the kidneys
2.Lower organ infection: that is, in the urinary bladder, urethra and prostate.
Simple and complex infection
There is a clear distinction between a simple infection in the urinary tract, that is, inflammation of the lower urinary tract in a non-pregnant woman, and a complex infection (all that remains). Every infection in a man, as well as a kidney infection, is a complex infection. An infection of this type requires specific examinations and intervention by specialists.
The most common infection
Of all human infections, urinary tract infection is the most common and requires antibiotic treatment. The inflammatory rate increases with age, and it is more prevalent among women: between the ages of 16-35 it reaches 20% and at the age of 65 and more it reaches 40%. The incidence of infections in men, up to the age of 35, is less than 1% and increases to 20% and more over the age of 65, as a result of an enlarged prostate.
Urinary tract infection is usually an ascending infection, that is, the bacteria that cause the infection are from the vulva of the woman (anus). The occurrence of infection is related to bacterial violence and type, as well as to factors related to the patient. For example, there is great importance for a complete emptying of the bladder. Because of factors such as an enlarged prostate in a man, or an uterine prolapse in a woman, the emptying is not complete. The infection may stem from a valve defect between the ureters and the urinary bladder, from the presence of stones in the urinary system, or from every birth defect in the urinary system.
Featured cases:
Urethritis - may imitate urinary cystitis symptoms, but the cause may be a bacterium other than the one mentioned above, such as chlamydia. In this case, the treatment is with the tetracycline antibiotic.
Recurrent bladder infection - There is a tendency to recurrent infection in girls with increased sexual activity, or in menopause women. This infection leads to great discomfort. It requires an in-depth examination, consultation of a urologist / infectious disease specialist, and long-term preventive treatment with antibiotics. In a few cases, there may be anatomical disorder or urinary tract.
Bacterial infection in a pregnant woman
A pregnant woman is recommended to have a urine test every third of the pregnancy. Germs are found in 4% to 7% of cases, even without symptoms. The presence of germs in the urine of a pregnant woman requires antibiotic treatment due to fear of infection reaching the kidneys.
Symptoms of urinary tract infection
Symptoms related to urinary tract infection vary according to the source of the inflammation: upper or lower urinary tract. Heartburn, pain when urinating, frequent urgency, usually associated with infection in the lower organ, while fever, chills, nausea and pain in the loin routes are usually associated with kidney infection. Prostate infections may mimic each of the two modes, and urethritis is characterized by burning accompanied by purulent or purulent secretion.
Diagnosing a urinary tract infection
Diagnosis of infection is based on the discovery of white blood cells (leukocytes) and germs in the urine. These days, there are rapid tests to be discovered. Because white blood cells can be found in 95% of cases of urinary tract infection, their presence is considered almost necessary to diagnose the presence of infection, and the standard level for the diagnosis of inflammation is at least 10 white cells in the microscopic field. Among the rapid tests to detect infection in the urinary tract, there is a nitrate test (Nitrate) that enables the identification of a wide variety of bacteria.
Urine culture is of great importance. Which can identify the bacterium and determine its sensitivity to antibiotics. The culture medium is taken from urine in the middle of the stream, and this is of great importance, because the urethral end is contaminated with germs that have nothing to do with infection. The amount of germs greater than 100,000 per cubic poison is a very important inflammation. Urine culture examination should be done close to the time of dispatch to the laboratory.
The most common germs that cause infection
Volatile
Klebsiella
E. coli (E. coli, Klebsiella Proteus)
In patients undergoing hospital treatment or those who have had a catheter in the bladder, the classification of germs is different and fungus can be found. If there is a suspicion of a kidney infection, then there is a need to take a blood culture.
To fully diagnose a urinary tract infection, a more comprehensive examination is required, sometimes with radiological examinations. In simple cases, an ultrasound of the urinary system can be satisfied, but in complex cases - a cystography, a total scanning or computerized tomography (CT) is added.
Urinary tract infection treatment
Urinary tract infection treatment is divided into several stages:
1.Hydration is good, i.e. giving a large amount of fluid.
2.Give narcotic pain relievers (a substance called phenazopyridine).
3.Antibiotic treatment.
The antibiotic is chosen according to several characteristics: the patient's gender and age, the source of infection in the bladder or kidney, the bacterial sensitivity to antibiotics in the region.
For example, medications that were effective in the past against the etiology of urinary infection (Escherichia coli), such as ampicillin, have lost their efficacy as a result of excessive treatment.
According to research done in the last decade, 30-50% of urine germs have developed resistance to these types of antibiotics.
Treatment for lower urinary tract infection includes oral antibiotics. The duration of treatment for this infection takes 3-7 days, depending on the type of medication. For example, treatment with quinolones (such as ofloxacin) lasts only 3 days and its efficacy reaches 95%. While treatment with cephalosporines (such as zinnat) continues for 5 days. A very effective drug for urinary tract infection is nitrofurantoin. Its efficacy reaches 90% and can be taken during pregnancy.
In a prostate infection, especially in a kidney infection that may appear as a systemic infection (sepsis - sepsis), intravenous antibiotics are often needed. Choosing the right medicine is for the hospital doctor. These types of antibiotics are also useful against germs that have developed resistance to drugs outside the hospital.
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