urinary tract infection (UTI)

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Introduction

An infection in the urinary tract caused by the invasion of pathogenic micro-organisms, which proceed to establish themselves, multiply, & produce various symptoms in their host.

Classification

Etiology

* inadequate data linking multidrug-resistant uropathogenic E coli to beef or other animal sources of food[9]

Epidemiology

  • in neonates the female/male ratio is < 1
  • in children, the female/male ratio is > 1
  • 30% of women will have a UTI by age 24 years[15]
  • in adults, UTIs are largely a disease of sexually-active women
  • the female/male ratio is 2:1 after age 60
  • UTIs are the most common bacterial infection in elderly
    • commonly overdiagnosed in the elderly & treated[14][29]
  • UTIs are a common source of sepsis

Pathology

Clinical manifestations

* children

Diagnostic criteria

Laboratory

* consideration of clinical hydration status, withholding diuretics &/or psychotropics, & a period of observation is recommended prior to urine dipstick testing in institutionalized elderly women with altered perception, disorganized speech, & lethargy[35]

Diagnostic procedures

Radiology

* initial tests in men[6]

Differential diagnosis

Management

acute uncomplicated bacterial lower UTI

complicated bacterial UTI

empiric oral antibiotics

* superior to Bactrim for empiric treatment of urinary tract infection in elderly women[5] & superior to Augmentin in younger women[10]

* serious side effects generally outweigh the benefits[43]

empiric intravenous antibiotics

UTI during pregnancy

UTI during lactation

UTI in elderly

recurrent UTI

patient education

follow-up, prevention

surgical indications

More general terms

More specific terms

Additional terms

References

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