Urinary Tract Infections: Symptoms and Treatment
Urinary tract infection( UTI) is a group of diseases of the organs of urination and urination that develop due to infection of the urinary tract with pathogenic microorganisms.With UTI, a bacteriological study in 1 ml of urine reveals at least one hundred thousand colony-forming microbial units.In women and girls, the disease occurs ten times more often than men and boys.In Russia, UTI is considered the most common infection.Contents: Classification UTI, promotional Factors UTI Pathogens UTI Symptoms of urinary tract infections Diagnosis of urinary tract infections The treatment of urinary tract infections, prevention of urinary tract infections
- In whicheverWhich department of the urinary tract infects infectious agents, the following types of UTI are distinguished:
- upper urinary tract infection is a pilonefrit at which suffer kidney tissue and the renal collecting system;
- Infection of the lower urinary tract is cystitis, urethritis and prostatitis( in men) in which the inflammatory process develops in the bladder, ureters, or prostate gland, respectively.
- Depending on the origin of the infection in the urinary system, several of its types are distinguished:
- uncomplicated and complicated. In the first case there is no violation of outflow of urine, that is, there are no abnormalities in the development of urinary organs, nor functional disorders.In the second case, there are abnormalities of development or impaired functions of the organs;
- hospital and community-acquired. In the first case, the causes of the infection are diagnostic and therapeutic manipulations performed by the patient.In the second case, the inflammatory process is not associated with medical interventions.
- Clinical symptoms are characterized by the following types of disease:
- clinically significant infections;
- is an asymptomatic bacteriuria.
Urinary tract infections in children, pregnant women and men in most cases are complicated and poorly treatable.In these cases, there is always a high risk not only of recurrence of the infection, but also the development of sepsis or kidney abscess.Such patients undergo an extended examination in order to identify and eliminate the complicating factor.
FACTORS AFFECTING THE DEVELOPMENT OF THE IMM:
- Congenital malformations of the genitourinary system;
- functional disorders( vesicoureteral reflux, urinary incontinence, etc.);
- Concomitant diseases and pathological conditions( urolithiasis, diabetes mellitus, renal failure, nephroptosis, multiple sclerosis, kidney cyst, immunodeficiency, spinal cord lesions, etc.);
- Sexual life, gynecological operations;
- advanced age;
- foreign bodies in the urinary tract( drainage, catheter, stent, etc.).
Older people are a separate risk group.Infection of the urogenital tract is facilitated by the inconsistency of the epithelium, weakening of the general and local immunity, reduction of the secretion of mucus by the cells of the mucous membranes, microcirculation disorders.
Urinary tract infections in women develop 30 times more often than men.This is due to some features of the structure and functioning of the female body.A wide and short urethra is located in close proximity to the vagina, which makes it accessible to pathogenic microorganisms in case of inflammation of the vulva or vagina.High risk of urinary tract infection in women with cystocele, diabetes, hormonal and neurological disorders.In the risk group for the development of UTI fall all women during pregnancy, women who started sexually early and have made several abortions.Non-observance of personal hygiene is also a factor contributing to the development of inflammation of the urinary tract.
The frequency of UTI increases with age in women.The disease is diagnosed in 1% of girls of school age, in 20% of women aged 25-30 years.Its peak incidence in women over 60 years.
In the vast majority of cases, urinary tract infections in women recur.If the symptoms of UTI appear again within a month after recovery, this indicates a lack of therapy.If the infection returns after a month after treatment, but no later than six months, it is believed that there was a re-infection.
UTILIZERS OF THE UTIS AND THE WAYS OF THEIR PENETRATION IN THE
ORGANISM The main role of the etiology of all types of UTI is played by E. coli.The causative agents of the disease can be Klebsiella, Proteus, Pseudomonas aeruginosa, Enterococcus, Streptococcus, Candida fungi.Sometimes the infection process causes mycoplasma, chlamydia, staphylococcus, hemophilic rod, corynebacteria.
The etiological structure of UTI is different in women and in men.The first is dominated by E. coli, while in the latter the disease is usually caused by Pseudomonas aeruginosa and Proteus.Hospital UTIs in ambulatory patients are twice as likely to cause E. coli as compared with inpatients.At bacteriological research of urine at patients who are on treatment in a hospital, more often are sown Klebsiella, Pseudomonas aeruginosa, Proteus.
To assess the results of bacteriological examination of urine, doctors use the following quantitative categories:
- up to 1000 CFU( colony forming units) in 1 ml of urine - a natural urine infection when passing through the urethra;
- from 1000 to 100 000 CFU / ml - the result is doubtful, and the study is repeated;
- 100 000 and more CFU / ml is an infectious process.
Routes of penetration of pathogens into the urinary tract:
- is a urethral( upward) pathway when the infection from the urethra and the bladder "rises" along the ureters to the kidneys;
- a downward path, in which pathogenic microorganisms from the kidneys "descend" downwards;
- lymphogenous and hematogenous pathways, when pathogens get into the urinary organs from nearby pelvic organs with a current of lymph and blood;
- through the wall of the bladder from adjacent foci of infection.
SYMPTOMS OF INFECTIONS OF URINARY OUTPUT
In newborns with urinary tract infections, the symptoms of the disease are not specific: vomiting, irritability, fever, poor appetite, low weight gain.When a child has at least one of these symptoms, you should immediately consult a pediatrician.
The clinical picture of a urinary tract infection in preschool age children is most often a dysuric disorder( pain and urination when urinating, frequent urination in small portions), irritability, apathy, sometimes fever.A child may complain of weakness, chills, abdominal pain, and lateral parts.
- In school-age girls with urinary tract infection, the symptoms of the disease in most cases are reduced to dysuric disorders.
- In boys under 10 years, body temperature often rises, and in boys 10-14 years of age, urinary disorders predominate.
Symptomatic of UTI in adults is an increase in frequency and frequency of urination, fever, weakness, chills, pain over the pubis, often radiating to the lateral abdomen and lower back. Women often complain of vaginal discharge, men - on discharge from the urethra.
The clinical picture of pyelonephritis is characterized by pronounced symptoms: high body temperature, abdominal pain and in the lumbar region, weakness and fatigue, dysuric disorders.Recommended to read:
DIAGNOSTICS OF INFECTIONS OF URINE WAYS
For the diagnosis, the doctor finds out the patient's complaints, asks him about the onset of the disease, about the presence of concomitant pathology.Then the doctor conducts a general examination of the patient and gives directions for examinations.
The main biological material for research with suspected UTI is urine collected in the middle of urination after careful perineum toilet and external genitalia.For bacteriological inoculation, urine should be collected in sterile dishes.In the laboratory, clinical and biochemical analyzes of urine are carried out, and material is sown to nutrient media to identify the causative agent of the infectious process.
Important: the urine prepared for analysis needs to be quickly delivered to the laboratory, as the number of bacteria in it doubles every hour.
If necessary, the doctor appoints ultrasound of the urogenital tract, X-ray, CT, MRI, etc. And then, based on the results obtained, confirms whether or not the UTI is diagnosed, differentiating the level of the lesion and indicating the presence or absence of factors complicating the course of the disease.
TREATMENT OF INFECTIONS OF URINARY TRACT
A patient with a diagnosis of a urinary tract infection can receive treatment both in an outpatient setting and in a hospital.Everything depends on the form and severity of the course of the disease, on the presence of complicating factors.
Important : The treatment of any infectious process in urinary organs should be handled by a physician: therapist, pediatrician, nephrologist or urologist.Self-treatment threatens the development of complications and relapses of the disease.
For urinary tract infections, treatment starts with routine interventions.These include limiting physical exertion, frequent and regular( every two hours) urination, abundant drinking to increase the amount of excreted urine.In severe cases, patients are assigned bed rest.
From the diet should be excluded smoked meat and marinades, more you need to eat products that contain ascorbic acid.This is necessary for acidification of urine.
Antibiotics or sulfonamides are mandatory for medicinal products, to which the pathogen of infection is identified.Treatment of concomitant diseases is being carried out.
With a pronounced clinical picture of UTI, antispasmodics, antipyretic drugs, antihistamines and pain medications are used.A good effect is provided by phytotherapy and physiotherapy.According to the indications, a local anti-inflammatory treatment is performed - installations through the urethra in the bladder of medicinal solutions.
Prevention of urinary tract infections
Prevention of UTI is as follows:
- timely detection and elimination of factors contributing to the development of infection in the urinary tract( anatomical abnormalities, inflammatory processes in the body, hormonal disorders, etc.);
- maintaining a healthy lifestyle and respecting personal hygiene;
- treatment of existing diseases;
- for women - registration with a doctor for pregnancy at its earliest.
Zaluzhanskaya Elena Aleksandrovna, medical reviewer