PATHOPHYSIOLOGY AND ETIOLOGY

Urinary tract infections (UTIs) are the inflammation of

the urinary epithelium that is usually caused by the bacteria flora in the gut
Can occur at any part along the path of the urinary tract
Occurs when the pathogen bypasses or overcomes the
defense mechanisms of the host, there is extensive reproduction
Two factors that play a role in determining the presence
of a UTI are defense mechanisms of the body and virulence of the pathogen
In a healthy person, the defense mechanisms of
the body prevent bacteria from entering the
urethra and bladder, keeping it sterile
Virulence is how well a pathogen is able to
invade the defense mechanisms of the host,
causing illness and disease
Cystitis is the inflammation of the lower tract, including
the bladder and urethra
Acute cystitis is the most common UTI and is
an inflammation of the bladder
Pyelonephritis is the inflammation of the upper urinary
tract, including the ureter, renal pelvis and interstitium
Most common forms are E. coli, Proteus or
Pseudomonas
Often occurs from a lower UTI
Chronic pyelonephritis is an infection of the
kidney that is recurrent and causes kidney scarring

Uncomplicated UTI occurs in a normally functioning

urinary system
Complicated UTI occurs in a dysfunctional urinary system or compromised individuals
RISK FACTORS
Factors increasing urinary stasis (tumour, stones, fibrosis, urinary retention)
Foreign bodies (in-dwelling catheter)
Anatomical factors (congenital defects, fistula, female
anatomyshorter urethra)
Sexual activity, pregnancy, diaphragm and spermicide
use, and pelvic organ prolapsed
Factors compromising immune response (HIV, Diabetes
Mellitus)
Functional disorders (constipation, voiding dysfunction
with sphincter dysnergia)

MANIFESTATIONS
Lower UTIs (cystitis): dysuria, nausea, vomiting, fever,
chills, discomfort, urgency and frequency to void, abdominal distension, hematuria, cloudy and concentrated
urine, foul odour to urine, and incomplete emptying of
bladder
Upper UTIs (pyelonephritis): can exhibit the same signs
and symptoms as cystitis in addition to flank and lower
back pain as the infection has now spread to the kidneys
MANAGEMENT
Pharmacological Treatment: Cystitis
Nitrofurantoin Monohydrate/Macrocrystals
Trimethoprim (TMP)- Sulfamethoxazole
(SMZ)
Fosfomycin Tromethamine
Methenamine Hippurate
Doripenem

Pharmacological treatment: Pyelonephritis

Levofloxacin
Doripenem
Methenamine Hippurate

Pharmacological treatment: Pain

Phenazopuridine Hydrochloride

Non-pharmacological treatment
Increase fluid intake to increase urine output

For more information, please refer to our website: http://urinarytractinfection1.weebly.com/

References for this one page summary are listed on the reference page of the above website.