Evidence Based Management of Urinary Tract Infections
|
|
- Joel Ellis
- 5 years ago
- Views:
Transcription
1 Evidence Based Management of Urinary Tract Infections Urinary tract infection (UTI) is the most common bacterial infection in humans. They account for more than 8.6 million physician visits (84% by women) and over 1 million hospital admissions in the United States each year. It remains one of the most common indications for prescribing antimicrobials to otherwise healthy women, 1 and up to 60% of women have at least one symptomatic UTI during their lifetime. Young, sexually active women aged between years have the highest incidence of UTIs. About 25% of these women have spontaneous resolution of symptoms, and an equal number become infected. The prevalence of UTI in men is significantly lower than in women, occurring primarily in men with urologic structural abnormalities. 2 Pathogenesis In healthy woman, bacterial urinary infections usually spread to the urinary tract through an ascending route of fecal flora, from the fecal reservoir through the urethra into the bladder. Also, colonization of the mucosa of the vaginal introitus is an essential step in the pathogenesis of UTI. Once the introitus is colonized, sexual intercourse or urethral manipulation can force bacteria into the female bladder. 1 In pregnant woman, increased bladder volume and decreased bladder tone, contribute to increased urinary stasis and ureterovesical reflux. Additionally, up to 70 percent of pregnant women develop glycosuria, which encourages bacterial growth in the urine. Also increases in urinary progestins and estrogens may lead to a decreased ability of the lower urinary tract to resist invading bacteria. All these factors may contribute to the development of UTIs during pregnancy. 9 In patients with indwelling catheters, bacteria may enter the bladder through contamination of the tip during insertion with the flora of the distal urethra or from bacteria ascending outside or inside of the catheter. 10 Another possible route to the development of UTI is hematogenous dissemination secondary to organisms in the bloodstream (specifically pyelonephritis). Direct extension from adjacent organs via the lymphatic system, as in the case of retroperitoneal abscesses or severe bowel obstruction, has been proposed as another mechanism for UTI pathogenesis. 1 Urinary Pathogens Escherichia coli is the most common infecting organism in patients with UTI. It causes around 85% of medical newsletter I as a service to the medical profession I 09
2 Table 2.1 : Clinical Presentation of Cystitis, Pyelonephritis, and Urosepsis and Grading of Severity 11 Acronym Clinical diagnosis Clinical symptoms Grade of severity CY-1 Cystitis Dysuria, frequency, urgency and suprapubic pain 1 PN-2 Mild and moderate pyelonephritis Fever, flank pain, Costovertebral-angle tenderness with or without symptoms of CY 2 PN-3 Severe pyelonephritis As PN-2, but in addition, nausea and vomiting with or without symptoms of CY 3 US-4 Urosepsis (simple) Temperature >38 0 C or <36 0 C; heart rate >90 beats/min; respiratory rate >20 breaths/min or PaCO 2 <32mm Hg (<4.3kPa); WBC> cells/mm 3 or <4000 cells/mm 3 or 10% immature (band) forms; with or without symptoms of CY or PN 4 US-5 Severe urosepsis As US-4, but in addition, associated with organ dysfunction, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities may include but are not limited to lactic acidosis, oliguria, or an acute alteration of mental status. 5 US-6 Uroseptic shock As US-4 or US-5, but in addition, with hypotension despite adequate fluid resuscitation along with the presence of perfusion abnormalities that may include but are not limited to lactic acidosis, oliguria, or an acute alteration in mental status. Patients who are on inotropic or vasopressor agents may not be hypotensive at the time that perfusion abnormalities are measured. 6 CY = cystitis; PN = pyelonephritis; US = urosepsis; WBC = white blood cells. Adapted with permission from the European Association of Urology community-acquired infections and approximately 50% of nosocomial infections. In Bangladesh the major pathogens causing UTI are E.coli, Pseudomonas spp, Proteus spp, Klebsiella spp. etc. Recently one study in Bangladesh showed that women are the usual victims of the urinary pathogens and E.coli is the predominant causative organism which accounts for around 66% followed by Proteus spp (11%), Klebsiella spp (5%) and Pseudomonas spp (4%). 8 The vast majority of recurrent episodes of cystitis in women are thought to be reinfections. Two-thirds of such episodes involve the same strain of bacteria as uropathogenic strains can persist in the fecal flora for years after elimination from the urinary tract. 1 Classification of UTI based on Clinical Features In 2010 The European Section of Infection in Urology (ESIU) in collaboration with the International Consultation on Urological Diseases (ICUD) launched an initiative to improve the diagnostics and management of urologic diseases worldwide. As part of this initiative, a new classification of UTI based on clinical presentation was introduced. Symptomatic UTIs are classified as cystitis, pyelonephritis, and urosepsis, with urethritis and male accessory gland infections (prostatitis) considered separately, given the great diversity of clinical presentations. A severity scale was suggested considering that the urosepsis syndrome is the most severe form, and pyelonephritis is more severe than cystitis. The relevant clinical presentations when a UTI is suspected were grouped into five main categories (Table 2.1). 11 Diagnosis Urinary tract infection is assessed by urinalysis or microscopic examination of urine. It is most commonly done in laboratories in primary care for the diagnosis of UTI. Assessment for pyuria and bacteriuria is also performed with the use of commercially available dipsticks. However, results of the dipstick test provide little useful information when the history is strongly suggestive of urinary tract infection. A urine culture is performed to confirm the presence of bacteriuria and the antimicrobial susceptibility of the infecting uropathogen. This test is indicated in all women with suspected pyelonephritis but is not necessary for the diagnosis of cystitis, given the reliability of the patient s history in establishing the diagnosis and the delayed availability of culture results. 3 Management Urinary tract infections is a benign condition, with early resolution of symptoms observed in 25 to 42% of women 10 I medical newsletter I as a service to the medical profession
3 Patient Population Premenopausal women of any age Table 2.2 : Predisposing Risk Factors for UTI 2 Risk Factors Diabetes Diaphragm use, especially those with spermicide History of UTI or UTI during childhood Mother or female relatives with history of UTIs Sexual intercourse Postmenopausal and older adult women Men and women with structural abnormalities Estrogen deficiency Functional or mental impairment History of UTI before menopause Urinary catheterization Urinary incontinence Extrarenal obstruction associated with congenital anomalies of the ureter or urethra, calculi, extrinsic ureteral compression, or benign prostate hypertrophy Intrarenal obstruction associated with nephrocalcinosis, uric acid nephropathy, polycystic kidney disease, hypokalemic or analgesic nephropathy, renal lesions from sickle cell disease with only rare cases of progression to pyelonephritis. However, it is associated with considerable morbidity and antimicrobial drugs are routinely prescribed, the primary goal being the rapid resolution of symptoms. The choice of regimen has become more complicated as antimicrobial resistance among the uropathogenic strains of E. coli has increased worldwide. A study that was conducted in a private medical college of Dhaka in the year 2015 investigated in vitro susceptibility of E. coli strains that cause urinary tract infection and revealed rates of resistance to cefuroxime 82%, azithromycin 56%, cefixime 47%, cotrimoxazole 43%, ceftriaxone 41%, ciprofloxacin 38%, amoxicillin-clavulanic acid 31%, cefepime 30%, and low resistance which ranges from 9 to 1% included gentamycin 9%, meropenem 3%, nitrofurantoin 2% and amikacin 1%. 8 Moreover, UTI caused by extended-spectrum -lactamase producing ( -lactam resistant) strains of E. coli are increasingly being reported worldwide. 3 This increased emergence of bacterial resistance and the limited options of novel antimicrobial agents have necessitated the reintroduction of some old antimicrobial agents. One such drug is fosfomycin. 4 The antimicrobial agent fosfomycin was discovered in 1969, at a time when bacteria had not yet produced extended spectrum β lactamases (ESBL) or carbapenemases. Decades later, it is not uncommon for Gram negative organisms to be multidrug resistant and even pan resistant to available antibiotic regimens, leaving clinicians with few therapeutic alternatives. Because fosfomycin has been shown to retain activity against these virulent pathogens, there is renewed interest in its use as a therapeutic agent. The bactericidal action of fosfomycin occurs at an earlier step in cell wall synthesis than that of β lactam antibiotics. From an in vitro standpoint, fosfomycin generally has high activity against ESBL and carbapenemase producing Enterobacteriaceae. Multidrugresistant Pseudomonas aeruginosa susceptibility appears to be more dependent on the local antibiogram. Fosfomycin formulations have a large volume of distribution, penetrate biofilms, and concentrate in the urine. Both oral and intravenous fosfomycin formulations are effective for a wide range of Gram negative infections and disease severities. 5 A study of Czech Republic in the year 2014 investigated the susceptibility to fosfomycin of UTI pathogens, particularly Gram-negative rods including those producing β-lactamase. Three thousand two hundred and ninty five unique isolates of Gram-negative bacteria which had caused urinary tract infections were examined. The antibiotic susceptibility was measured by disk diffusion test. The most frequently tested bacterial isolates were Escherichia coli (51.3%, n = 1703), Klebsiella pneumoniae (19.4%, n = 643) and Proteus spp. (11.8%, n = 392). Among all isolates 29.0% (n = 963) were resistant to medical newsletter I as a service to the medical profession I 11
4 Severity Gradient of severity Symptoms No symptoms Local symptoms Dysuria, frequency, urgency, pain or bladder tenderness + General symptoms Fever, Flank pain Nausea, vomiting Systemic response SIRS Fever, shivering Circulatory failure Circulatory and organ failure Organ dysfunction Organ failure Diagnosis ABU CY-1 PN-2 PN-3 Febrile UTI US -4 US-5 US-6 Investigations Dipstick (MSU Culture + S as Required) Dipstick MSU Culture + S Renal ultrasound or IV Pyelogram/renal CT Dipstick MSU Culture + S and Blood culture Renal ultrasound and/or Renal and abdominal CT Uncomplicated UTI Complicated UTI Medical and Surgical Treatment NO* Empirical 3-5 d Empirical + directed 7-14 d Empirical + directed 7-14 d Consider combining 2 antibiotics Empirical + directed d Combine 2 antibiotics Drainage/surgery as required Fig 2.1: Synoptic view of the classification of urinary tract infection as proposed by the European Association of Urology Section of Infection in Urology and including the basic principles of diagnosis and treatment. Reproduced with permission from the European Association of Urology CT= computed tomography; ABU=asymptomatic bacteriuria; CY = cystitis; IV = intravenous; MSU = midstream sample of urine; PN = pyelonephritis; US = urosepsis; UTI = urinary tract infection. * Two presently accepted exceptions: during pregnancy and prior to urological surgery. Table 2.3 : Overall in-vitro Susceptibility of the Common Gram-negative Rods to Commonly Used Per-oral Antibiotics 6 Fosfomycin Nitrofurantoin Ampicillin Cefuroxime Ciprofloxacin Co-trimoxazole E. coli (n=1703) K. pneumoniae (n=643) Proteus sp. (n=392) Enterobacter sp. (n=261) Citrobacter sp. (n=97) E. coli- Escherichia coli, K. pneumoniae-klebsiella pneumoniae, Proteus sp.- Proteus species, Enterobacter sp.-enterobacter species, Citrobacter sp.- Citrobacter species. fluoroquinolones, 11.3% (n = 374) produced extended spectrum β-lactamase and 4.2% (n = 141) produced AmpC β-lactamase. The overall in vitro susceptibility was significantly higher for fosfomycin compared to the other tested oral antibiotics (nitrofurantoin, ampicillin, co-trimoxazole, ciprofloxacin and cefuroxime) against all tested Gram-negative rod isolates (Table 2.3). From this study, it is found that fosfomycin is a promising antibiotic for urinary tract infection. 6 Cystitis Recommended empirical treatment regimens for acute uncomplicated cystitis are shown in Table 2.4. Short-course regimens (ranging from a single dose to a 5-day regimen, depending on the antimicrobial agent) are recommended as first-line treatment, since they are as effective as longer regimens in achieving symptomatic cure and have fewer adverse effects. If a first-line 12 I medical newsletter I as a service to the medical profession
5 Table 2.4 : Empirical Treatment of Acute Uncomplicated Cystitis.* 3 Antimicrobial Regimen First-line therapy Nitrofurantoin monohydrate macrocrystals, 100mg twice daily for 5 days (with meals)# TMP-SMX, 160 mg and 800 mg twice daily for 3 days** Fosfomycin 3-g sachet in a single dose Second-line therapy Fluoroquinolones: ciprofloxacin, 250 mg twice daily for 3 days**; levofloxacin, 250 mg or 500 mg once daily for 3 days** -lactams (e.g., amoxicillin clavulanate, cefdinir, cefaclor, and cefpodoxime proxetil) for 3 to 7 days# Efficacy Clinical efficacy of 5-to-7-day regimen: 93% (84 to 95%); a 3-day regimen appears to be less effective than longer regimens; minimal in vitro resistance to E. coli Clinical efficacy of 3-day TMP-SMX regimen:93% (90 to 100%); similar efficacy with trimethoprim alone, 100 mg twice daily for 3 days**; avoid if resistance rate is greater than 20% or if exposure occured within prior 3 to 6 months. Clinical efficacy: 91% based on a single, randomized trial. Clinical efficacy: 90% (85 to 98%); minimal in vitro resistance, but high prevalence of in vitro resistance in some regions of the world Clinical efficacy of 3-to-5-day regimens: 89% (79 to 98%); less effective than TMP-SMX or fluoroquinolones; few efficacy data on narrow-spectrum cephalosporins (e.g., cephalexin); avoid empirical amoxicillin or ampicillin Comments Minimal ecologic adverse effects; avoid if pyelonephritis is suspected; common side effects include nausea, headache, and flatulence. Probably fewer ecologic adverse effects than seen with fluoroquinolones;common side effects include nausea, vomiting, anorexia, rash, urticaria, hematologic complications and photosensitivity. Minimal ecologic adverse effects; avoid if pyelonephritis is suspected; common side effects include diarrhea, nausea, headache, and vaginitis. Common side effects include nausea, vomiting, diarrhea, headache, drowsiness, and insomnia Probably fewer ecologic adverse effects than seen with parenteral broad-spectrum cephalosporins; common side effects include diarrhea, nausea, vomiting, rash, and urticaria * Efficacy rates and ranges and antimicrobial recommendations are based on the Infectious Diseases Society of America guidelines. Cure rates should not necessarily be compared across agents, owing to differences among trials and varying local patterns of antimicrobial resistance. TMP-SMX denotes trimethoprim sulfamethoxazole. #This regimen presents no clear risk to the fetus, on the basis of studies in animals, humans, or both (pregnancy category B). ** Studies in animals have shown an adverse effect of this regimen on the fetus (pregnancy category C); use only if the potential benefit justifies the potential risk to the fetus. antimicrobial agent is not effective, fluoroquinolones or β-lactams are reasonable alternatives, although it is preferable to minimize their use because of concerns of adverse effects and increasing resistance. 3 Recurrent Cystitis Urinary symptoms that persist or recur within a week or two of treatment for uncomplicated cystitis suggest infection with an antimicrobial-resistant strain or, rarely, relapse. In such cases, a urine culture should be performed and treatment should be initiated with a broader-spectrum antimicrobial agent, such as a fluoroquinolone. Episodes of cystitis that occur at least 1 month after successful treatment of a urinary tract infection should be treated with a first-line short-course regimen (Table 2.4). If the recurrence is within 6 months, one should consider a first-line drug other than the one that was used originally, because of the increased likelihood of resistance. 3 medical newsletter I as a service to the medical profession I 13
6 Pyelonephritis Acute pyelonephritis should be classified clinically at the time of presentation into either uncomplicated or complicated categories. Most episodes of uncomplicated pyelonephritis are treated in the outpatient setting with either a fluoroquinolone (7-14 days) or trimethoprim/sulfamethoxazole (at least 14 days). Women should be admitted if pyelonephritis is severe, if there is hemodynamic instability or any complicating factor (e.g., diabetes, renal stone, or pregnancy), if oral medications are not tolerated, or if there is concern regarding potential non-adherence to treatment. 3 Therapy for patients with complicated pyelonephritis should include initial hospitalization, supportive therapies, administration of wide spectrum intravenous antibiotic therapy, and relief of aggravating conditions. Such maneuvers could consist of simple bladder catheterization, percutaneous nephrostomy drainage, or definitive surgery. These patients require longer duration of culture-specific antibiotic dosing, careful monitoring, long-term follow-up, and possible definitive management of their underlying condition. 7 Follow-up after Cystitis or Pyelonephritis After treatment for uncomplicated cystitis or pyelonephritis, a urine culture is unnecessary if symptoms have resolved, except in pregnant women. In women with recurrent uncomplicated cystitis or pyelonephritis, routine urologic evaluation (with the use of ultrasonography or computed tomography) has a low diagnostic yield and is not recommended. However, it should be considered in women who have persistent hematuria or multiple early recurrences of cystitis involving the same strain of bacteria. In women with pyelonephritis who have severe or worsening illness, persistent fever 48 to 72 hours after the initiation of appropriate antimicrobial treatment, or symptoms suggestive of a stone, abscess, or obstruction, urologic evaluation should be performed to rule out these latter abnormalities. It is also reasonable to perform imaging studies in women who have two or more recurrences of pyelonephritis. 3 Conclusion Urinary tract infection is the most common infection in women which require an antibiotic prescription. UTIs vary greatly by clinical presentation and classified into mainly cystitis, pyelonephritis and urosepsis. A definitive diagnosis can be made based on clinical features and laboratory tests like urinalysis and urine culture. It can be managed by empirical use of antibiotics. But as antibiotic resistance is one of the major challenge to human health, judicious antibiotic use can significantly reduce this problem. In recent years, fosfomycin has re-emerged as an alternative solution for the treatment of UTI. References 1. Juan NK, Steven G. Acute uncomplicated urinary tract infections. [Internet] Published; seasemanagement/infectious-disease/urinary-tract-inf ection/ 2. Helen SL, Jennifer L. Urinary Tract Infection [Internet]. PSAP 2018 BOOK 1. Available from _sample.pdf 3. Thomas MH. Uncomplicated Urinary Tract Infection. N Engl J Med 2012; 366: Vrushali P, Sarman S. Fosfomycin for the treatment of drug-resistant urinary tract infections: potential of an old drug not explores fully. Int Urol and Neph 2017:49(9): Julia LR, Winter JS. Fosfomycin for the treatment of resistant gram-negative bacterial infections. [Internet]. Publishing; 30 April phar Mirosav L, Pavla P. Lenka R, Fajfr et al. The susceptibility to fosfomycin of Gram-negative bacteria isolates from urinary tract infection in the Czech Republic: data from a unicentric study. BMC Urology :33 7. Nickle JC. The management of acute pyelonephritis in adults. Can J Urol.2001 Jun: 8 Suppl 1: Siddiqua M, Alam AN, Akter S. Antibiotic resistance pattern of bacteria causing urinary tract infection in a private medical college hospital, Dhaka. Ban j Med Sci. 2017;16 (01): JMT Barford, ARM Coates. The pathogenesis of catheter-associated urinary tract infection. Journal of Infection Prevention.2009;9(2): John E. Delzell, Michael L. Lefevre. Urinary Tract Infections during Pregnancy. Am Fam Physician 2000 Feb 1;61(3): Vitaly S, Kurt N, Truls EB. Improved Classification of Urinary Tract Infection: Future Considerations. European Urology Supplements 15 (2016) I medical newsletter I as a service to the medical profession
UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys.
UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys. 1-3% of Below 1 yr. male: female ratio is 4:1 especially among uncircumcised males,
More informationEMPIRICAL TREATMENT OF SELECT INFECTIONS ADULT GUIDELINES. Refer to VIHA Algorithm for the empiric treatment of Urinary Tract Infection
URINARY TRACT Refer to VIHA Algorithm for the empiric treatment of Urinary Tract Infection and Asymptomatic Bacteriuria on the VIHA Intranet: https://intranet.viha.ca/departments/pharmacy/clinical_pharmacy/pages/infec
More informationURINARY TRACT INFECTIONS 3 rd Y Med Students. Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan
URINARY TRACT INFECTIONS 3 rd Y Med Students Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan Urinary Tract Infections-1 Normal urine is sterile.. It contains fluids, salts, and waste products,
More informationURINARY TRACT INFECTIONS
URINARY TRACT INFECTIONS Learning Objectives Identify signs and symptoms that may indicate presence of UTI (both complicated and uncomplicated) List common causative organisms and risk factors for UTIs
More informationUrinary tract infection. Mohamed Ahmed Fouad Lecturer of pediatrics Jazan faculty of medicine
Urinary tract infection Mohamed Ahmed Fouad Lecturer of pediatrics Jazan faculty of medicine Objectives To differentiate between types of urinary tract infections To recognize the epidemiology of UTI in
More informationUTI IN ELDERLY. Zeinab Naderpour
UTI IN ELDERLY Zeinab Naderpour Urinary tract infection (UTI) is the most frequent bacterial infection in elderly populations. While urinary infection in the elderly person is usually asymptomatic, symptomatic
More informationRECURRENT URINARY TRACT INFECTIONS: WHAT AN INTERNIST
RECURRENT URINARY TRACT INFECTIONS: WHAT AN INTERNIST MUST KNOW PROF. MD. ENAMUL KARIM Professor of Medicine Green Life Medical College INTRODUCTION Urinary tract infection (UTI) is one of the commonest
More informationLecture 1: Genito-urinary system. ISK
Urinary Tract Infections Lecture 1: Genito-urinary system. ISK 07 08 2009. Getting Clear on the Terminology UTI Cystitis Urosepsis Asymptomatic Bacteriuria Asymptomatic UTI Pyuria Symptomatic UTI Pylonephritis
More informationSHABNAM TEHRANI M.D., MPH ASSISTANT PROFESSOR OF INFECTIOUS DISEASESE &TROPICAL MEDICINE RESEARCH CENTER, SHAHID BEHESHTI UNIVERSITY OF MEDICAL
URINARY TRACT INFECTION SHABNAM TEHRANI M.D., MPH ASSISTANT PROFESSOR OF INFECTIOUS DISEASESE &TROPICAL MEDICINE RESEARCH CENTER, SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES Definition inflammatory
More information11/15/2010. Asymptomatic Bacteriuria UTI. Symptomatic UTI. Asymptomatic UTI. Cystitis. Pylonephritis. Pyuria. Urosepsis
Urinary Tract Infections Renal vein Inferior vena cava Urinary bladder Urethra Renal artery Kidney Aorta Ureter Lecture 1: Genito-urinary system. 06 08 2010. (a) Sherwood Fig. 12-6a, p.530 An introduction
More informationUrinary Tract Infections: From Simple to Complex. Adriane N Irwin, MS, PharmD, BCACP Clinical Assistant Professor Ambulatory Care October 25, 2014
Urinary Tract Infections: From Simple to Complex Adriane N Irwin, MS, PharmD, BCACP Clinical Assistant Professor Ambulatory Care October 25, 2014 Learning Objectives Develop empiric antimicrobial treatment
More informationMICHIGAN MEDICINE GUIDELINES FOR TREATMENT OF URINARY TRACT INFECTIONS IN ADULTS
When to Order a Urine Culture: Asymptomatic bacteriuria is often treated unnecessarily, and accounts for a substantial burden of unnecessary antimicrobial use. National guidelines recommend against testing
More informationIt is an infection affecting any of the following parts like kidney,ureter,bladder or urethra
UTI Dr jayaprakash.k.p,asst prof,ich,govt.medical college,kottayam What is UTI? It is an infection affecting any of the following parts like kidney,ureter,bladder or urethra What is prevalence of UTI?
More informationUrinary Tract Infections in Hospitalized Patients
Urinary Tract Infections in Hospitalized Patients Puerto Rico Chapter Annual Meeting Daniel C. DeSimone, MD March 9, 2019 2017 MFMER slide-1 Disclosures for speaker: Date of presentation: 3/9/2019 No relevant
More informationUrinary tract infections, renal malformations and scarring
Urinary tract infections, renal malformations and scarring Yaacov Frishberg, MD Division of Pediatric Nephrology Shaare Zedek Medical Center Jerusalem, ISRAEL UTI - definitions UTI = growth of bacteria
More informationDiagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela
Diagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela Microbiology Department Medical Faculty, University of Indonesia Urinary Tract Infection
More informationDiagnosis and Management of UTI s in Care Home Settings. To Dip or Not to Dip?
Diagnosis and Management of UTI s in Care Home Settings To Dip or Not to Dip? 1 Key Summary Points: Treat the patient NOT the urine In people 65 years, asymptomatic bacteriuria is common. Treating does
More informationOCTOBER 2017 DRUG ANTIBIOTICS. Presence of bacteria in the urine with no symptoms or clinical signs.
OCTOBER 2017 DRUG ANTIBIOTICS This optimal usage guide is mainly intended for primary care health professionnals. It is provided for information purposes only and should not replace the clinician s judgement.
More informationURINARY TRACT INFECTIONS 3 rd Y Med Students. Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan
URINARY TRACT INFECTIONS 3 rd Y Med Students Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan Urinary Tract Infections-1 Normal urine is sterile in urinary bladder.. It contains fluids,
More informationCLASSIFICATION OF URINARY TRACT INFECTIONS AND SURGICAL FIELD CONTAMINATION CATEGORIES AS A BASIS FOR TREATMENT AND PROPHLAXIS
CLASSIFICATION OF URINARY TRACT INFECTIONS AND SURGICAL FIELD CONTAMINATION CATEGORIES AS A BASIS FOR TREATMENT AND PROPHLAXIS Magnus Grabe, M.D., Ph.D. Associate Professor of Urology University of Lund
More informationTreatment Regimens for Bacterial Urinary Tract Infections. Characteristic Pathogen. E. coli, S.saprophyticus P.mirabilis, K.
HEALTHSPAN URINARY TRACT INFECTIONS (ADULT FEMALE) Methodology: Evidence-Based Issue Date: 1-98 Champion: Internal Medicine Most Recent Review: 4-10, 4-12, 4-14 Key Stakeholders: IM, Urology, Next Review:
More informationAnatomy kidney ureters bladder urethra upper lower
Urinary tract Anatomy The urinary tract consists of the kidney, ureters, bladder, and urethra. Urinary tract infections can be either: upper or lower based primarily on the anatomic location of the infection.
More informationGUIDELINES ON THE MANAGEMENT OF URINARY AND MALE GENITAL TRACT INFECTIONS
GUIDELINES ON THE MANAGEMENT OF URINARY AND MALE GENITAL TRACT INFECTIONS M. Grabe (chairman), M.C. Bishop, T.E. Bjerklund-Johansen, H. Botto, M. Çek, B. Lobel, K.G. Naber, J. Palou, P. Tenke Introduction
More informationGUIDELINES ON UROLOGICAL INFECTIONS
GUIDELINES ON UROLOGICAL INFECTIONS (Text update April 2010) M. Grabe (chairman), T.E. Bjerklund-Johansen, H. Botto, M. Çek, K.G. Naber, R.S. Pickard, P. Tenke, F. Wagenlehner, B. Wullt Introduction Infections
More informationInvestigators Meeting
Outcomes of Urinary Tract Infection Management by Pharmacists (R x OUTMAP) Investigators Meeting June 11, 2017 Overview 1. Introductions and Opening Remarks 2. Epidemiology and Definitions 3. UTI Assessment
More informationNo Need to Agonize! Tips for the Diagnosis and Treatment of Complicated UTIs
ASCENSION TEXAS No Need to Agonize! Tips for the Diagnosis and Treatment of Complicated UTIs Austin Area Society of Health-System Pharmacists April 26, 2018 Amy Carr, PharmD PGY-2 Infectious Diseases Pharmacy
More informationUrinary Tract Infections
Urinary Tract Infections Michelle Eslami, M.D., FACP Professor of Medicine Division of Geriatrics David Geffen SOM at UCLA Urinary Tract Infection (UTI) One of most common infections in outpatient and
More informationKAISER PERMANENTE OHIO URINARY TRACT INFECTIONS (ADULT FEMALE)
KAISER PERMANENTE OHIO URINARY TRACT INFECTIONS (ADULT FEMALE) Methodology: Evidence-Based Issue Date: 1-98 Champion: Internal Medicine Most Recent Review: 4-10, 4-12 Key Stakeholders: IM, Urology, Next
More informationURINARY TRACT INFECTIONS IN LONG TERM CARE. Tuesday, 8 November, 11
URINARY TRACT INFECTIONS IN LONG TERM CARE OBJECTIVES UNDERSTAND THE SCALE OF DISEASE IN LTC SETTINGS DEVELOP AN UNDERSTANDING OF THE DIFFERENT PRESENTATIONS OF UTIs IN THIS SETTING AND WORKUP BECOME AWARE
More informationPrescribing Guidelines for Urinary Tract Infections
Prescribing Guidelines for Urinary Tract Infections Urinary Tract Infections in Children Urinary tract infections (UTIs) are common infections of childhood that may affect any part of the urinary tract,
More information6/4/2018. Conflicts Disclosure. Objectives. Introduction. Classifications of UTI. Host Defenses. Management of Recurrent Urinary Tract Infections
Conflicts Disclosure Presenter has no conflicts of interest to disclose Management of Recurrent Urinary Tract Infections COLIN M. GOUDELOCKE, M.D. JUNE 14, 2018 Objectives Attendees will review the identification
More informationTMP/SMZ DS Ciprofloxacin Norfloxacin Ofloxacin Cefadroxil * 30 Amoxicilin 86* 19 25
Evidence-Based Evaluation and Treatment of UTI UTI Prevalence Leslee L. Subak, MD Associate Professor Obstetrics, Gynecology & RS Epidemiology & Biostatistics University of California, San Francisco 50%
More informationUrinary tract infections Dr. Hala Al Daghistani
Urinary tract infections Dr. Hala Al Daghistani UTIs are considered to be one of the most common bacterial infections. Diagnosis depends on the symptoms, urinalysis, and urine culture. UTIs occur more
More informationClinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections
Special Article https://doi.org/10.3947/ic.2018.50.1.67 Infect Chemother 2018;50(1):67-100 ISSN 2093-2340 (Print) ISSN 2092-6448 (Online) Infection & Chemotherapy Clinical Practice Guidelines for the Antibiotic
More informationLower Urinary Tract Infection (UTI) in Males
Lower Urinary Tract Infection (UTI) in Males Clinical presentation For patients in care homes see UTI in adults where IV Antibiotics in the community may be appropriate (under development) History and
More informationUrinary Tract Infections: From Pyelonephritis to Asymptomatic Bacteriuria. Leslee L. Subak, MD
Urinary Tract Infections: From Pyelonephritis to Asymptomatic Bacteriuria Leslee L. Subak, MD Professor Obstetrics, Gynecology & RS Epidemiology & Urology University of California, San Francisco UTI Prevalence
More informationPediatric urinary tract infection. Dr. Nariman Fahmi Pediatrics/2013
Pediatric urinary tract infection Dr. Nariman Fahmi Pediatrics/2013 objectives EPIDEMIOLOGY CAUSATIVE PATHOGENS PATHOGENESIS CATEGORIES OF URINARY TRACT INFECTIONS AND CLINICAL MANIFESTATIONS IN pediatrics
More informationWhen should UTIs be treated in the Elderly? Shelby L. Wentworth, MS4 University of Florida College of Medicine 29 AUG 2018
When should UTIs be treated in the Elderly? Shelby L. Wentworth, MS4 University of Florida College of Medicine 29 AUG 2018 UTIs in Patients >/ 65 yo - Most common infectious illness [1]. - Urinary tract
More informationUrinary Tract Infection
67 Urinary Tract Infection Dr Kawa Ahmad PhD Pharmaceutics 1 Introduction The term urinary tract infection (UTI) usually refers to the presence of organisms in the urinary tract together with symptoms,
More informationStill Feelin the Burn? You Might Have a Urinary Tract Infection
Still Feelin the Burn? You Might Have a Urinary Tract Infection Jason Alegro, Pharm.D. BCPS Assistant Professor of Clinical Sciences, Roosevelt University Infectious Diseases Clinical Pharmacy Specialist,
More informationASPIRES Urinary Tract Infection Algorithm
ASPIRES Urinary Tract Infection Algorithm Dr. Jennifer Grant Dr. Tim Lau Donna Leung February 2013 VCH Antimicrobial Stewardship 1 Programme: Innovation, Research, Education & Safety KEY PRINCIPLES 1.
More informationCustomary urine test is the dip stick and the mid-stream culture of voided urine. Up to 77% of cystitis cases are cultured
9 million visits/year! Customary urine test is the dip stick and the mid-stream culture of voided urine. Up to 77% of cystitis cases are cultured Interpretation of the culture result has been controversial-
More informationStill Feelin the Burn? You Might Have a Urinary Tract Infection
Still Feelin the Burn? You Might Have a Urinary Tract Infection Jason Alegro, Pharm.D. BCPS Assistant Professor of Clinical Sciences, Roosevelt University Infectious Diseases Clinical Pharmacy Specialist,
More informationUrinary tract infections
بسم رلاهللا Urinary tract infections This sheet will only contain extra notes said by the dr. UTIs: - is the second most common type of infections in community(second only to RTIs) - Incidence=20-30% of
More informationOutpatient treatment in women with acute pyelonephritis after visiting emergency department
LETTER TO THE EDITOR Korean J Intern Med 2017;32:369-373 Outpatient treatment in women with acute pyelonephritis after visiting emergency department Hee Kyoung Choi 1,*, Jin-Won Chung 2, Won Sup Oh 3,
More informationBacterial Infections of the Urinary System *
OpenStax-CNX module: m64804 1 Bacterial Infections of the Urinary System * Douglas Risser This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 4.0 1 Learning
More informationUrinary Tract Infections KIDNEY INFECTIONS. Dr. AMMAR FADIL
Urinary Tract Infections KIDNEY INFECTIONS Dr. AMMAR FADIL General principles Urinary tract infections (UTIs) is inflammatory response of the urothelium to bacterial invasion. are common affect men and
More informationBacterial urinary tract infections
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Bacterial urinary tract infections Author : CATHERINE F LE BARS Categories : Vets Date : February 11, 2008 CATHERINE F LE
More informationPYELONEPHRITIS. Wendy Glaberson 11/8/13
PYELONEPHRITIS Wendy Glaberson 11/8/13 A 19mo infant girl was seen in the ED 3 days ago and diagnosed with a UTI. She was afebrile at the time and discharged on broad spectrum antibiotics. The child returns
More informationGUIDELINES ON THE MANAGEMENT OF URINARY AND MALE GENITAL TRACT INFECTIONS
16 GUIDELINES ON THE MANAGEMENT OF URINARY AND MALE GENITAL TRACT INFECTIONS K.G. Naber (chairman), B. Bergman, M.C. Bishop, T.E. Bjerklund-Johansen, H. Botto, B. Lobel, F. Jimenez-Cruz, F.P. Selvaggi
More informationUTI: A practical approach. Justin Seroy, DO Infectious Disease Attending BUMC-P
UTI: A practical approach Justin Seroy, DO Infectious Disease Attending BUMC-P UTI Pathophysiology Uropathogens colonize urethra, vagina or perineal area -> Enter lower urinary tract ->bladder ->kidney
More informationFeasibility of Remote Management of Uncomplicated Urinary Tract Infection: A Quality Improvement Project
Rhode Island College Digital Commons @ RIC Master's Theses, Dissertations, Graduate Research and Major Papers Overview Master's Theses, Dissertations, Graduate Research and Major Papers 5-2017 Feasibility
More informationDefinition/Epidemiology Approach to premenopausal and postmenopausal women A couple tricky cases DISCLOSURES. No financial relationships to disclose.
DISCLOSURES RECURRENT URINARY TRACT INFECTIONS No financial relationships to disclose. Anna C. Kirby, MD, MAS Acting Assistant Professor University of Washington Division of Urogynecology Department of
More informationCLINICAL CHARACTERISTICS AND ANTIBIOTIC RESISTANCE PATTERN OF PATHOGENS IN PEDIATRIC URINARY TRACT INFECTION
CLINICAL CHARACTERISTICS AND ANTIBIOTIC RESISTANCE PATTERN OF PATHOGENS IN PEDIATRIC URINARY TRACT INFECTION Yupaporn Amornchaicharoensuk Faculty of Medicine, Navamindradhiraj University, Bangkok, Thailand
More informationNew Medicines Committee Briefing. July Fosfomycin trometamol for the treatment of multidrug resistant urinary tract infection
New Medicines Committee Briefing July 2014 Fosfomycin trometamol for the treatment of multidrug resistant urinary tract infection (unlicensed indication) Fosfomycin trometamol to be reviewed for use within:
More informationCATHETER-ASSOCIATED URINARY TRACT INFECTIONS
CATHETER-ASSOCIATED URINARY TRACT INFECTIONS Hamid Emadi M.D Associate professor of Infectious diseases Department Tehran university of medical science The most common nosocomial infection The urinary
More informationORIGINAL ARTICLE SUSCEPTIBILITY PATTERNS IN GRAM NEGATIVE URINARY ISOLATES TO CIPROFLOXACIN, CO-TRIMOXAZOLE AND NITROFURANTOIN
SUSCEPTIBILITY PATTERNS IN GRAM NEGATIVE URINARY ISOLATES TO CIPROFLOXACIN, CO-TRIMOXAZOLE AND NITROFURANTOIN Anoop Sinha 1, Benny P V 2 HOW TO CITE THIS ARTICLE: Anoop Sinha, Benny PV. Susceptibility
More informationUpdate in diagnosis and management of UTIs
Update in diagnosis and management of UTIs I have no disclosures Brian S. Schwartz, MD UCSF, Division of Infectious Diseases Lecture outline Challenges in cystitis Complicated UTI/pyelonephritis Asymptomatic
More informationWhich is urinary tract infection (UTI) How is urinary tract infection. Clinical features of UTI in the elderly. Preventive measures in the elderly
O Which is urinary tract infection (UTI) How is urinary tract infection How is the diagnosis of UTI in the elderly Clinical features of UTI in the elderly Therapeutic considerations in the elderly Preventive
More informationNursing Care for Children with Genitourinary Dysfunction I
Nursing Care for Children with Genitourinary Dysfunction I 1 Assessment of renal function Clinical manifestations Laboratory tests Urinalysis Urine culture and sensitivity Renal/bladder ultrasound Testicular
More informationCHALLENGING UTI S: PRIMARY CARE MANAGEMENT
CHALLENGING UTI S: PRIMARY CARE MANAGEMENT Wendy L. Wright, MS, RN, APRN, FNP, FAANP Adult/Family Nurse Practitioner Owner Wright & Associates Family Healthcare, PLLC @ Amherst and @ Concord, NH Partner
More informationThe McMaster at night Pediatric Curriculum
The McMaster at night Pediatric Curriculum Robinson, J, et al. and the Canadian Pediatric Society. Urinary tract infection in infants and children: Diagnosis and management. Pediatr Child Health 2014;
More informationMODULE 2: ADULT URINARY TRACT INFECTIONS
MODULE 2: ADULT URINARY TRACT INFECTIONS KEYWORDS: Urinary tract infection (UTI); cystitis; pyelonephritis; uropathogens; antibiotics LEARNING OBJECTIVES At the end of this clerkship, the learner will
More informationPyelonephritis. I m not telling you it s going to be easy. I m telling you it s going to be worth it.
Please check the editing file to see if there are any changes Pyelonephritis Important! Doctor s Notes Only found in females slides Only found in males slides Extra Notes I m not telling you it s going
More informationGUIDELINES ON THE MANAGEMENT OF URINARY AND MALE GENITAL TRACT INFECTIONS
24 GUIDELINES ON THE MANAGEMENT OF URINARY AND MALE GENITAL TRACT INFECTIONS K. Naber (chairman), B. Bergman, M. Bishop, T. Bjerklund- Johansen, H. Botto, B. Lobel, F. Jimenez-Cruz, F. Selvaggi Eur Urol
More informationUTI. Monica Tegeler, MD
4 UTI Monica Tegeler, MD 2 Diagnosis Stone criteria >100,000 colonies of bacteria growing in urine with no more than 2 species of microorganisms Dysuria OR Fever AND 1 of following: Frequency Urgency Suprapubic
More information320 MBIO Microbial Diagnosis. Aljawharah F. Alabbad Noorah A. Alkubaisi 2017
320 MBIO Microbial Diagnosis Aljawharah F. Alabbad Noorah A. Alkubaisi 2017 Pathogens of the Urinary tract The urinary system is composed of organs that regulate the chemical composition and volume of
More informationManagement of UTI. Disclosures. Uncomplicated UTI UTI CLASSIFICATION. Where do UTI bugs come from? Food Sex
Management of UTI Thomas M. Hooton, M.D. University of Miami Miami, Florida Disclosures Fimbrion a biotech company with mission to develop novel approaches to treat and prevent UTI Co-founder and shareholder
More informationIndex. urologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acinetobacter baumannii, carbapenem-resistant, 497 498 Adolescents, urinary tract infections in, 520 521 Aminoglycosides, for UTIs and
More informationUrinary Tract Infections
Urinary Tract Infections Dr Mere Kende MBBS, MMed (Path), MAACB, MACRRM, MACTM Lecturer, SMHS, Taurama campus, UPNG Urinary Tract Infections Definitions (Terms) Microbiology and epidemiology Pathogenesis
More informationANTIBIOTIC USE DURING ENDOUROLOGIC SURGERY
ANTIBIOTIC USE DURING ENDOUROLOGIC SURGERY Comprehensive Kidney Stone Center at Duke University Medical Center Durham, North Carolina Glenn M. Preminger LEADING EDGE UROLOGY 49th Annual Duke Urologic Assembly
More informationMicrobiology. Hani Masaadeh. Hadeel Al-Momani
Microbiology UTI 1 Hani Masaadeh Hadeel Al-Momani 1 Page #1 Date :27/4/2016 Lecture#1 Micro Lecture#21 UGS Subject : UTI *Urinary tract is normally sterile due to the fact that bacteria moving upwards
More informationReview of Urinary Tract Infection
Review of Urinary Tract Infection Anthony P. Buonanno, Jr., MD Lehigh Area Medical Associates, Allentown, Pennsylvania Clinical Assistant Professor of Internal Medicine, Penn State University, Hershey,
More informationGuidelines on Urological Infections
Guidelines on Urological Infections M. Grabe (Chair), R. Bartoletti, T.E. Bjerklund Johansen, M. Çek, B. Köves (Guidelines Associate), K.G. Naber, R.S. Pickard, P. Tenke, F. Wagenlehner, B. Wullt European
More informationUrinary Tract Infections. Keri A. Mattes, Pharm.D., BCPS September 15, 2003
Urinary Tract Infections Keri A. Mattes, Pharm.D., BCPS September 15, 2003 Urinary Tract Infections 7 million episodes of acute cystitis and 250,000 episodes of pyelonephritis annually in the U.S. Epidemiology
More informationPlazomicin for complicated urinary tract infection
October 2016 Horizon Scanning Research & Intelligence Centre Plazomicin for complicated urinary tract infection NIHR HSRIC ID: 9787 Lay summary Serious infections caused by Gram-negative bacteria are becoming
More informationAntibiotic Guidelines for URINARY TRACT/ UROLOGY infections
Antibiotic Guidelines f URINARY TRACT/ UROLOGY infections CLINICAL CONDITION USEFUL INFORMATION RECOMMENDATIONS ALTERNATIVE (suitable in serious penicillin allergy) Asymptomatic Bacteriuria (in the absence
More informationUTI Update: Have We Been Led Astray? Disclosure. Objectives
UTI Update: Have We Been Led Astray? KAAP Sept 28, 2012 Robert Wittler, MD 1 Disclosure Neither I nor any member of my immediate family has a financial relationship or interest with any entity related
More informationAsyntomatic bacteriuria, Urinary Tract Infection
Asyntomatic bacteriuria, Urinary Tract Infection C. Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asyntomatic Bacteriuria in Adults (2005) Pyuria accompanying asymptomatic
More informationTHE EFFECT OF DIABETES MELLITUS ON THE CLINICAL AND MICRO-BIOLOGICAL OUTCOMES IN PATIENTS WITH ACUTE PYELONEPHRITIS
American Journal of Infectious Diseases 10 (2): 71-76, 2014 ISSN: 1553-6203 2014 Science Publication doi:10.3844/ajidsp.2014.71.76 Published Online 10 (2) 2014 (http://www.thescipub.com/ajid.toc) THE EFFECT
More informationTreatment of febrile neutropenia in patients with neoplasia
Treatment of febrile neutropenia in patients with neoplasia George Samonis MD, PhD Medical Oncologist Infectious Diseases Specialist Professor of Medicine The University of Crete, Heraklion,, Crete, Greece
More informationSevere β-lactam allergy. Alternative (use for mild-moderate β-lactam allergy) therapy
Recommended Empirical Antibiotic Regimens for MICU Patients Notes: The antibiotic regimens shown are general guidelines and should not replace clinical judgment. Always assess for antibiotic allergies.
More informationUrinary Tract Infections in Children
Urinary Tract Infections in Children Eric Balighian, MD,* Michael Burke, MD* *St Agnes Hospital, Baltimore, MD Educational Gaps Consideration of risk factors for urinary tract infections (UTIs) in young
More informationNone. Appropriate collection minimizes contamination Sample should be delivered to the laboratory in a timely fashion to limit bacterial growth
None Christopher J. Graber, MD MPH Assistant Clinical Professor of Medicine, UCLA Infectious Diseases Section VA Greater Los Angeles Healthcare System November 19, 2011 Clin Infect Dis 2005;40:643-54 Clin
More informationOriginal Article - Infection/Inflammation. Sungmin Song, Chulsung Kim, Donghoon Lim.
www.kjurology.org http://dx.doi.org/10.4111/kju.2014..4.20 Original Article - Infection/Inflammation http://crossmark.crossref.org/dialog/?doi=10.4111/kju.2014..4.20&domain=pdf&date_stamp=2014-04-1 Clinical
More informationPaediatrica Indonesiana. Urine dipstick test for diagnosing urinary tract infection
Paediatrica Indonesiana VOLUME 53 November NUMBER 6 Original Article Urine dipstick test for diagnosing urinary tract infection Syarifah Julinawati, Oke Rina, Rosmayanti, Rafita Ramayati, Rusdidjas Abstract
More informationUrinary tract infection ประส ทธ อ พาพรรณ สาขาว ชาโรคต ดเช อ ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยศ รนคร นทรว โรฒ
Urinary tract infection ประส ทธ อ พาพรรณ สาขาว ชาโรคต ดเช อ ภาคว ชาอาย รศาสตร คณะแพทยศาสตร มหาว ทยาล ยศ รนคร นทรว โรฒ Introduction Urinary tract infections (UTIs) are extremely common. Most frequent in
More information1/21/2016. Overview. Significance
Asymptomatic Bacteriuria: Myths, Magic and Management Christopher Ohl MD Professor of Medicine, Section on Infectious Diseases Wake Forest School of Medicine, Winston Salem, NC Slide credits to Katie Wallace,
More informationOutline. Urinary Tract Infection. Classification - UTI. Adult Genito-Urinary Infections Epidemiology, Etiology, and Diagnosis
Adult Genito-Urinary Infections Epidemiology, Etiology, and Diagnosis Geoffrey N. Box, M.D. Assistant Professor Director, Laparoscopic Urologic Surgery The Ohio State University Definitions: Urinary Tract
More informationManaging Urinary Tract Infections in the Nursing Home: Myths, Mysteries and Realities
ISPUB.COM The Internet Journal of Geriatrics and Gerontology Volume 1 Number 2 Managing Urinary Tract Infections in the Nursing Home: Myths, Mysteries and Realities H Kamel Citation H Kamel. Managing Urinary
More informationUrinary Tract Infection. Clinical Background. Quality Department
Quality Department Guidelines for Clinical Care Ambulatory Urinary Tract Infection Guideline Team Team Leader Steven E Gradwohl, MD General Medicine Team Members Catherine M Bettcher, MD Family Medicine
More informationUrogenital Tract / 3 rd year Urinary Tract Infections. Dr Hamed Al-Zoubi MD, PhD Associate Prof. of Medical Microbiology
Urogenital Tract / 3 rd year Urinary Tract Infections Dr Hamed Al-Zoubi MD, PhD Associate Prof. of Medical Microbiology Urinary Tract Infections ILOs 1. Define UTI 2. Classification 3. List the common
More informationClinical Pearls Infectious Diseases. Pritish K. Tosh, MD MN ACP Nov 7, [Answers and discussion slides will be posted after the meeting]
Clinical Pearls Infectious Diseases Pritish K. Tosh, MD MN ACP Nov 7, 2014 [Answers and discussion slides will be posted after the meeting] Case 1 A 33-year-old male with diffuse large B-cell lymphoma
More informationAntibiotic Protocols for Paediatrics Steve Biko Academic Hospital
Antibiotic Protocols for Paediatrics Steve Biko Academic Hospital Respiratory tract infections in children Uncomplicated URTI A child with a cold should not receive an antibiotic Paracetamol (15 mg/kg/dose
More informationUrinary Tract Infection and Pattern of Antibiotic Sensitivity in Hospitalized Patients with Diabetes Mellitus in Myanmar
Volume 2 Issue 1 2018 Page 147 to 153 Research Article Archives of Endocrinology and Diabetes Care Urinary Tract Infection and Pattern of Antibiotic Sensitivity in Hospitalized Patients with Diabetes Mellitus
More informationPrevention of Important HAIs: Principle & Case Scenario in VAP/CAUTI. CPT. Pasri Maharom MD, MPH Dec 15, 2015
Prevention of Important HAIs: Principle & Case Scenario in VAP/CAUTI CPT. Pasri Maharom MD, MPH Dec 15, 2015 Catheter Associated Urinary Tract Infection CAUTI CAUTI Epidemiology Key Principles of Preventing
More informationDrugs for UTIs and STDs. Dr.Vishaal Bhat Associate Professor MMMC Manipal
Drugs for UTIs and STDs Dr.Vishaal Bhat Associate Professor MMMC Manipal Classification of UTI s Clinical: Asymptomatic (98%) Symptomatic (1-2%) Anatomical: Lower tract dis: asymptomatic bacteriuria and
More informationUrology and Urinary Tract Infections in Adults
Urology and Urinary Tract Infections in Adults Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date (when this version
More informationMedical Management of childhood UTI and VUR. Dr Patrina HY Caldwell Paediatric Continence Education, CFA 15 th November 2013
Medical Management of childhood UTI and VUR Dr Patrina HY Caldwell Paediatric Continence Education, CFA 15 th November 2013 Terminology According to the current ICCS terminology guidelines Bladder and
More informationCase studies. Stephen Mark Rob Walker
Case studies Stephen Mark Rob Walker Case 1 31 yr old woman with 3 rd UTI. E coli Frequency and dysuria Asymptomatic after treatment Recurrent UTI Lower tract symptoms Coliforms Asymptomatic after treatment
More information