Urinary Tract Infections
|
|
- Vincent Parrish
- 6 years ago
- Views:
Transcription
1
2 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 inpatient settings UTI-not one size fits all Asymptomatic bacteriuria Acute uncomplicated cystitis (AUC) Recurrent cystitis Complicated cystitis Catheter associated asymptomatic bacteriuria (CA-ABS) Catheter associated UTI ( CA-UTI) Prostatitis Challenges Comorbid conditions may result in similar symptoms to UTI s Cognitive impairment may make reporting of symptoms difficult Older adults can have atypical presentations for infections There is lack of evidence based guidelines for symptomatic UTI s Risk Factors for UTI Premenopausal state Urinary tract instrumentation History of voiding problems Stones or ureteral stents Postmenopausal state Dehydration Screening for UTI No role in men or non-pregnant women Recommended in pregnancy Recommended for men before TURP or other urinary tract instrumentation resulting in mucosal bleeding Screening for Asymptomatic Bacteriuria Asymptomatic bacteriuria does not lead to HTN, CKD or decreased survival Prevalence highest spinal cord patients, hemodialysis, women >80yrs, diabetics No relationship to mortality Screening and treatment not recommended
3 IDSA Recommendations Routine screening for and treatment of ASB in older individuals in the community is not recommended. Screening for and treatment of ASB in elderly residents in LTCFs is not recommended. Signs and Symptoms of Acute Uncomplicated UTI (ACU) Acute onset dysuria, increased urgency and frequency Meta-analysis in ambulatory women found symptoms of UTI, no vaginal discharge or irritation had >90% probability of acute cystitis Do not need to do urinalysis Do not need a urine culture CID2005;40: Brent, S. et al. JAMA 2002; 287: Complicated UTI Anatomic, functional or metabolic abnormality of the urinary tract Pregnant women, bladder outlet obstruction Men- voiding dysfunction or related prostatic disorders Diabetic, immunocompromised, post menopausal or elderly Catheter, calculi or neurogenic bladder Differential Diagnosis of UTI in Young Women Vaginitis- vaginal discharge and external dysuria Uretheritis- vaginal discharge Irritation- vaginal itching and discharge - fever, malaise, nausea and vomiting, abdominal pain and back/flank pain Signs and Symptoms of UTI in Elderly Elderly patients may be more prone to have changes in mental status from baseline Elderly women--auc v. complicated UTI Elderly men--complicated UTI related to prostate Bacterial organisms include E-coli, Proteus, Klebsiella, Pseudomonas, Enterococus and Staph species are more common > 65 years old Signs and Symptoms of CA-UTI New onset or worsening fevers, AMS, malaise or lethargy without other cause, flank pain, CVA tenderness, acute hematuria or pelvic discomfort UCX > 1000 colonies of one bacterial species Includes foley, suprapubic, condom, intermittent catheterization or catheter removal within 48hrs
4 Criteria for Surveillance, Diagnosis and Treatment Consensus group recommendations McGeer criteria developed for surveillance and outcome assessments Used by Centers for Medicare and Medicaid Services Loeb criteria recommends minimal set of criteria necessary to initiate antibiotic therapy for UTI Similar to IDSA Guidelines Significance of Bacteriuria Indwelling Catheters Prevalence catheter use US NH residents: 100,000 in use Acute care: 15-25% Prevalence bacteriuria per day catheterization 3-8% short term 9-23% > 30 days 100% Complications BSI < 1% deaths due to BSI 1-4% Hooton TM et al. IDSA Guideline, CID 2010;50:625 Collecting Urine Samples Mid-stream or clean catch specimen for cooperative and functionally capable individuals. However, often necessary For males to use freshly applied, clean condom (external) catheter and monitor bag frequently For females to perform an in-and-out catheterization Residents with long-term indwelling catheters Change catheter prior to collection (sterile technique/equip.) Resident with short-term catheterization (< 30 days) Obtain by sampling through the catheter port using aseptic technique If port not present may puncture the catheter tubing with a needle and syringe If catheter in place > 2 weeks at onset of infection, replace CID 2009;48: CID 2010;50: Urinalysis and Culture Urinalysis Positive Nitrate; gram negative bacteria Positive Leukocyte esterase (>10 WBC) White blood cell casts Hematuria Urine culture Not always indicated for AUC in women but useful if no response to initial therapy Complicated UTI Elderly in LTCF or hospital Pyuria Pyuria (> 10 WBC / high-power field) is evidence of inflammation in the genitourinary tract Pyuria is commonly found with ASB Elderly institutionalized residents 90% (Infect Dis Clin North Am 1997;11:647-62) Short-term (< 30 days) catheters 30-75% (Arch IM 2000;160:673-82) Long-term catheters % (Am J Infect Control 1985;13:154-60) Pyuria Prevalence-Asymptomatic Pts Young women 32% Pregnant women 30-70% Diabetic women 70% Institutionalized elderly 90% Hemodialysis pts 90% Short term catheters 30-75% Long-term catheters % Nicolle et al. Clin Infect Dis 2005;40:
5 Pyuria Other Causes Any inflammatory cause Tuberculosis (sterile pyuria) STDs Interstitial nephritis legionella, leptospirosis, atheroemboli, granulomatous dis (sarcoid), allergy Irritation - stones, catheters Degree of pyuria not helpful re-rx Testing for UTI Blood cultures Diabetes Renal transplant Role of Diagnostic Imaging for UTI Uncomplicated UTI; expert consensus is that imaging adds little benefit except if a stone is suspected Men < 45 years or older men without voiding symptoms or hematuria Microbiology of UTI E-coli > 90% in uncomplicated cystitis and pyelonephritis Klebesiella, Proteus and Coagulase-negative Staph saprophyticus make up 5-10% Complicated UTI; E-coli, coliforms and enterococci CA-UTI short term; E-coli, Hospital acquired pathogens; Klebsiella, Citrobacter and Enterobacter Longterm catheter; polymicrobial Asymptomatic Bacteriuria (ASB) Laboratory diagnosis Positive urine culture Colony count significant (> 10⁵ cfu/ml) Absence of symptoms Clinical Infectious Disease 2010;50: No Benefit Treating ASB in the Elderly Large long-term studies of ASB in pre and postmenopausal women NO ADVERSE OUTCOMES in women not treated Randomized studies (treatment vs. no treatment) in elderly LTC residents NO BENEFIT to treatment No decreased rate of symptoms No improved survival CID2005;40:
6 Treatment for ASB Not Indicated Premenopausal, non-pregnant women Diabetic women Older persons living in the community Elderly living in long term care facilities Persons with spinal cord injury Catheterized patients Treatment for ASB Indicated Pregnant women Increased risk for adverse outcomes Urologic interventions TURP Any urologic procedure with potential mucosal bleeding CID2005;40: Treatment Regimens for Uncomplicated Cystitis Nitrofurantoin 100mg bid for five days Trimethoprim-sulfamethoxazole* bid for three days Fosfomycin 3g single dose Alternative agents Fluroquinolones three day course Beta-lactams three to seven day course Fosfomycin Active against a wide spectrum of gram positive and gram negative organisms including ESBL and VRE Clinical cure of 83% = five day course of cipro ( 81% for AUC) Not tested or reported in most clinical trials *excellent efficacy if local resistance <20% Treatment for Complicated UTI and Acute Pyelonephritis Fluoroquinolones Cipro 500mg bid qd for seven days Levaquin 750mg qd for five days Trimethoprim-sulfamethoxazole 14 day course Beta-lactams day course Consider initial IV dose of ceftriaxone or aminoglycoside Catheter Associated UTI (CA- UTI) CA rate bacteruria: 3-8% per day Treat only if symptomatic 100 CFu/mL in newly placed CA 1000 CFu/mL minimum count for CA-UTI or 48 hours after catheter removed Treatment usually seven days for symptoms that promptly resolve; days if delayed response
7 Recurrent UTI >= 3 UTIs within 12 months or >=2 UTIs within six months Postcoital antibiotic prophylaxis- half Bactrim SS Patient initiated therapy Daily or three times a week prophylaxis for 6-12 months Postmenopausal women- topical estrogen Nonpharmcologic Therapies and Prevention Push fluids Cranberry products RCT with twice daily cranberry juice v. placebo--no benefit RCT with cranberry capsule v. TMP-SMX--abx better result No definitive evidence available show that cranberry products help with treatment or prophylaxis Stapleton AE,et al.mayo Clin Proc 2012:87: Beereport MA,et al. Arch Intern Med2011;171: Conclusions UTIs are common E-coli is the most common pathogen in both young and old Guidelines focus on women with acute uncomplicated cystitis/pyelonephritis and are limited to premenopausal, non-pregnant CA-UTI in hospitalized patients is not reimbursed Abundant evidence supports nontreatment of asymptomatic bacteriuria Tool Kits Patient Information Clinical Guidelines
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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 informationArchCare ASB:Proposed Guidelines-DS-8/17/12 Pg 1 of 5 ArchCare Proposed Clinical Guidelines: Asymptomatic Bacteriuria
Pg 1 of 5 ArchCare Proposed Clinical Guidelines: Asymptomatic Bacteriuria Asymptomatic Bacteriuria (ASB) is defined as a positive urine culture obtained from a person without signs or symptoms referable
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 informationOHSU URGE OVERKILL - UTIS GRAEME FORREST, MBBS, FIDSA ASSOCIATE PROFESSOR OF MEDICINE VA PORTLAND HEALTHCARE SYSTEM AND OHSU
URGE OVERKILL - UTIS GRAEME FORREST, MBBS, FIDSA ASSOCIATE PROFESSOR OF MEDICINE VA PORTLAND HEALTHCARE SYSTEM AND DISCLOSURES NOTHING TO DISCLOSE THE INFORMATION PRESENTED IS MY MINE AND NOT A RECOMMENDATION
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 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 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 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 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 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 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 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 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 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 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 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 informationEducational Module for Nursing Assistants in Long-term Care Facilities: Urinary Tract Infections and Asymptomatic Bacteriuria
Educational Module for Nursing Assistants in Long-term Care Facilities: Urinary Tract Infections and Asymptomatic Bacteriuria Minnesota Department of Health Infectious Disease Epidemiology, Prevention,
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 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 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 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 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 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 informationAntimicrobial Stewardship and Urinary Tract Infections
Antimicrobial Stewardship and Urinary Tract Infections Samantha Loutzeheiser, PharmD, BCPS Andrea Pallotta, PharmD, BCPS (AQ-ID), AAHIVP Cleveland Clinic Medina Hospital Cleveland Clinic Main Campus Objectives
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 information(Facility Name and Address) (1D) Surveillance of Urinary Tract Infections in the Long-Term Care Setting
Policy Number: 1D Date: 4/16/14 Version: 1 (1D) Surveillance of Urinary Tract Infections in the Long-Term Care Setting Introduction: One-quarter of the older adult population in the United States will
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 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 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 information'Diagnostic Stewardship for Urinary Tract Infections. Surbhi Leekha MBBS, MPH Associate Professor, UMSOM Medical Director, Infection Prevention, UMMC
'Diagnostic Stewardship for Urinary Tract Infections Surbhi Leekha MBBS, MPH Associate Professor, UMSOM Medical Director, Infection Prevention, UMMC Objectives Describe the difference between asymptomatic
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 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 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 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 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 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 informationOne of the most feared potential complications from vertebroplasty
Published vember 11, 2008 as 10.3174/ajnr.A1385 REVIEW ARTICLE R.I. Popa L.A. Gray D.F. Kallmes Urinary Tract Infections in the Potential Vertebroplasty Patient: Incidence, Significance, and Management
More informationThere s More Than One Way to Skin a CAuTi:
There s More Than One Way to Skin a CAuTi: A Multidisciplinary Approach to Prevent Catheter Associated Urinary Tract Infections & Treatment of Asymptomatic Bacteriuria Objectives Identify causes of CAUTI
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 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 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 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 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 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 informationAntibiotic Stewardship and the Misdiagnosis of UTI
Antibiotic Stewardship and the Misdiagnosis of UTI Daniel J. Pallin, MD, MPH Director of Research, Department of Emergency Medicine Chairman, Clinical Investigation Committee Brigham and Women s Hospital
More informationPresented by: Phenelle Segal, RN CIC President, Infection Control Consulting Services, LLC
Catheter-associated Urinary Tract Infection (CAUTI) in Long-Term Care Settings Presented by: Phenelle Segal, RN CIC President, Infection Control Consulting Services, LLC Presenter has no financial disclosures
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 informationCatheter-Associated Urinary Tract Infection (CAUTI) Event
Device-associated Events Catheter-Associated Urinary Tract Infection () Event Introduction: The urinary tract is the most common site of healthcare-associated infection, accounting for more than 30% of
More informationURINARY TRACT INFECTIONS IN THE ELDERLY. Karen Hoffmann, RN, MS, CIC, FSHEA, FAPIC Clinical Instructor, UNC School of Medicine
URINARY TRACT INFECTIONS IN THE ELDERLY Karen Hoffmann, RN, MS, CIC, FSHEA, FAPIC Clinical Instructor, UNC School of Medicine DISCLAIMER The views and opinions expressed in this lecture are those of this
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 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 informationINFECTION SURVEILLANCE
INFECTION SURVEILLANCE IN LONG-TERM CARE 5 TH ANNUAL WYOMING INFECTION PREVENTION CONFERENCE, 2015 Russ Forney, PhD, MT(ASCP), Mountain-Pacific Quality Health THE PROBLEM Long-Term Care Acute Care Time
More informationKey Definitions. Downloaded from
Key Definitions In order to make sure that every member of the team is clear about the definitions that will be used, we have provided a list of key terms in the next few pages along with commonly used
More informationChildren s Services Medical Guideline
See also: NICE Guidelines These local guidelines are in conjunction with NICE UTI Algorithms Renal scarring and subsequent nephropathy are important causes of later hypertension and renal failure. Early
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 informationAsymptomatic bacteriuria When to screen and when to treat
Infect Dis Clin N Am 17 (2003) 367 394 Asymptomatic bacteriuria When to screen and when to treat Lindsay E. Nicolle, MD Departments of Internal Medicine and Medical Microbiology, University of Manitoba,
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 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 informationURINARY TRACT INFECTION
A LITTLE YELLOW INFECTION CONTROL BOOK Cartoons in this booklet by URINARY TRACT INFECTION http://www.davegibb.com.au/index.htm YES, IT IS A BACTERIURIA BUT IS IT A SYMPTOMATIC UTI? Resources For other
More informationP. Brandstrom has documented that he has no relevant financial relationships to disclose or conflict of interest to resolve.
P. Brandstrom has documented that he has no relevant financial relationships to disclose or conflict of interest to resolve. Prophylaxis or not? Per Brandström Queen Silvia Children s Hospital Gothenburg
More informationUTI : Requiem for a Heavyweight. Tom Finucane Maryland ACP February 3, 2018
UTI : Requiem for a Heavyweight Tom Finucane Maryland ACP February 3, 2018 No relevant disclosures Objectives 1. Report an involuntary shudder and feeling of unease each time the phrase UTI is uttered.
More informationUrinary Tract Infections in LTC
Urinary Tract Infections in LTC Barbara Grace Cowie, RN MN Nurse Continence Advisor Advanced Practice Nurse Introduction My goal is to provide you with a summary of related research evidence This is only
More informationEvidence Based Management of Urinary Tract Infections
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)
More informationCatheter-Associated Urinary Tract Infection (CAUTI) Event
Catheter-Associated Urinary Tract Infection () Event Introduction: The urinary tract is the most common site of healthcare-associated infection, accounting for more than 30% of infections reported by acute
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 informationCatheter-Associated Urinary Tract Infection (CAUTI) Event
Catheter-Associated Urinary Tract Infection () Event Introduction: Urinary tract infections (UTIs) are tied with pneumonia as the second most common type of healthcare-associated infection, second only
More informationGuidelines for the management of urinary tract infections in children 0-17 years
Guidelines for the management of urinary tract infections in children 0-17 years Guideline to be used where appropriate in conjunction with the Ashford and St Peter s sepsis guideline (Dr Ruth Mew 2016)
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 informationUTI Myths. Dr. Shruti Patel, MD, MPH.
UTI Myths Dr. Shruti Patel, MD, MPH. Objectives Epidemiology Pathogenesis Risk factors Diagnosis Special Scenario Asymptomatic Bacteriuria Treatment Prophylaxis Epidemiology Most common outpatient infection
More informationChronic urinary tract infections icd 10
Approximate Synonyms. Acute lower urinary tract infection; Acute upper urinary tract infection; Acute urinary tract infection; Bacterial urinary infection; Bacteriuria; Bacteriuria (bacteria in urine);
More informationState of Kuwait Ministry of Health Infection Control Directorate. Guidelines for prevention of catheter associated urinary tract infection
State of Kuwait Ministry of Health Infection Control Directorate Guidelines for prevention of catheter associated urinary tract infection Updated 2010 1 Introduction: The urinary tract is one of the most
More informationTypes of Intermittent Catheters and Access to Urological Supplies
Types of Intermittent Catheters and Access to Urological Supplies Anna Markiewicz; Sr Reimbursement Specialist Hollister Incorporated Lydia Cannady; Sr Product Manager Hollister Incorporated Why Catheterize?
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 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 informationGuidance for Industry Complicated Urinary Tract Infections: Developing Drugs for Treatment
Guidance for Industry Complicated Urinary Tract Infections: Developing Drugs for Treatment DRAFT GUIDANCE This guidance document is being distributed for comment purposes only. Comments and suggestions
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 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 informationFever Without a Source Age: 0-28 Day Pathway - Emergency Department Evidence Based Outcome Center
Age: 0-28 Day Pathway - Emergency Department EXCLUSION CRITERIA Toxic appearing No fever Born < 37 weeks gestational age INCLUSION CRITERIA Non-toxic with temperature > 38 C (100.4 F) < 36 C (96.5 F) measured
More informationURINARY TRACT INFECTIONS: Focus on CA UTIs
URINARY TRACT INFECTIONS: Focus on CA UTIs William A. Rutala, Ph.D., M.P.H. Director, Statewide Program for Infection Control and Epidemiology and Research Professor of Medicine, University of North Carolina
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 Infection in Women Over the Age of 65: Is Age Alone a Marker of Complication?
Urinary Tract Infection in Women Over the Age of 65: Is Age Alone a Marker of Complication? Michael L. Grover, DO, Jesse D. Bracamonte, DO, Anup K. Kanodia, MD, Frederick D. Edwards, MD, and Amy L. Weaver,
More informationReducing CAUTI Rates in MSICU by implementing a CAUTI Bundle
Reducing CAUTI Rates in MSICU by implementing a CAUTI Bundle Organization Name: St. Joseph Medical Center Type: Acute Care Hospital Contact Person: Jackie Galluzzo RN BSN Title: ICP E-Mail: JacquelineGalluzzo@catholichealth.net
More informationDOWNLOAD OR READ : URINARY TRACT INFECTIONS IN CHILDREN PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : URINARY TRACT INFECTIONS IN CHILDREN PDF EBOOK EPUB MOBI Page 1 Page 2 urinary tract infections in children urinary tract infections in pdf urinary tract infections in children MID 11
More informationNIH Public Access Author Manuscript Infect Dis Clin North Am. Author manuscript; available in PMC 2014 July 02.
NIH Public Access Author Manuscript Published in final edited form as: Infect Dis Clin North Am. 2014 March ; 28(1): 75 89. doi:10.1016/j.idc.2013.10.004. Diagnosis and Management of Urinary Tract Infection
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 information