URINARY TRACT INFECTION

dr.RODMAN TARIGAN, SpA.,MKes

UTI is the common term for conditions in
which there is growth of bacteria within the
urinary tract
Bacteriuria is presence of bacteria in
bladder urine
Growth of > 100.000 colony forming units
significant
AETIOLOGY
Escherichia coli (80-90% acute UTI)
(70-80% recurrent UTI)
Proteus, Staphylococcus epidermidis &
aureus, Enterococcus, Pseudomonas,
Klebsiella.
CLASSIFICATION
1. Clinical Problem
-Non complicated UTI (Non obstructive)
-Compilcated UTI (Obstructive)
- Abnormality urinary tract
- Abnormality immunology system
- Renal impairment
With or without symptom
- Symptomatic
Frequent syndrome
Acute pyelonephritis
Acute prostatitis
-Asymptomatic
PATHOGENESIS
1. Ascenderen (95%)
2. Hematogen (3%)
3. Lymphogen
LABORATORY
PYURIA
A. urine sedimen, leucocytes 5/HPF
B. urine leucocytes (non centrifuge)
2. BACTERIA IN URINE (non
centrifuge)
2 bact/10 HPF or 5 bact/HPF
3. CHEMICAL TEST
a. Nitrite test
b. Methylen blue reductase test
URINE SAMPLE LABORATORY
1. Perineal bag steril

2. Urine mid stream

3. Catheterization

4. Suprapubic aspiration
INTERPRETATION OF THE RESULT URINE
CULTURE
Sample Colony Culture UTI
Midstream >100.000 1 80%
>100.000 2 96%
Catheterization >100.000 1 95%
Supra pubic > 1 bact Gr - 1 99%
> 1000 bact Gr+ 1 99%
DIAGNOSIS
- SYMPTOMS

- PYURIA

- TRUE BACTERIURIA
CLINICAL PRESENTATIONS
- The symptoms of children with UTI
depend on the level of the infections as
well as the age of child
- Neonatal : anorexia, lethargy, feeding
difficults, body tenderness, hypothermia
- Infants : non toxic
- Childhood : classical symptoms

Management of Acute
Symtomatic
1. Eliminate infection
2. Establish clinical and microbiological
survailence to ensure
3. Prevent further infection
ANTI BACTERIAL
TREATMENT
Depend : culture & resistensi test

1. Bactericid & Bacteriostatic
2. No side effect
3.After treatment increase therapeutic level
4. Easy
5. No resistance
COMPLICATION
- Evaluate ---- Anomaly. VUR
and other obstruction

ren & CRF damage
If +
1. Prophylactic antibiotic
a. Complicated UTI, recurrence 3 X or
more in one year ( 1-2 years)
B. Uncomplicated UTI recurrence 3X or
more in one year (3-6 months)

Drugs : Nitrofurantoin, cotrimoxazol
Radiology : PIV, MSU, USG, Cyntigrahpy,
Cistography, Tomography computer, after
4-6 weeks no infections.
Urology intervention