Sunteți pe pagina 1din 22

I nterna de Medi ci na: Angi e k.

Paredes Caturi ny
Manejo de la ITU
Invasin, colonizacin y proliferacin bacteriana del tracto urinario, que puede comprometer desde la vejiga
hasta el parnquima renal.
Defnicin
rev chil Pediatr 2012; 83 (3): 269-278

Infeccin liitada a
la ve!i"a # a la
$retra% &'
frec$ente en
$!ere' a#(re' de
2 a)('*
+I,-I-I,

infeccin .$e
c(/r(ete el
/ar0n.$ia renal*
1' la f(ra &'
"rave de it$ en
ni)('*
-
Piel(nefriti'
a"$da
(P23)

Pre'encia de
$r(c$ltiv( /('itiv( #
a$'encia de
arcad(re'
in4aat(ri(' en el
e5aen (rina
c(/let( en
/aciente' 'in
'int(at(l("6a
cl6nica*
7acteri$ria
a'int(&tic
a
I-8 91+89912-1
I-8 91+89912-1
12 1 3:;
rev chil Pediatr 2012; 83 (3): 269-278
3 ( <
I-8
=a!a
2 ( <
P23
1 I-8
=a!a >
P23
Prevalencia: ?@
Incidencia: 3*1A1000 ni)a' (0-1Ba)(')
1*7A1000 ni)(' (0-1B a)(')
1l 9C8: 30-B0@ en D 2a)(' /('t I-8
EP23: 1n ni)(' D2a)(' c(n I-8 fe=rilF
1/idei(l("ia
G 3'(ciacin 1'/a)(la de Pediatr6a
40-
70%
40-
70%
P23: Harcad(r de an(al6a nefr($r(l("ica
P23: Harcad(r de an(al6a nefr($r(l("ica
G 3'(ciacin 1'/a)(la de Pediatr6a
P23
;
le'in
a"$da
Iie=re
<2Bh
ante' de
3-7
<39
J+
9C8<
III
P23:
G 3'(ciacin 1'/a)(la de Pediatr6a
Ke'in /eranente
renal
P23
en
"e'ta
nte
L-3
I9+
Ke'i(n /eranente renal
Ke'i(n /eranente renal
G 3'(ciacin 1'/a)(la de Pediatr6a
D2a)('
9etra'(
de
trataient
(
I-8
rec$rrente
9C8<III
8r(/atia
(='tr$ctiv
a
IT previa.
!istoria de fiebre recurrente sin foco.
"iagnstico antenatal de anomal#a renal.
$ntecedente familiar de reflujo vsico ureteral %rvu& o enfermedad renal.
'onstipacin.
"isfuncin miccional.
'horro dbil.
(lobo vesical.
)asa abdominal.
*esin espinal.
!T$.
)al desarrollo pondoestatural*
Iact(re' de 9ie'"( I-8
rev chil Pediatr 2012; 83 (3): 269-278
-a=la II* 3i'laient(' =acteri(l"ic(' en ni)(' c(n I-8 n( c(/licada
Microorganismo. Porcentaje
1'cherichia c(li 7?-90 @
Mle='iella '/ 1-8 @
Pr(te$' '/* 0%?-6 @
1nter(=acter '/* 0%?-6 @
P'e$d((na aer$"in('a 1-2 @
1nter(c(c( 3-8 @
1'tafl(c(c( 2-? @
;tr(' 1-2 @
3'(ciacin 1'/a)(la de Pediatr6a
MANIFESTAI!NES "INIAS
MANIFESTAI!NES "INIAS
Dia"n('tic(
rev chil Pediatr 2012; 83 (3): 269-278
Uroc#
lti$o
%ositi
$o
L+K
15* f6'ic(
15* De
(rina
Ka $e'traN
Ka $e'traN
rev chil Pediatr 2012; 83 (3): 269-278
7(l'a
rec(lect(r
a
9ec(lecci
n de 2J
ch(rr(
2(
inva'
iva
,(nde(
tran'$retr
al
P$ncin
ve'ical
Inva'
iva
rev chil Pediatr 2012; 83 (3): 269-278
"e# &'(c &)0 #l
7acterir$ria <15c
3/(#( dia"n('tic(: 8r(c$ltiv( /endiente
Tira
reacti$a
Sedimento de
orina
rev chil Pediatr 2012; 83 (3): 269-278
K(caliOacin del nivel de la I-8
+inti"ra
a
renal
c(n
DH,3
1c("raf6
a renal
1c("raf
a renal
c(n
/(Per
d(//ler
;=!etiv(' de la -era/ia
-93-3HI12-;

; = t e n e r l a e ! ( r 6 a
c l 6 n i c a

1 v i t a r l a d i ' e i n a c i n d e
l a e n f e r e d a d

1 v i t a r c ( / l i c a c i ( n e ' a
l a r " ( / l a O (
-93-3HI12-; 32-I7I;-I+;
I-8 =a!a: 1J linea: (1-B) trataient( (ral c(n cefal('/(ria'*
<B: 2itr(f$rant(ina% c(tri(5aO(l% cefal('/(rina'
2J Kinea: .$in(l(na' D: 3-Bdia'
I-8 alta: <3% /$ede reci=ir tera/ia (ral anti=i(tica de'de el
inici(*
L('/italiOacin: D3% 'e/'i' cl6nica% in$n('$/re'in%
vit(' falta de re'/$e'ta a tera/ia a=$lat(ria D-: 7-10
dia' 92: 10-1Bdia'
1JKinea: D3 a/icilina > ain("lic('id( ( cefal('/(rina de
3J"eneraci(n*
<3: cefal(i'/(rina'
2J Kinea: ain("l$c('id(' ( .$in(l(na'
*+AIAS