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SUPERVISOR:
Dr. Rahmawati, Sp.PD KGH

Urinary Tract Infections

PRESENTED BY :
1. SILVA RAHMA, S.KED
2. JULIANA SAFITRI, S.KED
3. VIVI ROVINA, S.KED
4. FADHILATUL KHAIR, S.KED
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URINARY TRACT INFECTIONS ARE AMONG THE

MOST PREVAILING INFECTIOUS DISEASES WITH A
SUBSTANTIAL FINANCIAL BURDEN ON SOCIETY. IN
THE US, UTIS ARE RESPONSIBLE FOR > 7 MILLION
PHYSICIAN VISITS ANNUALLY. APPROXIMATELY 15%
OF ALL COMMUNITY-PRESCRIBED ANTIBIOTICS IN
THE US ARE DISPENSED FOR UTI AND DATA FROM
SOME EUROPEAN COUNTRIES SUGGEST A SIMILAR
RATE. IN THE US, UTIS ACCOUNT FOR > 100,000
HOSPITAL ADMISSIONS ANNUALLY
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WHAT IS URINARY TRACT INFECTIONS?

Urinary tract infection (UTI) is a

collective term that describes any 1. Kidneys produce
urine.
infection involving any part of the
2. Ureters transport
urinary tract, namely the kidneys, urine.

ureters, bladder and urethra. The 3. Urinary bladder

stores urine.
urinary tract can be divided into the
upper (kidneys and ureters) and 4. Urethra passes
lower tract (bladder and urethra).
urine to outside.

Copyright The McGraw-Hill Companies, Inc. Permission required for

reproduction or display.
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Uncomplicated versus complicated UTI

Complicated UTI Uncomplicated UTI

An infection associated with a its occurrence in individuals

condition, such as a structural or without any identified risk factors
functional abnormality of the
genitourinary tract, or the
presence of an underlying
disease; this increases the risk of
the outcome of a UTI being more
serious than expected
Clinical presentation of the UTI and its 5
associated host risk factors
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Pathogenesis of UTIs

Ascending Infection (most

common) (e.g. E. coli and other
Enterobacteriaceae)
Blood borne spread
(Staphylococcus aureus, Candida
sp., Salmonella sp. and
Mycobacterium tuberculosis)
Lymphatogeneous spread
Direct extension from other organs
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Diagnosis

The symptoms focus on the anatomical level of infection, defined as:

Urethra: urethritis (UR) - (E. Coli)

Urinary bladder: cystitis (CY) - (E. Coli)
Kidney: pyelonephritis (PN) - K pneumonia
Bloodstream: sepsis (US) - Enterococcus sp.
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Urine dipstick analysis, as opposed to urinary microscopy, is a

reasonable alternative to urine culture to diagnose acute
uncomplicated cystitis.
Urine cultures are recommended for patients with risk factors for
complicated UTIs and in the following situations: (a) suspected
acute pyelonephritis; (b) symptoms that do not resolve or recur
within 24 weeks after completion of treatment; (c) women who
present with atypical symptoms; (d) pregnant women; and (e)
male patients with suspected UTI.
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Management

The choice of management option for UTIs depends on whether it is

simple (i.e. uncomplicated) or complicated. Simple uncomplicated
cystitis (lower UTI) responds very well to oral antibiotics.
In the management of pyelonephritis, clinicians need to correctly
differentiate between acute uncomplicated forms and complicated,
often obstructive, forms of UTI that require early appropriate imaging.
Early appropriate treatment can prevent urosepsis.
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Can anything be done to help
prevent UTIs?

Drink plenty of fluids.

Studies show that drinking a glass of cranberry juice each day may
help prevent recurrent UTIs.
Dont postpone going to the bathroom, urinate when you feel the
urge.
Women should also:
Wipe from front to back to prevent bacteria from the bowels from
getting into the urinary tract.
Cleanse the genital area every day and before having sex.
Empty your bladder completely before going to sleep.