What is the definition of a urinary tract infection (UTI)?
Presence of microorganisms with invasion of adjacent tissues that are part of the genitourinary system.
What are the main anatomical classifications of UTIs?
UTIs can be classified based on the anatomical location:
- Kidney (pyelonephritis)
- Bladder (cystitis)
- Urethra (urethritis)
What are the clinical classifications of UTIs?
UTIs are classified clinically as:
- Primary infection
- Recurrent infection
- Reinforcement infection
What is a primary infection in the context of UTIs?
The initial episode of a UTI caused by a microorganism infecting the urinary tract.
What is a recurrent infection in UTIs?
A UTI that occurs after a previous infection, typically defined as >2 episodes in 6 months or >3 episodes per year.
What is a reinforcement infection in UTIs?
After successful resolution of a UTI, an infection with the same microorganism occurs up to 3 weeks later.
What defines a new UTI infection after eradication?
Appearance of a new infection by a different microorganism after 7-10 days of having eradicated a previous UTI.
What are the common bacterial causes of UTIs?
Common bacterial causes include:
- Escherichia coli
- Klebsiella
- Proteus mirabilis
- Pseudomonas aeruginosa
- Staphylococcus saprophyticus
- Enterococcus faecalis
- Streptococcus agalactiae
What are non-bacterial causes of UTIs?
Non-bacterial causes include:
- Fungi: Candida spp.
- Viruses: Cytomegalovirus (CMV)
- Parasites: Trichomonas vaginalis, Schistosoma spp.
What are the mechanisms of UTI pathogenesis?
Mechanisms include:
- Systemic spread
- Colonization of kidneys
- Ascension to kidneys
- Biofilm formation
- Colonization and invasion of bladder
- Ascension via urethra
- Contamination of periurethral area
What are the clinical signs and symptoms of pyelonephritis?
Pyelonephritis symptoms include:
- Renal fossa pain
- Fever
- Chills
- Nausea
- Vomiting
What are the clinical signs and symptoms of cystitis?
Cystitis symptoms include:
- Pelvic pain
- Polakiuria (frequent urination)
- Hematuria (macro or micro)
- Straining
- Tenesmus
What are the clinical signs and symptoms of urethritis?
Urethritis symptoms include:
- Dysuria (painful urination)
- Polakiuria
- Purulent discharge (e.g., in Neisseria gonorrhoeae infections)
How is cystitis classified based on frequency?
Cystitis is classified as:
- Isolated or simple: Single episode
- Recurrent: >2 episodes in 6 months or >3 episodes per year
What are the specific symptoms associated with cystitis?
Cystitis-specific symptoms include:
- Tenesmus
- Polakiuria
- Urgency
- Terminal drip
- Hematuria
What defines pyelonephritis pathologically?
Pyelonephritis is the inflammation of the kidney parenchyma due to bacterial infection.
What are the risk factors for UTIs in women?
Risk factors in women include:
- Short urethra
- Proximity of urethra to anus
- Sexual activity
- Pregnancy
- Menopause (decreased estrogen)
What are the general risk factors for UTIs?
General risk factors include:
- Obstruction (e.g., kidney stones, prostatic hypertrophy, tumors)
- Vesicoureteral reflux
- Narrow urethra
- Pregnancy
What are the clinical features of a moderate UTI?
Moderate UTI features:
- Fever
- With or without flank pain
- Dysuria
- Polakiuria
- Bladder urgency
What are the clinical features of a severe UTI?
Severe UTI features:
- High fever (peaks at 72 hours)
- Nausea
- Vomiting
- Flank pain
What laboratory tests are used for UTI diagnosis?
Laboratory tests include:
- Blood tests
- General urine test
- Urine culture with antibiogram
What are the sensitivity and specificity of leukocyte esterase in UTI diagnosis?
Sensitivity: 83%
Specificity: 78%
What are the sensitivity and specificity of nitrites in UTI diagnosis?
Sensitivity: 53%
Specificity: 98%
What are the sensitivity and specificity of leukocytes in UTI diagnosis?
Sensitivity: 73%
Specificity: 81%
