Lower UTI
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lower UTI
• very common • secondary to resp infections • generally d/t bacterial infections (usually E Coli) • normal flora in genitalia migrating to urethra = common cause • can also arise from normal flora in gut migrating to UT • microbes can enter the circulatory system and cause sepiticemia
who is it more common in?
women d/t anatomic proximity of the vagina to the anus urethral entry (ascending infection into the bladder)
if it’s a lower UTI which structures does it affect and if its an upper UTI which structures does it affect?
lower = urethra and bladder upper = ureter and kidney
defenses
• washout • IR • periurethral flora in women: microbial antagonism (normal flora utilize resources and prevent establishment of invasive microbes) • mucin layer on surface of transitional epithelium • prostatic fluid in men: antibacterial properties
expand on the defense of the mucin layer
• secreted by cells that line the bladder • coats the bladder wall • composed of glycoproteins • provides a barrier between microbes and epithelial lining of bladder wall
risks
• catheterization - obstruction of urethra -> urine stasis in bladder and reflux
manifestations
• acute onset • lower back pain and abd pain • frequency • dysuria
diagnosis
• based on manifestations • labs but not if uncomplicated C&S -> identify bacteria and what Abx to use Urinalysis -> dipstick to look for leukocytes
treatment
• Abx -> broad spectrum, alter tx once C&S is analyzed (1 wk of abx) • fluids (helps flush out bacteria and w voiding) • address underlying cause