UrinaryTractInfection(尿路感染全英文)

CASE 1 32 year-old woman; DysBiblioteka Baiduria and frequency; Pyuria in the urine sediment; Gram negative bacilli. Escherichia coli (E. coli) .
CASE 2 65 year-old woman; Dysuria and frequency; Pyuria; Gram positive cocci. Enterococcus faecalis
Classification of UTIs（1）
Anatomic

Lower UTI:
urethritis 2. cystitis (mucosal infection)
1.

Upper UTI:
pyelonephritis 2. prostatitis 3. intrarenal and perinephric abscesses (tissue invasion)
TongjiHospital,TongjiU niversity
Content
Definitions 2. Epidemiology 3. Etiology 4. Pathogenesis 5. Pathology 6. Clinical presentation 7. Diagnosis 8. Treatments 9. Complication 10. Prevention
E. coli
Enterobacter Enterococcus Klebsiella Proteus Staphylococcus
E. coli
Etiology（2）
Causative organisms:
Escherichia coli Klebsiella, proteus and pseudomonas 1- Bacteria S. aureus, Staphylococcus epidermidis and S. saprophyticus
1.
Definition of UTI
UTI is defined as the presence of microorganisms in the urinary tract.
Most patients with UTI have significant bacteriuria, i.e. bacterial colony counts ˃ 105 /ml, in a mid-stream “clean catch” urine.
Conversely, colony counts ＜ 105/ml of midstream urine are occasionally due to specimen contamination. Acute urethral syndrome: dysuria, urgency, and frequency, but without bacteriuria.
CASE 3 18 year-old woman Dysuria and frequency; Pyuria; Gram positive cocci; Staphylococcus.
1.
Classification of UTIs（2）
Clinical

Uncomplicated UTI: 1. Lack structural or functional abnormalities of the urinary tract 2. Normal flow of urine 3. NO interference with the normal defenses
Complicated UTI: 1. Predisposing lesion of the urinary tract, structural or functional abnormalities, e.g. congenital abnormality of the urinary tract, stone, obstruction, catheter…. 2. Interference with the normal defenses, e.g. immunosuppression, renal disease, or diabetes.

Classification of UTIs（3）
Epidemiology

1.
Catheter-associated（nosocomial）infections:
Symptomatic 2. Asymptomtic

1.
Non Catheter-associated acquired）infections:
Asymptomatic bacteriuria is more common among elderly men and women.


Etiology（1）
Community-Acquired UTI
gram-negative bacilli is the most common agent
Enterococci (Streptococcus faecalis粪链球菌)
Mycobacterium tuberculosis Chlamydia trachomatis, Neisseria gonorrhoeae 2- Virus 3- Fungus 4- Protozoon Herpes simplex virus , HIV Candida, Histoplasma capsulatum Trichomonas vaginalis, Schistoma haematobium
（
community-
Symptomatic 2. Asymptomtic
Epidemiology

Almost half of all women will have at least one UTI in their lives. UTI is uncommon in men under the age of 50, but very common among women.