Urinary Tract Infections (UTIs) Lecture Notes

Introduction

• Focus of the lecture: Urinary Tract Infections (UTIs)
• Importance of understanding pathophysiology of UTIs
• Note availability at engineer.org

Anatomy of the Urinary Tract

• Components: kidneys, ureters, bladder, urethra
• Normal flow:
  • Kidneys produce filtrate
  • Filtrate flows down to bladder, then out through urethra

Causes of UTIs

• Common causative agents: Escherichia coli (E. coli)
• Mechanisms:
  • Infection can arise from various pathogens (viruses, fungi, bacteria)
  • Backflow due to obstructions or anatomical abnormalities can lead to infections

Risk Factors for UTIs

• Gender: Women are at higher risk due to:
  • Shorter urethra
  • Proximity of rectum to the urethra
• Medications:
  • Antibiotics can disrupt normal flora, allowing harmful bacteria to thrive
• Immunosuppression:
  • Conditions like diabetes increase risk due to glucose in urine
• Urinary Catheters: Provide a pathway for bacteria into the bladder
• Obstructions:
  • Kidney stones, enlarged prostate, etc. can cause retention and infection
• Hygiene Issues:
  • Improper cleaning techniques (e.g., wiping back to front)

Signs and Symptoms of UTIs

• Common symptoms include:
  • Burning sensation during urination (dysuria)
  • Increased frequency and urgency of urination
  • Dark, strong-smelling urine
  • Lower back pain (flank pain)
  • Fever and general malaise
  • Confusion or incontinence in geriatric patients

Diagnostic Procedures

• Urinalysis:
  • Clean catch mid-stream urine sample is preferred
  • Testing may reveal blood, white blood cells, and bacteria
• Urine Culture:
  • Identifies specific pathogens for targeted treatment
• Imaging:
  • Ultrasound or CT scans to identify obstructions or abnormalities

Treatment of UTIs

• Antibiotics:
  • Common types include sulfa drugs and fluoroquinolones
  • Watch for allergic reactions and educate on side effects (e.g., Achilles tendon rupture)
• Analgesics:
  • Pyridium (turns urine orange) for pain relief
• Symptomatic Treatment:
  • Tylenol for fever, Zofran for nausea

Patient Education

• Emphasize completing prescribed antibiotics
• Hydration: Encourage intake of ~3 liters of fluids daily
• Caution with cranberry juice in cases of cystitis
• Promote good hygiene practices:
  • Wipe front to back
  • Daily showers and avoiding baths and wet swimsuits
• Regularly empty bladder: Urinating every 3-4 hours
• Avoid irritants: Alcohol, caffeine, and certain soaps

Conclusion

• Summarized key points on UTIs, their causes, symptoms, diagnostics, treatment, and patient education strategies.
• Encouragement for further study and review.