The urinary tract and male reproductive system
C. Simon Herrington in Muir's Textbook of Pathology, 2020
Urinary tract infection may involve either the bladder or the kidneys and renal pelvis, or both. The single most important criterion for the diagnosis of urinary tract infection is the presence of bacteria in the urine, called bacteriuria. In urine obtained through a bladder catheter the presence of an organism is significant whereas in the commonly used midstream sample there may be some contamination by urethral or perineal organisms. In these latter samples a bacterial count of ≥105/mL is accepted as definitive of infection. Bacteriuria in the absence of symptoms is termed ‘asymptomatic bacteriuria’ and is of importance under two circumstances: In infancy, where, in the presence of ureteric reflux, it can lead to ascent of infection to the kidney.In pregnancy, where it may be followed by symptomatic infection predisposing to hypertension, pre-eclampsia, and prematurity.
Pregnancy, urinary tract infections and antibiotics
Peri J. Ballantyne, Kath Ryan in Living Pharmaceutical Lives, 2021
Pregnancy is the period in which a foetus grows and develops inside a woman’s body. The normal duration of a pregnancy is nine months or about 40 weeks. It is a physiological state in which women go through a number of physical and emotional changes. The physical changes can be accompanied by uncomfortable symptoms such as nausea or vomiting and cause women to seek medical support and advice. Among the many different types of health problems experienced during pregnancy, one common condition that can affect women is an infection of the urinary tract. A urinary tract infection (UTI) is normally caused by transfer of bacteria from the gut into the genitourinary tract where they can multiply and cause an infection (Flores-Mireles, Walker, Caparon, & Hultgren, 2015). Behaviours such as not drinking adequate water or wiping the genitals from back to front after urination are associated with developing urinary infections (Ghouri, Hollywood, & Ryan, 2018). UTIs are among the most frequently occurring infections in pregnancy and cause symptoms such as increased frequency of urination and burning pain when passing urine (Delzell & Lefevre, 2000). Infections can also be asymptomatic, however, meaning that bacteria can infect the urinary tract without any outward signs or symptoms.
The patient with acute renal problems
Ian Peate, Helen Dutton in Acute Nursing Care, 2014
One of the most common kidney infections is pyelonephritis. In many cases this is caused by the spread of bacteria such as Escherichia coli from the gut and, as with most urinary tract infection, it is more commonly seen in females due to the short urethra and the close proximity of the rectal and urethral openings. With pyelonephritis, the infection ascends into the bladder and then progresses to the ureters and eventually the kidneys, affecting the renal tubules and blood vessels. The symptoms are similar to those of all urinary tract infections in that they may include urgency and frequency of urination, pyrexia, back pain, increased leucocytes in the blood, dysuria and cloudy urine with bacteria present. If the infection becomes a chronic problem, scar tissue can form on the kidneys and lead to impaired function (McCance et al. 2010). Once infection is established other treatment is required in order to prevent long-term renal damage. This includes increased fluid intake to ‘flush’ the system (instigated for most patients unless there are specific reasons not to do so, such as fluid overload), antibiotic therapy and the prescription of antispasmodic drugs.
Urinary tract infection during pregnancy: current concepts on a common multifaceted problem
Published in Journal of Obstetrics and Gynaecology, 2018
Kallirhoe Kalinderi, Dimitrios Delkos, Michail Kalinderis, Apostolos Athanasiadis, Ioannis Kalogiannidis
Urinary tract infection (UTI) is a common health problem characterised by the presence of microbial pathogens in any part of the urinary tract including the kidneys, ureters, bladder or urethra. UTI is more common in women due to shorter urethra, closer proximity of the anus with vagina, as well as easier entry of pathogenic microorganisms by sexual activity (Mittal and Wing 2005). In pregnancy, it is considered as the most common bacterial infection with increased risks of maternal and neonatal (perinatal) morbidity and mortality (Foxman 2002). This review highlights the current knowledge on a UTI during pregnancy, focussing on the possible adverse maternal and neonatal outcomes, as well as the perspective of introduction of high-throughput DNA sequence-based techniques for urinary testing, in order to explore the role of resident urinary bacterial communities in health and disease.
Modified Zhibai Dihuang pill alleviated urinary tract infection induced by extended-spectrum β-lactamase Escherichia coli in rats by regulating biofilm formation
Published in Pharmaceutical Biology, 2023
Kaifa Chen, Yongsheng Zhu, Hongwei Su, Hao Jiang, Xin Liu
Urinary tract infections (UTIs) are infectious diseases caused by the abnormal reproduction of various pathogenic microorganisms in the urinary tract (Gupta et al. 2017). Complicated UTIs often lead to prolonged infection and eventually cause renal function damage and serious health hazards (Tandogdu and Wagenlehner 2016; Millner and Becknell 2019). Uropathogenic Escherichia coli (UPEC) is a typical bacterial UTI pathogen (Herrmann et al. 2002). Various virulence factors in the pathological group of UPEC provide more opportunities for bacterial survival (Behzadi et al. 2020). Currently, the main intervention measures for the clinical treatment of UTI are antibacterial drugs (Flores-Mireles et al. 2019). Approximately 60% of antibiotics are β-lactams, which have various chemical structures and are often used to treat different types of bacterial infectious diseases (Behzadi et al. 2020). The application of antimicrobials has led to β-lactamase production, resulting in drug-resistant bacterial strains (Issakhanian and Behzadi 2019). In a clinical study, 86% of ESBL-producing strains were isolated from UPEC, and there was neither a pattern of resistance nor ESBL production in UTI (Khonsari et al. 2021). The presence of extended-spectrum β-lactamase (ESBLs) E. coli makes the most common antimicrobial agent less effective in treating UTIs (Zowawi et al. 2015). Therefore, there is an urgent clinical need for alternative treatment options that target UTI pathogenesis.
Long-term urodynamic findings following radical prostatectomy and salvage radiotherapy
Published in Scandinavian Journal of Urology, 2018
Maria Ervandian, Jens Christian Djurhuus, Morten Høyer, Charlotte Graugaard-Jensen, Michael Borre
Before the urodynamic examination, a detailed medical history was obtained. Urine was analysed and tested to exclude the possibility of urinary tract infection. The urodynamic examination consisted of a spontaneous flow, registering flow type, maximum flow (Qmax), time to Qmax and voided volume, followed by residual urine measurement by way of catheterization. The uroflowmetry was followed by a filling cystometry and a pressure flow of voiding in a sitting position. This was repeated twice. A 6 Fr double-lumen catheter and a 9 Fr balloon catheter were used to assess the intravesical and abdominal pressures. Detrusor pressure was estimated as an electronic subtraction of intra-abdominal pressure from intravesical pressure. Saline was infused at a rate of 50 ml/min under the filling phase. Quality control coughs were performed at the start, every 1 min and at the end of the filling phase. Several values were measured during filling, including pressures and volumes at first sensation, normal desire, strong desire and maximal cystometric capacity. Bladder sensation was described as reduced or normal. Maximal cystometric capacity >350 ml was considered normal. During the storage phase, any sign of detrusor overactivity, defined as any involuntary detrusor contractions, was registered.