UTI: Topic Breakdown
- Introduction and definition
- Classification
- Lower versus upper UTI
- Uncomplicated versus complicated UTI
- Community-acquired versus catheter-associated UTI
- Recurrent UTI and asymptomatic bacteriuria
- Urinary-tract anatomy and normal defenses
- Etiology / causative organisms
- Pathogenesis and pathophysiology
- Risk factors
- Clinical features
- Acute cystitis
- Acute pyelonephritis
- Urosepsis
- Diagnosis
- Urinalysis, urine microscopy and culture
- Blood tests and blood culture
- Imaging indications
- Treatment
- Supportive care
- Antibiotic selection principles
- Uncomplicated cystitis
- Pyelonephritis and complicated UTI
- Special situations
- Pregnancy
- Children
- Men
- Older adults
- Catheter-associated UTI
- Recurrent UTI and prevention
- Complications, red flags, and clinical algorithms
Brief overview
A urinary tract infection (UTI) is an infection involving any part of the urinary system: urethra, bladder, ureters, or kidneys. Most are bacterial infections caused by organisms ascending from the periurethral area into the bladder. The commonest pathogen is uropathogenic Escherichia coli.
A lower UTI, usually acute cystitis, produces dysuria, urinary frequency, urgency, and suprapubic pain. An upper UTI, or acute pyelonephritis, involves the renal pelvis and kidney and can cause fever, flank pain, vomiting, and systemic illness. It is more serious because it can progress to bacteremia and sepsis.
Diagnosis is primarily clinical, supported by urinalysis and urine culture when indicated. Treatment depends on infection site, illness severity, pregnancy status, sex, kidney function, local antimicrobial resistance, and whether the infection is complicated. Do not treat bacteriuria in a person without urinary symptoms except in selected situations, chiefly pregnancy and before certain invasive urologic procedures.
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