Urinary Tract Infections - Causes, Symptoms and Treatment .MF .
Every year a huge number of patients, both adults and children's age, regardless of gender, is faced with a serious health problem like a urinary tract infection.Women suffer from this infection more often than men, but men in the development of urinary tract infections expects a tendency to a prolonged and even severe disease.
Urinary tract infection - is an inflammatory disease urinary system caused by infectious microorganisms having relapsing course with possible development of complications.
urinary system (urinary tract) is a single set of bodies to form urine and its separation from the body, it is a serious allocation system, from the smooth functioning of which depends not only on the state of the human body, but also the patient's life in some cases (in case of acute renal failure).Consist urinary tract from the kidney bean-shaped (in which the formation of urine), ureters (them urine into the bladder), the bladder (a reservoir for urine), urethra or the urethra (urine release out).
urinary tract play an important role in maintaining the water-salt balance of the body, the development of a number of hormones (EPO, for example), the release of the body of a number of toxic substances.Per day on average it is allocated to 1.5-1.7 liters of urine, the amount of which may vary depending on the fluid intake, salt, urinary tract diseases.
risk for urinary tract infections:
- Female gender (women suffer from such infections is 5 times more often than men, this is due to the physiological characteristics of the female organism - short and wide urethra Because with an infection more easily penetrate into the urinary tract).
- Children under the age of 3hletnego (immune deficiency, in particular, infection sochevydelitelnoy systems are the most common cause of fever of unknown origin in boys up to 3 years).
- The elderly due to the development of age-related immunodeficiency.
- Patients with structural features of the urinary tract (eg, enlarged prostate can obstruct the bladder outflow of urine).
- Patients with renal impairment (eg, urolithiasis, in which stones are an additional risk factor for the development of infections).
- Patients of branches of resuscitation and intensive care (these patients required at any time limit the excretion of urine via the urinary catheter - this is the entrance gate of infection).
- Patients with chronic diseases (eg, diabetes, in which there is a high risk of urinary tract infections by lowering the body's resistance).
- Women applying some methods of contraception (eg, diaphragmatic ring).
Factors predisposing to the occurrence of urinary tract infections are:
1) hypothermia (the bulk of the problems of this nature occur in the cooler months),
2) the presence of respiratory infection in a patient (marked part of the activation of urological
infections in the season of colds),
3) reduced immunity,
4) violation of the outflow of the different nature of the urine.
causes of urinary tract infections
The kidney is formed by microorganisms completely sterile urine, it contains only water, salt and various metabolic products.Infectious agent first penetrates into the urethra, which has created favorable conditions for its reproduction - develop urethritis.Next, apply the above to the bladder, in which there is inflammation of its mucous membrane - cystitis.In the absence of adequate medical care for the infection enters the ureters into the kidneys with the development of pyelonephritis.This is the most frequent type of ascending infection.
anatomy of the urinary system
Pathogens that cause urinary tract infections:
1) E. coli (Escherichia coli).This pathogen is a member of the normal flora of the colon and its getting into the urethra is mainly due to non-observance of rules of personal hygiene.Also, E. coli is almost always present on the vulva.90% of all urinary tract infections associated with E. coli it.
2) Chlamydia and mycoplasma - organisms, affecting mainly the urethra and reproductive system of ducts.Transmitted mainly through sexual contact and hit the genitourinary system.
3) Klebsiella, Pseudomonas aeruginosa may be the causative agents of urinary tract infections in children.
4) Periodically meet streptococci serogroups A and B.
How bacteria can enter the urinary tract:
1) Failure to comply with rules of personal hygiene after using the restroom.
2) During sexual intercourse, and anal sex.
3) When using certain contraceptive methods (diaphragmatic ring, spermicides).
4) In children this inflammatory changes due to stagnation of urine in the urinary tract diseases of various kinds.
Symptoms of urinary tract infections
What are the clinical forms of urinary tract infections are found in medical practice?It is an infection of the urethra or the urethra - urethritis ;bladder infection - cystitis ;Infection and inflammation of the kidneys - pyelonephritis .
also distinguish two main types of infection - is an infection ascending and descending.When ascending infection inflammation affects anatomically located below the organs of the urinary system, and then there is the spread of infection to the upper organs.An example is the cystitis and the subsequent development of pyelonephritis.One reason for the rising infection is the so-called functional character of the problem in the form of vesicoureteral reflux, which is characterized by a reverse current of urine from the bladder into the ureters and kidneys, even.Downward infection more clear by birth.In this case, the infectious agent is propagated from the higher sections mochevyvydelitelnoy located in lower system, for example, from the kidney to the bladder.
Many cases of infectious diseases of the urinary system are asymptomatic.Yet, for certain shapes have certain clinical symptoms for which patients complain more often.For the majority of patients are characterized by nonspecific symptoms: weakness, malaise, fatigue, irritability.This symptom is a fever unfounded at first sight (temperature) - in most cases a sign of inflammation in the kidney.
When urethritis patients concerned : stinging during urination, pain and burning sensation at the beginning of urination, discharge from the urethra muco-purulent character, with a specific smell.
Cystitis observed frequent urination, which can be painful, accompanied by painful sensations in the abdomen, feeling inadequate emptying of the bladder, sometimes the temperature can be raised.
pyelonephritis is characterized by the appearance of pain in the lumbar region, fever (acute process), fever, symptoms of intoxication (weakness, body aches), urinary disorders and the patient can not feel.Only when ascending infection can be confusing at first pain during urination, frequent urination.
summary, we list the symptoms of the urinary tract infections that require treatment to the doctor:
1) pain, cramps and burning during urination;
2) frequent urination;
3) abdominal pain in the lumbar region;
4) pain in the suprapubic region in women;
5) temperature and symptoms of intoxication without the phenomena of cold;
6) urethral discharge mucopurulent character;
7) change in urine color - becomes cloudy, the appearance of mucus, flakes, streaks of blood;
Features of urinary tract infections in children
Common causes of urinary tract infection in children - is obstruction of the urinary tract, various functional disorders, phimosis, congenital malformations of the urogenital tract, a rare bladder emptying.
Symptoms of urinary tract infections in children may be erased.Kids up to 1,5 years with such an infection can become irritable, whiny, refuse to eat, can not be very high, but causeless temperature currently treated poorly by conventional antipyretic drugs.Only from the age of two the child complains of pain in the abdomen or back, pain in the abdomen, you will notice frequent urination, urination disorders, body temperature often rises than is normal.
outcome of urinary tract infection in a child usually favorable, but there are consequences sclerosis renal tissue, hypertension, protein in the urine, impaired renal function.
Features of urinary tract infections in pregnant
Up to 5% of pregnant women suffer from inflammatory diseases of the kidney.The main reasons for this include hormonal changes the body during pregnancy, decreased immunological defense of the body, changing the location of some bodies associated with the growing fetus.For example, due to the increasing size of the uterus, there is pressure on the bladder, there are congestion in the urinary organs, and eventually lead to the proliferation of microorganisms.Such changes require frequent monitoring of this system in a pregnant woman.
Features of urinary tract infection in men
First of all, the reasons leading to the occurrence of urinary tract infections in men are different from women.This is basically the like pathology urolithiasis and increased size of the prostate.It disrupted the flow of urine and inflammatory changes in the urinary system.The program of treatment of men in this regard included such a clause as removing obstacles to the flow of urine (a stone, for example).Also some problems delivering chronic inflammation of the prostate gland, which requires massive antibiotic therapy.
diagnosis of urinary tract infections
preliminary diagnosis is based on clinical complaints of the patient, but not in all cases, it is sufficient for setting the correct diagnosis.For example, pyelonephritis may be accompanied only by the temperature and symptoms of intoxication, pain does not appear in the first days of illness.Therefore, no additional laboratory studies the doctor make a diagnosis difficult.
Laboratory diagnosis includes:
1) General clinical tests: complete blood count, urinalysis, biochemical blood tests (urea, creatinine) and urinary (diastasis).
most informative in the primary stage of a urinalysis.For the study takes an average serving of morning urine.In the study, the number of white blood cells, red blood cells, making it possible to suspect bacteriuria (bacterial inflammation).Also informative indicators such as protein, sugar, specific gravity.
2) bacteriological method (urine culture on special culture media in order to detect them in the growth of certain types of microorganisms), in which an average serving of morning urine is drawn in a sterile container;
3) PCR (for negative bakposeve and continuing mochevyvyodyaschih tract infection) - to identify microorganisms such as Chlamydia, Mycoplasma.
4) Instrumental methods of diagnosis: ultrasound of the kidneys and bladder, cystoscopy, radiopaque research or intravenous urography, radionuclide studies, and others.
Basic principles of treatment of urinary tract infections
1. security measures : polupostelny home treatment regimen for infections of the urinary system, and on the testimony of hospitalization or therapeutic urology department of a hospital.Compliance with the diet including salt restriction mode and a sufficient amount of liquid in the absence of renal failure.When kidney disease show a diet number 7, 7a, 7b for Pevzdneru.
2. Etiotropic treatment (antibacterial) includes a diverse group of drugs that
appoint a doctor after the correct diagnosis.SELF lead to the formation of antibiotic resistance of the pathogen infection and occurrence of frequent relapses of the disease.For treatment applied: primetoprim, Bactrim, amoxicillin, nitrofurans, ampicillin, fluoroquinolones (ofloxacin, ciprofloxacin, norfloxacin), if necessary - the combination of drugs.The course of treatment is 1-2 weeks, rarely longer (with concomitant pathology, development of septic complications, urinary system abnormalities).After treatment necessarily carried out monitoring the effectiveness of treatment of a complete laboratory testing, the designated physician.
Advanced cases of urinary tract infections with the formation of a prolonged course sometimes require longer courses of treatment etiotrop total duration of several months.
physician recommendations for the prevention of protracted course of urinary tract infections:
- drinking regime (adequate fluid intake during the day);
- the timely emptying of the bladder;
- hygiene of the perineum, the daily shower instead of a bath reception;
- Careful hygiene after sex;
- avoid self antibiotics;
- avoid spicy and salty foods, taking coffee;
- drink cranberry juice;
- slash up to the complete elimination of smoking;
- the period of treatment to avoid sexual intimacy;
- exclude alcohol.
Features therapeutic interventions in pregnant women:
When registering urinary tract infections in pregnant therapeutic measures are carried out without delay, for the prevention of more serious problems (premature delivery, toxemia, hypertension).The choice of antibiotic is for the doctor and depends on the duration of pregnancy, evaluation of its effectiveness and the possible risks to the fetus.Appointment of drugs is strictly individual.
3. Posindromalnaya therapy (fever with temperature, urological fees, herbal
uroseptiki eg Phytolysinum, immunomodulators, etc.).
4. Herbal medicine against infections of the urinary tract : used infusions of herbs (birch leaves, bearberry, herb horsetail, dandelion root, juniper fruit, fennel fruit, black elderberry, parsley fruits, chamomile flowers and others).
main problem of urinary tract infections - frequent development of relapsing forms of infection. This problem is typical mainly for women, each 5th woman after the initial debut of urinary tract infection occurs with the repetition of all the symptoms, that is, the development of relapse and sometimes frequent relapses.One of the important properties of recurrence - is the formation of new strains of microorganisms modified with an increase in the frequency of relapses.These modified strains of bacteria have become resistant to and specific drugs that will certainly affect the quality of the treatment of the following infections exacerbations.
recurrences of urinary tract infections can be linked:
1) with incomplete primary infection (due to abnormally low doses of antimicrobials, non-compliance with treatment, the development of resistance of the pathogen to the drug);
2) with a long persistence of the pathogen (the pathogen's ability to attach to the mucous membrane of the urinary tract, and long to be in the focus of infection);
3) with the occurrence of reinfection (reinfection with a new pathogen periurethral space, direct kischki skin of the perineum).
prevention of infections of the urinary system
1) The importance of preventive measures is given timely readjustment of foci of chronic
bacterial infection (tonsillitis, sinusitis, cholecystitis, dental caries, etc.) from which the infection can spread to the bloodstream and hit the urinary system.