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Urinary Tract Infections

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Submitted By estradac
Words 1359
Pages 6
Evaluation & Management of
Urinary Tract Infections

UTI - Topics
Ø Epidemiology
Ø Definition/

Classification

Ø Diagnosis
Ø Pathogenesis/ l Risk Factors

GU “Zones”: Perineal, Bladder, Ureteral,
Renal

Ø Radiological

Evaluation/ Management

2

UTI Epidemiology
Ø Only

during 1st year of life, males have more UTI than females
Ø Uncircumcised boys 10X risk than noncircumcised
Ø U.S. Healthcare Cost and Utilization
Project (HCUP) (Freedman, 2004) l l

51/100,000 children & 174/100,000 infants hospitalized annually with UTI
Girls hospitalized 2.5X more than boys
3

UTI Epidemiology
Ø UTI

= 2.4 – 2.8% of physician visits
Ø Cost: (HCUP + National Association of
Children’s Hospitals and Related
Institutions [NACHRI]) l l l 40,000 admissions for UTI per year
Mean cost of $4500 per child for each UTI
= $180 million/year without factoring the ambulatory visits
4

Definition of UTI
Ø What

defines a “significant” clinical UTI controversial Ø Urinary tract normally sterile
Ø “Colonization” v. “Infection” is debatable Ø Collection technique is related to the reliability for UTI diagnosis

5

Classification of UTI
Ø Many

vague classification systems in use: complicated v. uncomplicated, upper v. lower tract, persistent v. reinfections, symptomatic v. aysmptomatic Ø Most useful clinically: first infection v. recurrent or “other” infections

6

UTI - Diagnosis
Ø Symptoms

of dysuria, urgency, frequency and enuresis are nonspecific
Ø Fever as a marker for pyelonephritis: sensitivity (53-84%) and specificity (44-92%)
Ø Urinalysis and urine culture
Ø Serum tests?
Ø Radiologic testing
7

Urine collection
Ø Bagged

specimen
Ø Midstream void
Ø Catheterization
Ø Suprapubic aspiration Less Invasive, not

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