SEARCH RESULTS FOR: lower-urinary-tract-infections-complications

lower-urinary-tract-infections-complications

Predisposing Factors:
Immunocompromised state, diabetes, 
elderly, female (short urethra), stagnant 
urine (anatomical variant, obstruction, 
neurogenic bladder, urinary reflux)
Bacterial entry (Less Common):
Indwelling catheter, surgical inoculation, 
hematogenousspread, trauma
(Staphylococcus, Enterococcus, Candida)
Fecal bacteria access urethra 
(E. coli, Proteus, Klebsiella)
Impairment of body's natural defense 
systems, or stagnant urine, allow for 
bacterial accumulation
Portal of entry bypasses body's physical 
defenses (gravity and repetitive outward 
urine flow)
Bacterial fimbriae and pili allow 
them to ascend urethra and 
adhere to epithelium 
Lower Urinary Tract Infection (LUTI): Pathogenesis and clinical findings
Suprapubic 
Tenderness
Bacterial colony irritates 
urinary epithelium
Urgency:
Sensation of need to urinate 
quickly or impending 
incontinence
Stimulation of 
inflammatory 
response 
Stimulation of urinary reflex
Pathogens use 
enzymes to reduce 
nitrate to nitrite 
Delirium in Elderly
Frequency:
Repetitive need to 
urinate
Unique response of altered fluid 
status, electrolytes and mental 
status, likely as a result of 
increased inflammatory cytokines 
Lower Urinary Tract Infection (“Cystitis”): 
Infection of bladder or distal tract by capable bacteria 
colonizing epithelium and causing symptoms
Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published March 16, 2014 on www.thecalgaryguide.com
Author: 
Brett Edwards
Reviewers:
Riley Hartmann
Jan Rudzinski
Haotian Wang
Steve Vaughan*
* MD at time of publication
Usual Pathogens (“KEEPS”):
K – Klebsiella
E – E. coli (90%)
E – Enterococcus, Enterobacteriaceae
P – Proteus, Pseudomonas
S – Staph. saprophyticus, Serratia
Urine Findings:
↑ Colony Count (>107 CFU/L)
↑ WBC (>10 WBC/μL)
(+) Bacterial culture
(+) Nitrites, Leukocyte Esterase
(+) Foul, turbid urine
+/- Hematuria (rare)