Urinary Tract Infection: Difference between revisions
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Australian Institute of Sport and the Australian Paralympic Committee position statement: urinary tract infection in spinal cord injured athletes | |||
http://bjsm.bmj.com.libproxy.bellarmine.edu/content/49/19/1236.full | |||
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Revision as of 04:01, 22 March 2016
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Kaylee Whitehead, Melanie Anderson, Cate Hurst, Kim Jackson, Lucinda hampton, Vidya Acharya, Temitope Olowoyeye, Elaine Lonnemann, Krista Polanin, WikiSysop and Nicole Hills
Definition/Description[edit | edit source]
Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
Urinary Tract infections that are left untreated may lead to many complications, including urosepsis, systemic inflammatory response syndrome (SIRS), and chronic kidney infections. Sepsis associated with UTIs often requires hospitalization [5]. Urosepsis spreads into the bloodstream from its origin in the urinary tract. Kidney infections also progress to the blood stream, referred to as septicemia [9]. This complication can be life threatening. Systemic inflammatory response syndrome can also become life threatening if treatment fails. SIRS is usually the first incidence of multi-organ failure [10].
Medical Management (current best evidence)[edit | edit source]
Urinary tract infections are most commonly treated by antibiotic prescription. Frequently prescribed antibiotics include [8]:
- Nitrofurantoin
- Amoxicillin
- Trimethoprim
- Fluoroquinolones
Antibiotics are usually taken anywhere from 3 days to 10 days, depending on severity of symptoms, comorbidities, complications of infection, and dosage [1] [8]. Overutilization of antibiotics is a common issue, particularly in hospitals and long term facilities, which may cause patients to develop resistance to the medication over time [1].
Alternative treatment includes the use of probiotics, ensuring proper hydration, drinking cranberry juice, and urinating frequently [2] [5] [9]. Using a heating pad on the patient’s lower back or abdomen may also help the symptoms of the UTI [9]. Surgery may be required in the presence of an anatomical abnormality [8].
Physical Therapy Management (current best evidence)[edit | edit source]
Physical therapists that are trained in pelvic floor dysfunction can greatly improve a UTI patient’s quality of life. A typical approach includes manipulative techniques, local heat, breathing and relaxation techniques, postural education, muscle coordination reeducation, and behavioral therapy [3]. Therapists are also encouraged to educate the patient on drinking and voiding schedules to ensure consistency [6]. Treatments and patient education have been found to improve efficiency of emptying the bladder, create better bowel habits, and promote full relaxation of the pelvic-floor when voiding [3]. All of these factors may lead to a decreased incidence and reoccurrence of UTIs.
For those patients in the hospital, recent studies have shown that mobilization of patients with a catheter is safe and is not associated with urinary-related adverse effects, including urinary tract infections [4].
Differential Diagnosis[edit | edit source]
Other conditions that can cause symptoms similar to UTI include:
- Herpes genitalis (HSV)
- Urethritis
- N. Gonorrhoeae
- Chlamydia
- Trichomonas
- Vaginitis
- Prostatitis
- Nephrolithiasis
- Trauma
- GU tuberculosis
- GU neoplasm
- Intra-abdominal abscess
- Sepsis [7]
In post-menopausal women
In children
Case Reports/ Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Physiotherapy For Women With Recurrent Urinary Tract Infection: A Promising Approach
Pelvic floor therapy in girls with recurrent UTIs
Resources
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American Urological Association
http://www.auanet.org/education/adult-uti.cfm
NYU School of Medicine Department of Urology
http://www.med.nyu.edu/urology/patient-care-information/conditions-we-treat/recurrent-urinary-tract-infections#diagnosis
European Association of Neurology
http://uroweb.org/wp-content/uploads/19-Urological-infections_LR2.pdf
Choices in Health
http://choicespc.net/physical-therapy-for-urinary-problems-and-pelvic-floor-dysfunction/
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
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Australian Institute of Sport and the Australian Paralympic Committee position statement: urinary tract infection in spinal cord injured athletes
http://bjsm.bmj.com.libproxy.bellarmine.edu/content/49/19/1236.full
References[edit | edit source]
see adding references tutorial.