감염내과_ Uncomplicated UTI and Complicated UTI

1. Complicated UTI

1) Overview

- Presence of metabolic, anatomic, and functional abnormalities

- Underlying disease prone to complicated UTI

- Risk factors: Male gender, Elderly, Pregnancy, Catheterization, Diabetes, Infection stones

2) Etiology

- E. coli, Klebsiella spp

3) Structural and functional abnormality

- Obstruction: Ureteric/urethral strictures, Tumors, Urolithiasis

- Instrumentation: Indwelling urethral catheter

- Impaired voiding: Neurogenic bladder, Cystocele

- Metabolic abnormalities: Nephrocalcinosis, Renal failure

4) Diagnosis

- Urine Analysis, Urine Culture

5) Treatment

- Antimicrobial therapy

2. Uncomplicated UTI

1) Overview

- No structurally and functionally abnormal urinary tract

- No underlying disease prone to acquire UTI

- Acute cystitis, pyelonephritis in nonpregnant outpatient women w/o anatomic abnormalities or instrumentation of the urinary tract

- Asymptomatic bacteriuria

- Infection involving normal urinary tract

2) Etiology

- Acute Uncomplicated Cystitis: E. Coli(70-95%), Staphylococcus saprophyticus(10-15%)

- Acute Uncomplicated Phyelonephritis: E. Coli(80%)

3) Symptoms

- Uncomplicated Cystitis: Dysuria, Frequency, Urgency, Hematuria, Suprapubic pain

- Uncomplicated Pyelonephritis: Fever, Flank pain, Nausea, Vomiting, Abdominal pain

4) Diagnosis

- Urine Analysis: Dipstick method, Microscopic analysis

- Urine culture

5) Treatment

- Uncomplicated Cystitis: Short term antibiotics