Urinary Tract Infection - Definition, Classification, Etiology, Pathophysiology, Signs and Symptoms

Urinary Tract Infection

Definition

Urinary Tract Infection (UTI) is a condition of microorganism infection in the urinary tract (Agus Tessy, 2001).
Urinary Tract Infection (UTI) is a state of bacterial infection of the urinary tract (Enggram, Barbara, 1998).


Classification

Types of urinary tract infections include:

1. Bladder (cystitis)
2. Urethra (urethritis)
3. Prostate (prostatitis)
4. Kidney (pyelonephritis)

Urinary Tract Infection (UTI) in old age, can be divided into:

1. Uncomplicated UTI (simple)
   Simple UTI that occurs in patients with urinary tract that is not good, normal anatomic and functional. This UTI in advanced age mainly concerns female sufferers and infection only affects the bladder superficial mucosa.
2. Complicated UTI
   Often cause many problems because often the germs that cause it are difficult to eradicate, the germs that cause it are often resistant to some kinds of antibiotics, often occur bacteremia, sepsis and shock. This UTI occurs when there are the following conditions:
   
   • Abnormalities of the urinary tract, such as stones, urethral urethral reflex obstruction, bladder atony, paraplegia, permanent bladder catheters and prostatitis.
   • Renal physiology abnormalities: ARF or CRF.
   • Impaired immune system.
   • Infections caused by virulent organisms such as the spp-producing prostate urease.

Etiology

1. Types of microorganisms that cause UTI, including:

• Escherichia Coli: 90% causes of uncomplicated UTI, (simple)
• Pseudomonas, Proteus, Klebsiella: causes of complicated UTI
• Enterobacter, staphylococcus epidemidis, enterococcus, and others.

2. The prevalence of causes of UTI in old age, among others:

• Remaining urine in the bladder increases due to ineffective emptying of the bladder
• Decreased mobility
• Nutrition is often poor
• Decreased immune system, both cellular and humoral
• There is an obstacle in the flow of urine
• Loss of the bactericidal effect of prostate secretion

Pathophysiology

Urinary Tract Infections are caused by the presence of pathogenic microorganisms in the urinary tract. These microorganisms enter through: direct contact from the nearest infection site, hematogen, lymphogen.

There are two main pathways for UTI, asending and hematogenous. Asending, namely:

• The entry of microorganisms in the bladder, among others: anatomic factors in which women have shorter urethra than men so that the incidence of UTI is higher, urinary pressure factors when micturition, faecal contamination, installation of tools into the urinary tract (cystoscopic examination, use of a catheter), the presence of infected pressure sores.
• Rise of bacteria from the bladder to the kidneys

Haematogenous namely: often occurs in patients whose immune system is low so as to facilitate the spread of hematogenous infections. There are several things that affect the structure and function of the kidneys so as to facilitate the spread of hematogenous, namely: the presence of a total urine dam resulting in bladder distension, intrarenal dam due to scarring, and others.
In the elderly, the occurrence of UTI is often caused by:

• Remaining urine in the bladder increases due to incomplete or ineffective emptying of the bladder.
• Mobility decreases
• Nutrition is often not good
• A decreased system of immunity
• There are obstacles in the urinary tract
• Loss of the bactericidal effect of prostate secretion.

The increased amount of urine in the bladder results in excessive distention resulting in pain, this condition results in a decrease in resistance to bacterial invasion and the residual urine becomes a bacterial growth medium which in turn results in impaired kidney function itself, then this condition is hematogenously spread to all urinary tracts. . In addition, some things that predispose to UTI, among others: the presence of proximal urinary flow obstruction which causes the accumulation of pressurized fluid in the renal pelvis and ureters called hydronephrocess. Common causes of obstruction are: scarring of the kidneys, stones, neoplasms and prostate hypertrophy that are often found in men over the age of 60 years.


Signs and symptoms

Signs and symptoms of UTI at the bottom (cystitis):

• Frequent pain and burning sensation when urinating
• Spasame in the bladder and suprapubis area
• Hematuria
• Back pain can occur

Signs and symptoms of upper UTI (pyelonephritis)

• Fever
• Shivering
• Pelvic and hip pain
• Pain when urinating
• Malaise
• Dizzy
• Nausea and vomiting

BIBLIOGRAPHY

• Doenges, Marilynn E. (1999)
• Engram, Barbara. (1998).
• Parsudi, Imam A. (1999).
• Price, Sylvia Andrson. (1995).
• Smeltzer, Suzanne C. (2001).
• Tessy Agus, Ardaya, Suwanto. (2001).

Tag : Urinary Tract Infection