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UTI Tubulointerstitial Drugs

UTI Tubulointerstitial Drugs

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Published by Vaibhav Krishna

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Published by: Vaibhav Krishna on May 19, 2010
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01/24/2013

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URINARY TRACTURINARY TRACTINFECTIONINFECTION
DR. B. PaudelDR. B. Paudel
 
 
OVERVIEW:OVERVIEW:
UTI is an extremely common medical problem.UTI is an extremely common medical problem.
Many infections resolve spontaneously, but mayMany infections resolve spontaneously, but mayprogress to renal impairment/sepsis.progress to renal impairment/sepsis.
UTI implies causation by gram negative gut floraUTI implies causation by gram negative gut floraof the group Enterobacteraciae. Rarely, UTI canof the group Enterobacteraciae. Rarely, UTI canresult from virus, fungus, TB, staph etc.result from virus, fungus, TB, staph etc.
Diagnosis of UTI is the exclusion of infectionsDiagnosis of UTI is the exclusion of infectionswhich only involve the urethra, such aswhich only involve the urethra, such asgonococcal urethritis or the acute urethralgonococcal urethritis or the acute urethralsyndromesyndrome
 
 
DIAGNOSISDIAGNOSIS
::
Normal urine is sterile.Normal urine is sterile.
UTI: a single viable gram -ve bacterium inhabits theUTI: a single viable gram -ve bacterium inhabits theurinary tract (kidney, ureters, bladder).urinary tract (kidney, ureters, bladder).
Most people with urinary tract infection have 10Most people with urinary tract infection have 10
44
-10-10
66
 bacteria/ml. The acute number will depend on the urinebacteria/ml. The acute number will depend on the urineflow rate, characteristics of the urine, the duration of flow rate, characteristics of the urine, the duration of infection, etc.infection, etc.
1010
55
bacteria/ml of “clean catch” urine to diagnose UTI isbacteria/ml of “clean catch” urine to diagnose UTI isused since at this level, < 1% of the representused since at this level, < 1% of the representcontaminants.contaminants.
At counts of 1000-10,000/ml, there is a 50/50 chance theAt counts of 1000-10,000/ml, there is a 50/50 chance theresult represents contamination (two different c/s showresult represents contamination (two different c/s showsame organism-confirms true infection).same organism-confirms true infection).
The second criteria for diagnosing UTI is the presence of The second criteria for diagnosing UTI is the presence of pyuria (> 5 WBC/HPF) on the urinalysis.pyuria (> 5 WBC/HPF) on the urinalysis.

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