URINARY TRACT

INFECTION
Definition

• Urinary Tract Infection (UTI) is the presence and

multiplication of antimicrobial pathogens within the
normally sterile urinery tract.
• Women are most at risk of developing a UTI. About half of
all women will develop an UTI episode during their
lifetimes, and many will experience more than once.
• UTI is the second most common type of infection in human,
Pembagian ISK dibagi menjadi
Etiologi
Faktor Predisposisi ISK
FAKTOR PREDISPOSISI ISK
• Litiasis
• Ostruksi Saluran Kemih
• Penyakit ginjal polikistik
• Nekrosis papilar
• Diabetes Mellitus pasca transplantasi ginjal
• Nefropati analgesik
• Penyakit Sikle-cell
• Senggama
• Kateterisasi

• Kehamilan dan peserta KB dengan tablet progesteron

Manifestasi Klinis
Pyelonephritis
• Infection of the kidney
• symptoms – fever, nausea, vomiting, headache
• Diagnosis:
• Urinalysis, urine culture, CBC
• Treatment:
• 2-weeks of Trimethroprim/sulfamethoxazole or fluoroquinolone
• Hospitalization and IV antibiotics if patient unable to take po.
• Complications:
• Perinephric/Renal abscess:
• Suspect in patient who is not improving on antibiotic therapy.
• Diagnosis: CT with contrast, renal ultrasound
• May need surgical drainage.
• Nephrolithiasis with UTI
• Suspect in patient with severe flank pain
• Need urology consult for treatment of kidney stone
Prostatitis
• Symptoms:
• Pain in the perineum, lower abdomen, testicles, penis, bladder
irritation,, and sometimes blood in the semen
• Diagnosis:
• Typical clinical history (fevers, chills, dysuria, malaise, myalgias,
pelvic/perineal pain, cloudy urine)
• Will have an increased PSA
• Urinalysis, urine culture
• Treatment:
• Trimethoprim/sulfamethoxazole, fluroquinolone or other broad
spectrum antibiotic
• 4-6 weeks of treatment
Urethritis
• Chlamydia trachomatis
• Frequently asymptomatic in females, but can present with
dysuria, discharge or pelvic inflammatory disease.
• Treatment:
• Azithromycin – 1 g po x 1
• Doxycycline – 100 mg po BID x 7 days
• Neisseria gonorrhoeae
• May present with dysuria, discharge,
• Send UA, urine culture
• Treatment:
• Ceftriaxone – 125 mg IM x 1
• Ciprofloxacin – 500 mg po x 1
• Levofloxacin – 250 mg po x 1
• Ofloxacin – 400 mg po x 1
• Spectinomycin – 2 g IM x 1
Complications of UTI

The most serious consern in a UTI is if to avoid its

progress to acute pyelonephritis.

Fortunately acute uncomplicated pyelonephritis in rarely

progresses to renal functional impairment and chronic
renal disease.
 Diagnostic Testing
• Proteinuria, pyuria, hematuria microskopis are ususally found in
urinalysis, glomerular cast is a sign for pyelonephritis.
• The urine culture is an important diagnostic procedure to
determine the type and number of bacterian in urine.
• Urine culture and antimicrobial susceptibility testing.
• Ultrasound exam to look for stones and obstruction.
• BNO – IVP to look for structural abnormality.
Penatalaksanaan
Penatalaksanaan
Pencegahan

• Minum air mineral kurang lebih 2L/hari

• Jangan menahan jika ingin BAK
• Jaga kebersihan
• Untuk wanita, hindari penggunaan spray atau sabun khusus
untuk daerah kewanitaan
• Bersihkan daerah genital dari arah depan ke belakang
• Gantilah pembalut secara teratur
TERIMA KASIH