The Urinary Tract Infections - Coursework Example

THE URINARY TRACT INFECTIONS A DISCUSSION OF URINARY TRACT INFECTIONS 9th April, 2012 Abstract Urinary tract infections occurs when micro-organisms enter the urinary tract system, persists on mucosa linings causing a disease. Its the second most common group of human diseases but are not serious and treatment is easily achievable after a single antibiotic therapy. Usually starts as a lower urinary tract infections where by patients experiences pain, discomfort and frequent small volume urination, and may progress into upper urinary tract infections leading to nausea, fever and other systemic symptoms. Generally urinary tract infections are common in females due to predisposition of urethra and surrounding organs. The patient s should be subjected into an immediate diagnosis and proper treatment when clinical symptoms are suspected, to avoid spread or systemic disease development. Introduction The urinary tract infections (UTIs) occurs when disease causing micro-organisms enters the urinary tract system (UT). The urinary tract comprises of organs such as the urinary bladder, urethra, a pair of ureters and the kidneys. Bacteria are the most causal agents of urinary tract infections, most commonly Escherichia coli (E. coli) and in a lesser extent by Mycoplasma which only affects the urethra. However urinary tract infections can be caused by fungal infections for instance Chlamydia, or viral infections affecting only urethra or with the reproductive system. The infections results to inflammation of the urethra (urethritis), urinary bladder (cystitis), but sometimes if early treatment is not administered the disease causing microbes may ascend from the ureters into the kidneys causing pyelonephritis (Foxman and Schaefer, 2011). Infection starts when microbes enter the urinary tract system especially from the bowell microbes, but for Chlamydia and Mycoplasma micro-organisms may be sexually transmitted prompting treatment of sexual partners against such infections. Urinary tract infections are the second most common group of infections, causing discomfort and pain they easily responds to antibiotic therapies and therefore rarely serious conditions. The urinary tract has several mechanisms to prevent systemic infections, but some bacteria may be persistent and attach onto its lining mucosa causing these infections. For instance before micro-organisms ascend through urethra into urinary bladder, urine washes them out avoiding disease development. Also the point ureters attach onto the bladder is a one-way valves which prevents urine and thus micro-organisms in the urinary bladder, from going up toward the kidneys (Foxman and Schaefer, 2011). The immune system prevents infection along the urinary tract. Generally women are more prone to these type of infections, as their urethra is shorter allowing fast ascend of microbes into the urinary bladder, and it opens near microbes sources from anus and vagina. Male's prostate gland releases certain secretion that slow bacterial growth. Urinary tract infections depends on various predisposing factors, including poor personal hygiene, central nervous system injuries affecting urinary bladder emptying, sexual intercourse exposures, urinary tract obstruction especially in enlarged prostate and kidney stones, diabetes, certain family control technique in women, and prolonged catetherisation of patients. Nervous interruption of urinary bladder emptying of urine and any urinary tract obstruction may cause proliferation of bacteria in urine causing these infections. Chronic diseases and other physiological processes such as pregnancy may lower body immunity and this can easily lead to urinary tract infections. During sexual intercourse especially for women (as seen by high urine microbial count after sex), bacteria can be massaged into urethral opening leading to a possibility of these infections. Birth control methods may also predispose urinary tract infections occurrence especially in women, this is due to skin surface irritation by spermicides, diaphragm urine obstruction, and condom related traumas. Prolonged insertion of catheters into the urethra interferes with normal clearance of microbes by the body, and through it bacteria may enter urinary tract and attach to a catheter-related traumatised mucosal lining causing disease (Beyere and Tsegaye, 2011). Recurrent urinary tract infections may be a problem of a lifetime to most women, due to improper approaches to treatment and prevention. Urinary tract infections (UTIs) Significance Urinary tract infections mostly are not serious infections, and their response to antibiotics is good, though they cause pain and discomfort on patients. Urinary tract infections can be transmitted sexually especially those caused by Chlamydia and Mycoplasma organisms, causing infections of partners. The ascending infections from urinary bladder into ureters and kidney causes pyelonephritis. Pyelonephritis may disseminate bacteria into the circulatory system resulting into septicaemia and blood further spread the infection causing a systemic disease which is life threatening (Foxman and Schaefer, 2011). Also urinary tract infections may lead to reproductive system infections, causing reproductive health problems such as infertility or pregnancy complications. Early treatments and proper management of recurrent cases of urinary tract infections, is therefore a very important health issue. Urinary tract infections symptoms Depending on the level of ascent, urinary tract infections may portray different symptoms. Early infections which involves only the lower urinary tract system, it is characterised by symptoms such as, urinary bladder or urethral pain/burns feelings on urination, frequent and intense urge to urinate small volumes of urine. When the infections spread to the upper urinary tract system, these patients develops weakness, and muscle aches, lower abdominal pains, high frequency in urination in small volumes, cloudy or bloody foul smelling urine. On pyelonephritis the symptoms will be back pain , frequent chills and fever and sometimes there is nausea feelings and vomiting together with symptoms of lower urinary tract infections. Fever indicates that th infections have spread into the kidney, prostate and even into the circulatory system (septicaemia). Patient specimen collection, methods for collecting urine The only specimen sample taken from patients of urinary tract infections is urine, and this is very important in clinical diagnosis of these conditions and therefore treatment. In order to perform a quality sample analysis (urinalysis), a clean catch of urine is required which is free of normal flora (microbes) or environmental/skin bacteria (Foxman and Schaefer, 2011). This is achieved by tapping urine at halfway on urination aseptically into a sterilised container. These depends on the patient and generally specimen collection can be done in different ways which includes; Paediatric Special plastic bags are used with a sticky strip on one end, and for infants another collection bag may be required. Wash the genital organs and fit the bag into the organs, then you can check to obtain the clean urine sample (Gauthier et al., 2012). Adult male Clean the penis with a sterile wipe, and may retract the fore skin if not circumcised. Urinate a small volume of urine into the toilet bowl, before taking a clean sample with a sterilised bowl and then empty the rest of the urinary bladder into toilet. Adult female Fingers are used to spread labia and using two separate wipers clean labia and urethral opening to remove normal flora. While labia being open urinate a small volume of urine into toilet, before taping a clean sample in a sterilised bowl for urinalysis and empty urinary bladder into toilet. Surgical and other patients Surgical patients may give their sample on surgery, paracentesis where by the urine is aspirated by a needle and a syringe across abdominal cavity, or by catheterisation. This procedures are useful when there is chronic infections or a total or partial obstruction, resulting to anuria (no urination). Laboratory diagnosis Laboratory diagnosis on a clean catch urine specimen is analysed in a process called urinalysis. Physical and biochemical characteristics of urine is tested, and first increased bacteria counts and white blood cells in urine is a sign of urinary tract infections the urine becomes turbid. Bacteria count under light microscopy and media inoculation of bacteria cultures are the major diagnostic tools for urinary tract infections. Sensitivity cultures in specific media may be prepared to determine antibiotic suitable for that particular infection. Treatment options Treatment of urinary tract infections depends on severity or recurrence of the disease and it is based on use of antibiotics, because of a good response achieved on administration. This is commonly applied when there is urinary bladder and lower urinary tract system infections (Foxman and Schaefer, 2011). Depending on sensitivity test in the laboratory diagnosis, an effective antibiotics is prescribed for patients. Medical prescriptions should not be stopped at halfway dose even if symptoms subsides because effective cure may not have been achieved. For recurrent and persistent infections, preventive measures should be taken into consideration for the patients (Grimes and Lukacz, 2011). Usually different treatment regime can be advocated to assist these patients cope with this problem, especially for women and this can done through various treatment regimes as follows; Low doses of prescribed medication at night for longer than 6 months Single dose after sexual intercourse 3 days dose on clinical symptoms Good hygiene especially for women after visiting a toilet, should wipe themselves front to back Proper body hydration by drink plenty of water every day, not advised for diabetic patients Cotton under wears advised to avoid dampness urinate as frequent as the urge arises Wash microbes by urinating after sexual intercourse Change current birth control methods and Intake of Vitamin C for acidic urine hindering bacterial growth. Conclusion Urinary tract infections are a very important group of infections in human medicine, due to their economic and health importance. Its advisable to go for laboratory diagnosis once clinical signs are manifested, for early identification and treatment of these infections thus avoiding spread to partners or systemic infections (which are fatal). Treatment dose after a sensitivity test should be fully administered even after clinical signs have disappeared, to avoid recurrence or developing resistance and becoming carriers. References Betsy Foxman and Anthony Schaefer (2011), Urinary Tract Infections in Adults; Kidney and Urologic Information ClearingHouse (NKUDIC) Beyene G, Tsegaye W (Jul, 2011), Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in jimma university specialized hospital, southwest ethiopia. [Journal Article] Ethiop J Health Sci 2011 Jul; 21(2):141-6. Grimes C L and Lukacz E S (Nov, 2011), Urinary Tract Infections, [Journal Article] Female Pelvic Med Reconstr Surg; 17(6):272-8. Gauthier M, Gouin S, Phan V, et al. (2012), Association of Malodorous Urine With Urinary Tract Infection in Children Aged 1 to 36 Months. [JOURNAL ARTICLE] Pediatrics 2012 Apr 2 Read More