Study Guide for Urinary Tract Infection in Pregnant Women PATHOPHISIOLOGY
1. Bacteriuria occurs commonly in pregnancy, typically during early pregnancy. Without treatment, as many as 30 to 40 percent of pregnant women with asymptomatic bacteriuria will develop a symptomatic urinary tract infection (UTI). Other organisms responsible for infection included Klebsiella and Enterobacter species (3 percent each), Proteus (2 percent), and gram-positive organisms, including group B Streptococcus (10 percent).The smooth muscle relaxation and subsequent ureteral dilatation that occurs in pregnancy are thought to facilitate the ascent of bacteria from the bladder to the kidney, accounting for the greater risk of pyelonephritis. Additionally, untreated
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●As in nonpregnant women, Escherichia coli is the predominant uropathogen found in both asymptomatic bacteriuria and UTI in pregnant women.
3. ●Screening should be done for all pregnant women at least once for asymptomatic bacteriuria. Screening for asymptomatic bacteriuria is performed at 12 to 16 weeks gestation with a midstream urine for culture. The diagnosis is made by finding high-level bacterial growth (≥105 colony forming units [cfu]/mL) on urine culture in the absence of symptoms consistent with UTI.
4. ●Acute cystitis should be suspected in pregnant women who complain about new onset dysuria, frequency, or urgency. The diagnosis is made by finding of bacterial growth on urine culture in this
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Acute pyelonephritis during pregnancy is suggested by the presence of flank pain, nausea/vomiting, fever (>38ºC), and/or costovertebral angle tenderness, with or without the typical symptoms of cystitis, and is confirmed by the finding of bacteriuria in the setting of these symptoms. Pregnant women may become quite ill and are at risk for both medical (eg, sepsis, respiratory failure) and obstetrical complications from pyelonephritis
MEDS
6. ●Management of asymptomatic bacteriuria in pregnant women includes antibiotic therapy tailored to culture results, which reduces the risk of subsequent pyelonephritis and is associated with improved pregnancy outcomes. Potential options include beta-lactams, nitrofurantoin, and fosfomycin . Following treatment, follow-up cultures are performed to confirm sterilization of the urine. For those women with persistent bacteriuria, prophylactic or suppressive antibiotics may be warranted in addition to retreatment.
7. Management of acute cystitis in pregnant women includes empiric antibiotic therapy that is subsequently tailored to culture results. Potential options for empiric and directed therapy include beta-lactams, nitrofurantoin, and fosfomycin . As with asymptomatic bacteriuria, follow-up cultures are performed to confirm sterilization of the urine. For those women with persistent bacteriuria or recurrent cystitis, prophylactic or suppressive antibiotics may be warranted in addition to
A sample of the patients bacteria causing the urinary tract infection can only be used if a urine sample is bacteriologically viable (1 Radar). Infected urine and sterile urine are common samples used for the diagnosis of patients (1 Radar). It is important to gain further knowledge of multiple organisms’ resistance to antibiotics that cause urinary tract infections (1Radar). Escherichia coli has distinct characteristics and structures that help identify their unique properties (2 Johnson). Escherichia coli is the most common and most prevalent bacteria present in the fecal flora of the human colon (2 Johnson). Because of Escherichia coli unique ability to overcome the obstacles of a new environment, it makes easy for bacteria to spread into the urinary tract and produce a discomforting infection (2 Johnson). All research conducted lead to the belief that Escherichia coli was the Enterobacteriaceae pathogen causing the UTI in the patient. In order to confirm this prediction a set of differential tests and biochemical test must be conducted.
The four specific databases that were used in this research are, Cinahl, Medline, Joanna Briggs and Cochrane Library. All of these databases were chosen because they provided up to date peer reviewed evidence that was relevant to the search terms. This ensures that the evidence that was found was relevant and reliable. The Cinahl website was useful to gather background information on the topic such as how a UTI is contracted and how it effects the body. The Cochrane Library and Medline website was useful to because it gave specific information on studies that had already been done by other researchers. This helped to ensure that the study that is being undertaken was searching for the right results.
Which antibacterial agent(s) would be effective in the therapy of Mr BT’s urinary tract infection?
Although it is preferred that pregnant women do not take medications because of the affects it could have on the baby, there are a number of antibiotics that are effective in treating kidney and urinary tract infections that are known to be safe for both mother and baby. Such antibiotics are cephalexin, ampicillin, and
Authors suggested that the accurate diagnosis of a UTI will play a role in the cost-effective medical care and appropriate antimicrobial utilization. The objective of the article is to summarize the top ten, misconceptions of UTI that result in extraneous testing and antimicrobial treatment. This article is well organized, consist of an abstract, introduction, list the myths with mistaken beliefs pertaining to diagnosis, a discussion and conclusion. One reason this article was of an interesting choosing was, due to myth number, “falls and acute altered mental status changes in the elderly patient are usually caused by UTI.” The article suggests that elderly patients with acute mental status changes accompanied by bacteriuria, pyuria without clinical instability or other signs or symptoms of UTI can reasonably be observed for resolution of confusion for 24-48 hours without antibiotics, which searching for other causes. The article describes in detail that elderly patients with acute mental status change and functional decline are nonspecific and are clinical manifestation of several circumstances such as, dehydration, hypoxia, and ploy-pharmacy adverse reaction. In the discussion section, the article also suggests that an increase in education and evidence-based guidelines aimed at physicians, advance practice
Urinary tract infection also referred to as UTI is the second most common infection in the body. The urinary tract system in your body which includes the bladder and kidneys makes urine and carries it out of your body. When germs get into the urinary tract system an infection is typically formed. UTI’s are usually caused when unwanted bacteria enters through the urethra and begins to multiply (www.mayoclinic.org). The bacteria that are normally found in the large intestine and feces are the most common source of a UTI. Sexual intercourse is one of the common causes of urinary tract infections for women, causing bacteria to move up into the urinary tract. Sometimes in a hospital setting a patient who is on a catheter can also get a urinary tract infection.
The decision to have antibiotic treatment depends on you, if you have a low risk of having GBS. Some homeopathic physicians recommend taking herbal remedies to prevent infection a few weeks before delivery.
T.M. was admitted to the sub-acute unit for an UTI. UTI is usually cause by an organism called Escherichia coli. Risk factors for UTI in males can be bladder stones, kidney stones, an enlarge prostate, catheter use, or bacterial prostatitis. Some of the symptoms of UTI are burning sensation when urinating, frequent urination, fever, chills, foul smelling urine, urine retention, and lethargy. T.M. has a diagnosis of BPH and repeated history of UTI which increase his risk for UTI. A short-term goal will be that the patient will be display no UTI sign of symptoms. A long-term goal will be that the patient will demonstrate behavioral techniques to prevent future UTI. To accomplish these goals, the patient should be encouraged to void every 2 to
Most urinary tract infections are primarily caused by bacteria that live in the bowel region of the body. The bacterium Escherichia coli, commonly referred to as “E. coli”, causes most UTIs. The urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act as only one way valves to prevent urine from moving back up toward the kidneys. Urination is intended to wash microbes and any infectious bacteria out of the body. In males, the prostate gland produces secretions that slow down bacterial growth in the urinary tract. In both woman and men, immune defenses try to prevent infections, but despite these safety procedures put in place by the body, infections still do occur in some individuals.
UTI is an infection of the urethra, bladder, ureters and kidneys that occurs when bacteria gain access to the urinary system (Dailly, 2011). This makes a patient's urine to contain bacteria during a laboratory test, and this bacteria is more prone to being active when
When a person contracts a UTI, drugs are usually the first thing taken to try to get rid of the UTI. But, in recent studies, e.coli’s resistance to common UTI drugs is rising. Veronique Greenwood conducted a study in 2012 that showed the rise in drug resistance of e.coli bacterias. The study showed a 14% increase in resistance in the drug ciprofloxacin, a 6% increase in trimethoprim-sulfamethoxazole, the two most prescribed drugs. As the e.coli becomes resistant to these drugs, large problems can arise for many people. For instance, when the drugs become fully ineffective, a large population of people can become sick from the e.coli bacteria, or become harmed from the toxic drugs doctors would have moved onto. Also, is the bacteria is left untreated, the infection can spread from the urinary tract to the bladder and eventually to the kidneys causing kidney failure. In brief, whether contracted from a fecal incident, or unsanitized food, e.coli can be extremely dangerous and can result in a sickness or
factor for UTI.114 During the first 6 months of life, there are more uropathogenic organisms around the
Coli bacteria. In adjustment for an infection to occur, the E. Coli bacilli has to attach itself to the beef lining the float or the urethra (the tube that carries the urine out of the body). The ache of E. Coli that has been the a lot of acknowledged at causing a urinary amplitude infection has developed a circuitous set of adhering molecules that act like tiny assimilation cups to attach themselves to the tissue of the urinary tract. Once those adhering molecules become absorbed to the tissue of the urinary tract, they anon alpha to reproduce. This causes affliction and the archetypal affection of an infection like burning, aching urination, and a faculty of coercion to urinate. If the infection spreads to the kidneys, it can could could cause added problems like lower aback pain, fever, and
Nearly 1 in 3 women will have had at least 1 episode of UTI requiring antimicrobial therapy by the age of 24 years. Specific subpopulations at increased risk of UTI include infants, pregnant women, the elderly, patients with spinal cord injuries and/or catheters, patients with diabetes or multiple sclerosis, patients with acquired immunodeficiency disease syndrome/human immunodeficiency virus, and patients with underlying urologic abnormalities. There are important medical and financial implications associated with UTIs. In the nonobstructed, nonpregnant female adult, acute uncomplicated UTI is believed to be a benign illness with no long-term medical consequences. However, UTI elevates the risk of pyelonephritis, premature delivery, and fetal mortality among pregnant women, and is associated with impaired renal function and end-stage renal disease among pediatric
Clinically UTIs are subdivided into two main categories, uncomplicated and complicated. An uncomplicated UTI is defined as one occurring in a generally healthy, nonpregnant premenopausal woman with a structurally and neurologically normal urinary tract. This type can undoubtedly be treated with antimicrobials, but developing antimicrobial resistances make treatments progressively troublesome (Wanget al., 2013).