Urinary Tract Infections In Women

According to the Centers for Disease Control and Prevention [CDC] (2017), “Urinary tract infections (UTIs) are the fourth most common type of healthcare-associated infection, with an estimated 93,300 UTIs in acute care hospitals in 2011. UTIs additionally account for more than 12% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract” (p. 7-1).

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.

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

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.

In the course of daily practice, nurses soon realize that many patients will acquire urinary tract infection (UTI) during their stay in hospital. Research and practice have both shown that the main cause of frequent UTI in hospital has been urethral catheter for the patients. Meddings, Reichert, Robers, Saint, Stephansky & McMahon (2012) find that most (59% to 86%) hospital-acquired urinary tract infections (UTIs) are catheter-associated urinary tract infections (CAUTIs) (p. 305). According to Dailly (2011), "approximately 20 per cent of all healthcare-associated infections are urinary tract infections (UTIs), with an estimated 80 per cent of those linked to urethral catheters," (p. 14). "It is estimated that 2 6% of people with catheters will develop a UTI," (Slater, n.d., p. 168).

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

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).

Lehne (2013) continues by stating that in nosocomial caused cystitis E. coli makes up only 50 percent of UTI’s. In hospital settings more common gram negative causative agents of cystitis are Pseudomonas, Proteus or Klebsiella pneumoniae. There is also a gram positive agent named Staphylococcus saprophyticus that makes up 10 to 15 percent of nosocomial UTI’s.

Research indicates that urinary tract infection (UTI) is the third most common infection experienced by humans after gastrointestinal and respiratory infections. It is also the most common precursor of community-acquired and nosocomial infections for all patients admitted to healthcare facilities. Foxman and Buxton (2013) have indicated that for better management and prognosis of this prominent problem, it is crucial to understand the possible site of the infection; whether it is an upper or lower UTI. This study focuses on the difference between pharmaceutical and nonpharmaceutical interventions among patients with lower uncomplicated UTI, focusing on female patients from 18 to 30 years old, which is the population most affected by this

It is evident, the current UTI protocol is not coherent with evidenced- based guidelines. According to recent research, high number of antibiotics are used prophylactically and a great number of antibiotics are prescribed for asymptomatic urinary tract infections. In turn, this results in increase prevalence of antibiotic resistance and clostridium difficile infections (Fleming et al., 2013). Facilities are now moving forward with the McGeer criteria as part of their protocol.

Urinary tract infection is a more common bacterial infection in women than men because women have shorter urethra where bacteria can migrate up and cause an infection.1 Majority of the infections are caused by E. coli, but can also be caused by Enterobacter, K. pnemoniae, and other Staphylococci.2 Women may contract the infections due to sexual intercourse, pregnancy, insertion of catheter into the urinary bladder, diabetes, history of antibiotic use and many more.1 They can be asymptomatic or symptomatic by experiencing fever, nausea, dysuria, urgency to urinate, or abdominal pain. Antibiotics such as sulfamethoxazole-trimethoprim (Bactrim) and nitrofurantoin (Macrobid) are the choice for treating urinary tract infections (UTIs)

Up to 50% of women get UTIs because the urethra, which transports urine from the bladder to the outside of the body, is located close to the anus. When bacteria from the large intestine such as E. coli exits the anus, it can easily invade the urethra and travel to the bladder and kidneys causing a UTI. Women with shorter urethras are more susceptible to getting a UTI, and sexual activity can cause a UTI.

First a clean catch urine sample which is a urine sample collected after cleaning off urinary opening and catching urine midstream to minimize contamination. Second test to be completed was a urine C and S. This is a laboratory test that is an attempt to grow on bacteria on a culture medium in order to identify it and determine which antibiotics is sensitive to the bacteria. (2013) Final test to be administered was a KUB which is an x-ray of the kidneys, ureters, and bladder. Completions of the urinary analysis exhibited pyuria (presence of pus in urine), bacteriuria (bacteria in the urine), and slightly acidic ph (oxygen deprived fluid). After the x-ray test acute pyelonephritis (inflammation of the renal pelvis and kidney. resulting from the cystitis, which already has made its way up to the kidney and the bladder. Pyelonephritis is the most common types of kidney disease. There may be large amount of white blood cells and bacteria in the urine. Pyelonephritis could explain the bloody urine. (2013) The patient was place on antibiotic and advised to drink lots of fluid in amount of two litters per day. This is common treatment for a patient diagnosed with urinary tract

Bacterial urinary tract infections represent the most common type of nosocomial infections. Often, the ability of bacteria to both establish and maintain these infections are directly related to biofilm formation on indwelling devices or within the urinary tract itself (30). Enterococci (especially E. faecalis) are one of the main causative agents of urinary tract infection and Catheter-associated urinary tract infections (CAUTIs) besides gram-negative pathogens (31, 32). In these infections Biofilm provides a favorable milieu for microbial survival within the host as the organisms are shielded from the host immune response, as well as antibiotics and antimicrobial agents (33, 34). Several studies conducted to introduce main virulence genes of enterococci that are associated with biofilm formation in these bacteria (11, 13,-17), but virulence mechanism and related genes for biofilm formation are not well understood (35). In this study we investigated biofilm formation of clinical enterococci isolates isolated from Urinary tract infections. These strains were characterized for presence of adhesions and secretory virulence factors. Isolates had diverse presence of virulence from lack to highest amount of virulence genes. Several previous studies investigated relation of virulence genes and biofilm formation, especially presence of esp and gel. Enterococci esp has been implicated as a contributing factor in colonization and persistence of infection within the urinary tract