Urinary Tract Infection: Causes, Symptoms, and Management

This presentation provides an overview of urinary tract infection (UTI), including its causes, symptoms, and management. It covers nursing management, non-surgical management, and interventions for prevention. The effectiveness of cranberry capsules and the challenges of overprescribing antibiotics are discussed. The presentation also explores UTI in older adults and the impact of antibiotic therapy.

Urinary tract infection
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Introduction
Urinary tract infection (UTI) refers to the presence of
infection, which affects the different parts of the union of
genital tract
 It is commonly referred to as bladder infection or cystitis
when it affects the lower portion of the urinary tract
(Flores-Mireles, Walker, Caparon & Hultgren, 2015)
 It is also referred to as pyelonephritis or kidney infection
while affecting the upper region of the urinary tract
 Symptoms of UTI frequently overlap symptoms of
bacterial infection, which requires the need for
distinguishing between the two

Nursing management
Administration of nitrofurantoin or
trimethoprim as alternative to amoxicillin is
considered as the ideal treatment for
uncomplicated UTI
 Quinolone is also recommended by
healthcare professionals for 10-14 days
among patients who have presenting
complaints of pyelonephritis (Ribeiro, 2015)
Providing patient education is an effective
measure for preventing the relapse of UTI,
along with antibiotic prophylaxis

Uncomplicated and complicated UTI
Uropathogenic organisms that are
multidrug-resistant have been identified
as a major concern to public health.
 Multidrug resistance is found in
enterococcal bacteria, against
clindamycin, trimethoprim, penicillin,
and cephalosporin (Ana, Jennifer,
Michael, & Scott, 2015)
 Combination therapies encompassing
the administration of ceftazidime along
with avibactum have been found
effective against such bacteria
Researchers have also established
efficacy of medicine based vaccines in
blocking interaction between the host
and pathogen, thereby preventing
infection in urinary tract Figure 1
Source- (Ana, Jennifer,
Michael, & Scott, 2015)

The nature of immune responses
 The first line of defence against
pathogen is the epithelial cells that
secrete antibacterial agents and
proinflammatory cytokines
 These inhibit bacterial growth and
expansion through elimination of
growth factors from urine (Soman &
Yuxua, 2015)
Following onset of UTI, neutrophils are
also recruited to the urinary bladder
Onset of infection also results in
recruitment of macrophages inside the
urinary tract submucosa that bring
about release of chemokines and
cytokines in the vicinity Figure 2
Source- (Soman &
Yuxua, 2015)

Non-surgical management
Appropriate implementation of antibiotic therapy
increases the rate of bacterial eradication and symptom
relief among women having uncomplicated cystitis
 These help in balancing the discomfort and pain with
the risk and cost of resistance development towards
antimicrobial therapy
 Common prophylaxis options include self-starting
continuous prophylaxis, and pre- and post-coital
bleeding (Bergamin & Kiosoglous, 2017)
 Intravesical installation of chondroitin sulfate and
hyaluronic acid are also used for replenishment of
glycosaminoglycan layer

Effectiveness of Cranberry Capsules
Administration of profile lactic antibiotics
controversial going to multi drug resistance and the
adverse effects of the antibiotics
Prophylaxis with cranberry has been identified as a
potential management strategy
Cranberry comprise of proanthocyanidin that are
stable phenolic compounds having an anti-adhesion
activity against bacteria (Caljouw et al., 2014)
Administration of cranberry capsules to patients
help in lowering the incidence rate when compared
to placebo among patients identified at high uti risk

Interventions for prevention of urinary
tract infection
The researchers tried to identify the strategies that are
commonly used for reducing UTI amid nursing home residents
 Comprehensive search of different electronic databases led to
retrieval of 5794 articles
Maintenance of hand hygiene helps to reduce UTI rate
(Jennifer et al., 2017)
 Encouraging patients for adequate hydration and fluid intake
reduces infection
 Enhancement of patient hygiene brings about an
improvement in occurrence of UTI
 Use of cranberry products and vitamin or mineral
supplements as a major form of profile access are also
effective

Urinary Tract Infection in Older Adults
UTI is a significant cause of mortality
and morbidity among older adults
Administration of antibiotics for
clinically suspected UTI among the
elderly are inappropriate
One major challenge is related with
history taking among patients who
report baseline cognitive impairment
(Nicolas, Barbara & Robin, 2017)
Antibiotic therapy is most effective
for providing symptomatic relief to
patients, and preventing for the
health complications like
bacteria, perinephric abscess, and
pyelonephritis
Figure 3
Source- (Nicolas,
Barbara & Robin, 2017)

Overprescribing antibiotics
Case review conducted among patients aged more
than 70 years who had been admitted to NHS
trust hospitals in England
UTI confirmed among 13% patients receiving
urine dipstick
60 patients obtained second dipstick test that
helped in additional 13 cases of UTI diagnosis
(Emily, Michael, Emily, Paula & Beryl, 2019)
 Dipstick test are more performed among patients
who have previous fall history, in comparison to
those who report signs and symptoms of dementia

Antibiotic management
157264 adults aged more than 65 years were assessed
for hospital admission bloodstream infection and all-
cause mortality, a month after being diagnosed with UTI
 7.2% failed to show any antibiotic restriction and 6.2%
demonstrated delay in antibiotic administration
 There were 0.5% cases of bloodstream infection after
initial UTI, which was significantly more among those
who did not receive any antibiotic (Myriam et al., 2019)
 Hospital admission rate was double among patients
without any antibiotics (27.0%) and deferred antibiotic
(26.8%), in comparison to those who had been
prescribed immediate antibiotics (14.8%)

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