Know the signs and symptoms of UTI’s and the most common organisms associated with
them. UTI (acute cystitis)
Urinary tract infections (UTIs) – inflammation of the urinary epithelium usually caused by bacteria from gut flora.
Urinary tract infections (UTIs) are commonly caused by the retrograde movement of bacteria into the urethra and
bladder.
Urinary tract infections (acute cystitis) S/S Common Organism associated with
Elderly are commonly asymptomatic (highest risk UTI) The MOST common infecting microorganisms are
Clinical manifestations of cystitis are related to the uropathic strains of Escherichia coli
inflammatory response:
• Frequency
and the second most common is Staphylococcus
• Urgency saprophyticus.
• Dysuria (painful urination
• Suprapubic and low back pain Less common: Klebsiella, Proteus, Pseudomonas, fungi,
More serious s/s viruses, parasites, or tubercular baccilli
• Hematuria
• Cloudy urine
Schistosomiasis Most Common cause of parasitic invasion
• Flank pain (infects >200 mill – association with bladder Ca)
Gram-negative bacilli move into the urethra and bladder
then to ureter and kidney.
10% of individuals with bacteriuria have no symptoms
30% with symptoms are abacteriuric
Uropthic stains of E. coli have type-1 fiimbrae bind to
latex catheters. These stains have P fimbrae
Elderly may be asymptomatic or confused or vague abd
(pyelonephritis- associated fimbriae) and bind to
pain.
uropithelium of individuals with P blood group antigen.
,2
Elderly with recurrent UTIs and comorbidities have a Some women are genetically susceptible to certain strains
higher risk of mortality of E coli
Cystitis is an inflammation of the bladder commonly
caused by bacteria and may be acute or chronic.
Painful bladder syndrome/interstitial cystitis includes nonbacterial infectious cystitis
and interstitial cystitis, which is related to autoimmune injury.
,3
Types of incontinence
Type Description
Urge incontinence (Most common in older adults) Involuntary loss of urine associated with abrupt &
strong desire to void (urgency), often associated
with involuntary contractions of detrusor; when
associated with neurologic disorder, this called
detrusor hyperreflexia; when no neurologic
disorder exists, this called detrusor instability, may
be associated with decreased bladder wall
compliance
Stress incontinence (most common in women <60 Involuntary loss of urine during coughing,
& men who have had prostate surgery) sneezing, laughing or other physical activity
associated with increased abdominal pressure
Overflow incontinence Underactive bladder (UAB) Involuntary loss of urine with overdistention of
is a condition in which the duration or strength of bladder; associated with neurologic lesions below
contraction is inadequate to empty the bladder, S1, polyneuropathies, and urethral obstruction
resulting in distention and overflow incontinence. (e.g. enlarged prostate)
Mixed incontinence (most common in older Combination of both stress and urge incontinence
woman)
Functional incontinence Involuntary loss of urine attributable to dementia
or immobility
, 4
Pyelonephritis s/s Glomerulonephritis s/s
Acute pyelonephritis s/s: (an infection of one Acute glomerulonephritis: commonly results
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