文档介绍：General remarks
In this chapter, UTI resulting from bacterial invasion is discussed.
Anatomically. It is divided into upper tract urinary infection (pyelonephritis) and lower tract urinary infection (cystitis)
incidence:UTI is mon disease (2% in population), particularly in female adults( 10%).
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Etiology and pathogenesis
Pathogen:
gram-negative bacteria ( Specifically coliform bacteria, proteus bacteria )
Pyocyanic infection is frequently seen in patients with instrumentation.
Proteus bacteria is often seen in patients with calculus.
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Bacterial virulence factors
A high degree of bacterial adherence, which is mediated by the bacterial fimbriae.
Some bacteria can produce hemolysin which can resist the body’s defense system .
Drug resistance strains
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Host defense mechanisms
Efficient emptying of the bladder with voiding .
A protective glycosaminoglycan layer.
The high osmolality and extremes of pH .
IgG, IgA anic acid secreted by urinary tract mucosa.
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Host susceptibility factors
urinary tract Obstruction
such as calculus, vesicoureteral reflux or intrarenal reflux.
(the presence of UTI with structurally or functionally abnormal urinary tract is plicated UTI)
The deformity of urinary system
Instrumentation of the urinary tract
Host defense system get weak, for instance, diabetes mellitus
Pregnancy,gender
neurogenic bladder
ic factor
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Infection route
The ascending route:
periurethral tissues → urethra → bladder → ureter →renal pelvis→renal medulla
The hematogenous route
Lymphogenous spread
Direct extension from ans may occur
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