Avtor/Urednik		Lindič, Jelka
Naslov		Complicated urinary tract infections
Tip		članek
Vir		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Leto izdaje		2000
Obseg		str. 329-35
Jezik		eng
Abstrakt		Complicated urinary tract infection (UTI) is defined as acute or chronic parenchymal infection, associated with structural or functional abnormalities in urinary tract. In patients with complicated UTI the risk and incidence of reinfection is increased as well as the probability of therapeutic failure. The majority of patients with complicated UTI can be categorized in proposed risk groups of patients with: structural abnormalities (obstruction, prostatic infection, external urinary derivation, stents, VUR, neurogenic bladder, parenchymal abscesses), metabolic or hormonal abnormalities (diabetes mellitus, pregnancy, renal impairment, malakoplakia, xantogranulomatous pyelonephritis), impaired host response (transplant recipients, neutropenia, immunodeficiency syndromes) and unusual pathogens (yeasts, fungi, Mycoplasma, resistant bacteria). In patients with possible complicated urinary tract infection increased medical attention and follow-up is necessary. Little data on epidemiology of complicated UTI exists. The risk for infection is increased in patients with acute or chronic obstruction because of decreased urine flow and reduced defense mechanisms. Foreign bodies and catheters promote colonization and multiplication of organisms. Multiple pathogens are frequently present. Bacterial urease and hemolytic toxin production contribute to host damage. The urinalysis of midstream specimen usually demonstrates pyuria, but urine culture is essential to confirm the microbiological etiologic agent. Clinical symptoms are similar as in patients with uncomplicated UTI. In many patients nonspecific systemic symptoms are presented: fatigue, nausea, headache, etc. Therapeutic regimens are mostly empiric, guided by results of urine culture. The correction of structural or functional abnormalities is necessary. In some patients suppressive therapy is advocated.
Deskriptorji		URINARY TRACT INFECTIONS PROSTATITIS KIDNEY TRANSPLANTATION