Urinary tract infection (UTI) is a frequently encountered condition seen in clinical practice. It is a broad term that encompasses asymptomatic bacteriuria and asymptomatic infection with microbial invasion and inflammation of urinary tract (Kunin, 1964) .
While UTI affects patients of all ages and both sexes it is more common in females, about 10 times more common than men (Acharya Un. Al. 1994) due to anatomical reasons i.e. shorter urethra.
The observations of Kass (1957) suggested that this number, taken to indicate significant bacteriuria, is about 100,000 organisms/ml, of urine.
UTI is the most frequent cause of illness in humans after respiratory tract infections. Like all other infections, the out come of the UTI is an interplay of the virulence factors of the pathogen and the predisposing host factors.
[...] In IICO SENS project by Kahlmeter G the rates of resistance among E.coli stain were: Ampicillin and Sulphamethoxazole Trimethoprim Nalidixic acid Ciprofloxacin Nitrofurantotin 2%. In the study conducted by Newell et al; 2000 in London of 86 urinary isolates 28 were resistant to Trimethoprim to Amoxycillin to Cephradine and 3 to Nitrofurantotin. Bajaj JK. et al CMC Aurangabad reported resistance to Gentamicin in 83% S. aures Klebsiella spp E.coli pseudomonas aeruginosa and remaining isolates. A large number of isolates were resistant to Ampicillin, Co-trimoxazole, Erythromycin and Chloramphenicol. [...]
[...] DIAGNOSIS The main diagnosis of UTI is achieved through quantitative urine culture analysis. QUANTITATIVE URINE CULTURE The diagnosis of significant bacteriuria is made by collecting. the midstream urine in sterile bottle. Catheterization or suprapubic aspiration is necessary for urine culture (Wallery. 1965) Sometimes, the patients may be symptomatic yet the bacterial count in mine may be < 10" CFU/ml. This is called symptomatic bacteriuria (also called urethra! syndrome) (Stamium W.E. 1994) Like wise a patient may not be symptomatic but have significant bacteriuria.(> CFU/ml) called asymptomatic bacteriuria (Novvbv S.R 1997). [...]
[...] In addition antibiotic resistance among uropathogens also constitute a major deciding factor in establishment and eradication of the disease. (Shobha Ram et al 1997- Most uncomplicated UTI is caused by Aerobic Gram negative organisms that are found in lower gastrointestinal tract. The most common organism is ! Escherichia coli (Gillen mater 1979) The less frequency of infection is caused by Proteus spp, Pseudomonas sppklebsiella spp, 1'jiterobacter spp. Enterococcus and staphylococcus infection -•creases greatly especially in presence of structural abnormalities. It is common isolate more than one organism from urine because instrumentation and multiple course of antimicrobial therapy are common in these patients. [...]
[...] Adenovirus CLINICAL SYMPTOMS Clinical symptoms depend on whether the infection is in the lower urinary tract (urethritis, cystitis) or in the upper urinary tract (acute nonobstructive pyelonephritis) 1. Urethritis:- Symptoms include dysuria, frequency and urgency of urination Cystitis:- Symptoms include suprapubic pain and tenderness, diminished bladder capacity and occasional hematuria Acute nonobstructive pyelonephritis:- Symptoms include flank pain, renal tenderness, fever, chill and hematuria. The clinical manifestations of acute pyelonephritis may resolve spontaneously in the absence of therapy. Incidents of UTI is more in women than men at least partially because of short female urethra and its proximity to anus. [...]
[...] Acquired Resistance - Bacteria previously susceptable become resistant. THE PROBLEM OF ANTIBIOTIC RESISTANCE Antibiotic resistance is becoming a cause for treatment failure in ''•bacterial diseases. (Tenover & Hughes 1996; Tenover & Me Gowan 1996). lnfection with antibiotic resistant bacteria lead to the use of more expensive and more toxic drugs , increased length of infection and subsequent hospital and increased costs. REVIEW OF LITERATURE The term urinary tract infection (UTI) denotes several distinct entities with the common features of significant pyuria and bactenuria. [...]
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