URINARY TRACT INFECTIONS

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BIOL 2010 – Lab Section 27

Lecture Khalil Khollesi

Lab Amir Jahani

Urinary Tract Infections

Manypeople in the world had affected urinary tract infection in a longtime before the bacteria were recognized as the causes and the studyof this disease was started. Until early 19th century, thestudy of this disease was published popularly. The publishedresearches mostly focused on describing the urinary tract infectionsbut did not provide information about what was causing them. Duringthat time, methods used to manage and treat this infection wereexaggerated. Some of them included hospitalizing the patient, bedrest, change of diets, and at times went to the extent of usingherbal medicine and plasters. Later, medical practitioners were ableto discover that the bacteria was the main cause of the infectionsand this led to the invention of better treatments for the disease.Various antibacterial agent such as hexamine and mercurochrome werediscovered but they were disappeared when tested. Thus treatment ofurinary tract infections wasn`t conclusive in their performance untilthe discovery of antibiotics (Goel &amp Mukherjee 2016).

The urinary tract infection is a disease that affects the urinarysystem. Bladder infection describes infections that affect the upperpart of the urinary tract while kidney diseases influence the toppart of the urinary tract. The lower urinary tract infectionssymptoms include frequent pain when urinating, frequent urination andan itchy need to urinate even when the bladder is empty. The bladderinfection symptoms combined with fever flank infection are symptom offever infections. These diseases affect mainly the urinary system.This system consists of the urethra, ureters, urinary bladder andalso the kidneys. The urinary tract is combined of these parts thattake a role of the drainage system of urine and the urinary and theurinary bladder store the urine then it is released during urination.The urinary system also serves other functions in the body such asmaintaining the homoeostasis of water, ph., checking the bloodpressure and calcium levels in the body, and also maintaining thehomeostasis of the red blood cells. Kidneys, which are bean shapedorgans found on the abdominal cavity walls also play an importantrole in in the body. Firstly, they help in filtering waste productsfrom the body. They also filter ions and other chemicals which attimes are excessive in the body and disposes them from the blood andbody in the process of urination. Theurinary bladder receive the urine from the ureters and also isavailable for storage and wait urination. These ducts have valves atthe end by ureterovesical valves which help prevent the backflow ofthe urine. From the urinary bladder, urine passed through the urethraand disposed at the end by the penis. There are muscles present inthe urethra which play an important role in the body. The contractionof the internal and external sphincter muscles create the feeling forurination as this movement show that the bladder is full(Jones Hard &amp Mohr 2013).

The urinary tract infections primary cause are the bacteria thattravels through the urethra to the bladder. The body use some defensesystems to avoid this kind of diseases. Various bacteria present inthe body are excreted through urination thus leaving the body clean.The muscles present at the ureter play a big role as they preventurine from heading back up to the kidneys when the urinary bladdergets full. Men have the prostate glandthat secretes substances that help fight and eradicate infections.White blood cells are the defense in an immune system of body. Eachpart of the body has its own defense system against disease causingbacteria. The urinary bladder is lined with mucus thus bacteriacannot attach itself on it and also other harmful organisms.The vagina is a female organ related with the urinary systemthat also has lactobacilli. Lactobacilli microorganisms provide manybenefits by maintaining an acidic environment which cannot harbourbacteria. Hydrogen peroxide is produced by this agent that killsbacteria and deposition of Escherichia coli, which stays on thevagina cells, is reduced. Urinary tract infections are classifiedinto two categories i.e. the uncomplicated and uncomplicatedinfections that depend on factors that trigger the infection and theprimary or recurrent infections that depend on the number of timesthe disease has affected the given person. Uncomplicated infectionsmostly affect the females complicated urinary infections affect bothgenders of any age and are more severe, hard to treat and recurrent.Women are more susceptible to this disease. Urinary tract infectionstend to be more repetitive in women than in men.Recurrence of this infection can either occur throughreinfection of relapse. If the harmful bacteria is reintroduced tothe person a few weeks after treatment, reinfection tends to occur.Relapse is mainly connected to kidney infections and is notcommon. It occurs due to treatment failure.

At times a person may have no signs of infection, but bacteria hasinvaded the urinary tract thus causing a condition calledasymptomatic urinary tract affections. This type of bacteria is notharmful though it increases the risk of getting the other type ofinfections that display symptoms. Screening is necessary so as todetect this bacteria’s and remove them from time to time to avoidaccumulation, especially in pregnant women. And people undergoingurologic surgery. Different bacteria causes this infection. Anexample is the Escherichia coli which invade the vagina thus causinginfections. Kidney infections are caused by bacteria similar to thosethat cause cystitis. Flu and common cold are treated by the mostcommon medical treatment UTIs. They also occur more to women than tomen. According to different researches cases of this disease are morewitnessed in women and recurrence cases are also very high(Hooton Hughes &amp Stamm, 1996). The woman’s urethra isshorter than in the male system and this increases the risk ofinfection as bacteria can invade a woman’s urinary system morequickly due to the closeness to other waste excretion areas.

Urinary tract infections in women are mostly caused by sex. Women in their celibate period have lower risk UTIs. Use ofsome types of contraceptives can also increase the risk ofcontracting UTIs.at the age of 50 years, men tend to be moresusceptible to this disease than women and such can lead to worsediseases like prostate cancer. Cases this infection are rare in menbut tend to be more serious to those who contract them than in women.Infections less likely to occur to children and their percentage ofinfection is three percent. In children,the most common cause ofurinary tract infection is the vesicoureteral reflux. (Mccance &ampHuether, 2015). This a condition where the valves at the end of theureter are weak thus when the bladder gets full, urine tends to goback up to the kidneys. Another cause of urinary tract infections isthe use of catheters mostly when collecting a clean urine sample inhospitalized patients and children. Thus it is clear that olderpeople are at a higher risk of contracting urinary tract infectionsdue to the use of catheters and this increase the risk of contractingother diseases which are more serious.

Urinary tract infections are usually diagnosed and treated indifferent ways. The first method is where urinalysis is carried out.Urinalysis involves the lab testing of a urine sample so as to knowwhat it contains. It involves identification of the urine colour andhow clear it is by using ph. Papers and also by examination of aurine sample using the microscope. Urine culture involves growing thebacteria in a urine sample so as to be able to identify the specificbacteria causing the infection. Thus the doctors can know the bestantibiotics to use for treating the person. At other moments use ofcatheters is applied to individuals who cannot be able to provide aurine sample such as children and old people, and this ends upcausing bacterial infections in some cases. When a contamination doesnot react to the medicine used, other tests such as x-rays andultrasounds are used to diagnose the disease. Use of imaging helps inidentifying any abnormalities affecting the urinary system, anythingobstructing the performance of the system and also in telling whethera child has vesicoureteral reflux. (CelikAydogdu &amp Yucel 2013). Some other conditions may havesimilarities in symptoms with UTIs. Diseases like sexuallytransmitted infections, vaginitis and interstitial cystitis portraysimilar symptoms but should not be confused with UTIs to avoid wrongtreatment. Although antibiotics are the more preferred treatment ofthis infections, some bacteria have strains which are resistant tothem thus leading to use of nitrofurantoin and fosfomycin as thealternative therapies(Gupta Hooton &amp Stamm 2001). Otherantibiotics like Trimethoprim-Sulfamethoxazole (TMP-SMX) areavailable but are toxic when used on patients who have allergies(Carmeli Armstrong &amp Gasink 2016).

So as to enable the control of this disease, hygiene should be theutmost priority. Avoid wearing tight clothes, using a lot water andmild soap for waste dispensing and using shower instead of bathingthat all is solution to reduce infection for ladies. Further researchis being carried out by medical facilities to enable better treatmentof this infections. Assumptions should not be made on their severitybecause when left untreated they can cause more severe diseases.

References

Carmeli,Y., Armstrong, J., Laud, P. J., Newell, P., Stone, G., Wardman, A., &ampGasink, L. B. (2016). Best available therapy in patients withceftazidime-resistant Enterobacteriaceae and Pseudomonas aeruginosincomplicated urinary tract infections or complicated intraabdominalinfections (REPRISE): a randomised, pathogen-directed, phase3 study.&nbspThe Lancet Infectious Diseases,&nbsp16(6),661-673.

Celik,O., Ipekci, T., Aydogdu, O., &amp Yucel, S. (2013). Current medicaldiagnosis and management of vesicoureteral reflux inchildren.&nbspNephro-Urology monthly,&nbsp6(1).

Goel,S., &amp Mukherjee, S. B. (2016). Urinary tract infection–A taleof 50 years.&nbspIndian Paediatrics,&nbsp53(1),57-58.

Gupta,K., Hooton, T. M., &amp Stamm, W. E. (2001).study on increasingantimicrobial resistance and the management of uncomplicatedcommunity-acquired urinary tract infections.&nbspAnnals ofinternal medicine,&nbsp135(1), 41-50.

Hooton,T. M., Scholes, D., Hughes, J. P., Winter, C., Roberts, P. L.,Stapleton, A. E., … &amp Stamm, W. E. (1996). A prospective studyof risk factors for symptomatic urinary tract infection in youngwomen.&nbspNew England journal of medicine,&nbsp335(7),468-474.

Jones,T. C., Hard, G. C., &amp Mohr, U. (Eds.). (2013).&nbspUrinarysystem. Springer Science &amp Business Media.

McCance,K. L., &amp Huether, S. E. (2015).&nbspPathophysiology: Thebiologic basis for disease in adults and children. ElsevierHealth Sciences.