Urinary Tract Infections

Definitions

  • Lower: urethritis, cystitis (superficial infection of bladder)
  • Upper: pyelonephritis (inflam of renal parenchyma), renal/perinephric abscess, prostatitis
  • Uncomplicated: confined to bladder. No upper tract or systemic infection signs.
  • Complicated: extends beyond bladder (fever, rigors, malaise, flank pain, CVA tenderness, pelvic/perineal pain in male). Men, those w/ nephrolithiasis, strictures, stents, urinary diversions, immunocompromised, poor controlled DM, are not automatically complicated. Follow closely w/ low threshold to escalate Rx. Pregnant & renal Tx are complicated.

Microbiology

  • Uncomplicated: E. coli (80%), Proteus, Klebsiella, S. saprophyticus (CID 2004;39:75). In healthy, nonpregnant women, strep and coag-neg staph (except