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Related Concept Videos

Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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Acute Pyelonephritis I: Introduction01:27

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Microbiota of the Urogenital Tract01:28

Microbiota of the Urogenital Tract

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The human urogenital system, once thought to be sterile in healthy individuals, is now recognized as a complex microbial habitat. Advancements in molecular sequencing techniques have revealed that even in healthy adults, the kidneys and bladder harbor microbial populations similar to those found in the distal urethra, albeit in much lower abundance. These resident microorganisms, while generally innocuous, can become opportunistic pathogens under conditions that alter the urogenital...
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Urinary Tract Infection I: Introduction01:26

Urinary Tract Infection I: Introduction

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Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Establishment and Characterization of UTI and CAUTI in a Mouse Model
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Association Between Uropathogen and Pyuria.

Nader Shaikh1, Timothy R Shope2, Alejandro Hoberman2

  • 1Division of General Academic Pediatrics, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania nader.shaikh@chp.edu.

Pediatrics
|June 23, 2016
PubMed
Summary
This summary is machine-generated.

In symptomatic children with a urinary tract infection (UTI), pyuria is often absent when specific bacteria like Enterococcus or Klebsiella are present. This finding suggests alternative diagnostic markers are needed for accurate UTI diagnosis.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Urinary tract infections (UTIs) are common in children.
  • Pyuria, the presence of white blood cells in urine, is a common indicator of UTI.
  • However, pyuria can be absent in some children with confirmed UTIs.

Purpose of the Study:

  • To identify factors associated with the absence of pyuria in children with symptomatic UTIs and positive urine cultures.
  • To investigate the relationship between specific uropathogens and the presence or absence of pyuria.

Main Methods:

  • Retrospective analysis of data from children evaluated for UTI between 2007-2013.
  • Inclusion criteria: symptomatic children with paired urinalysis and urine culture, positive for a single uropathogen.
  • Exclusion criteria: unknown collection method, genitourinary anomalies, immunocompromise, multiple organisms.

Main Results:

  • Out of 1181 children meeting criteria, 13% lacked pyuria.
  • Children with Enterococcus, Klebsiella, or Pseudomonas aeruginosa were significantly less likely to have pyuria compared to those with E. coli.
  • Absence of pyuria correlated with negative leukocyte esterase test results.

Conclusions:

  • Certain uropathogens are less frequently associated with pyuria in symptomatic children.
  • Pyuria and leukocyte esterase may not be sufficiently accurate biomarkers for diagnosing UTIs in all cases.
  • Development of more accurate diagnostic biomarkers is needed to optimize UTI treatment.