Simple cystitis, a one-off episode of ascending pyelonephritis, and occasionally even recurrent cystitis in the right context can be considered as simple UTI, provided there is a prompt response to first-line antibiotics without any long-term sequela.Īny urinary tract infection that does not conform to the above description or clinical trajectory is considered a complicated UTI. This anatomy increases the frequency of infections.
The normal female urinary tract has a comparatively short urethra, and therefore, carries an inherent predisposition to proximal seeding of bacteria. An example would be a patient with a Foley catheter or an incidental positive urine culture in an asymptomatic non pregnant immune competent female. Pyuria and/or bacteriuria without any symptoms is not a UTI and may not require treatment. Typically this is an infection in a nonpregnant immune competent female patient. In a clinical context that is not associated with treatment failure or poor outcomes, a simple UTI, or simple cystitis, is an infection of the urinary tract that occurs due to appropriate susceptible bacteria. It is important to properly define a complicated UTI as infections which carry a higher risl of treatment failure as these typically require longer antibiotic courses and sometimes additional workup. It is vitally important to determine if the presenting episode is the result of these risk factors and whether the episode is likely to resolve with first-line antibiotics. UTIs can also be complicated by several risk factors that can lead to treatment failure, repeat infections, or significant morbidity and mortality with a poor outcome. Some are simple UTIs that can be managed with outpatient antibiotics and carry a reassuring clinical course with almost universal good progress, and on the other end of the spectrum, florid urosepsis in a comorbid patient can be fatal. UTIs have a wide variety of presentations. Urinary tract infections (UTIs) are among the most common causes of sepsis presenting to hospitals. This activity reviews the evaluation and management of complicated urinary tract infections and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients. Additionally, urinary tract infections that recur despite adequate treatment are complicated.
Complicated urinary tract infections include those that occur: in males, in pregnant females (including asymptomatic bacteriuria), as a result of obstruction, hydronephrosis, renal tract calculi, or colovesical fistula, in immunocompromised patients or the elderly, due to atypical organisms, after instrumentation or in conjunction with medical equipment such as urinary catheters, in renal transplant patients, in patients with impaired renal function, or after prostatectomies or radiotherapy. Complicated urinary tract infections are those that carry a higher risk of treatment failure, and typically require longer antibiotic courses and often additional workup. It is vitally important to determine if the patient's infection may have resulted from one of these risk factors and whether the episode is likely to resolve with first-line antibiotics. There are several risk factors that can complicate urinary tract infections and lead to treatment failure, repeat infections, or significant morbidity and mortality. On the other end of the spectrum, florid urosepsis in a patient with comorbidities can be fatal. Some are simple UTIs that can be managed with outpatient antibiotics and lead to almost universally good outcomes. Urinary tract infections (UTIs) are among the most common presenting causes of sepsis in hospitals, and urinary tract infections have a wide variety of presentations.