Antimikrobna terapija kompliciranih infekcija urinarnog trakta

master's thesis

• Title (english): Antimicrobial therapy of complicated urinary tract infections
• Author: Tomislav Perković
• Mentor: Robert Likić (mentor)
• Committee member: Luka Bielen (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Robert Likić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Infekcije urinarnog trakta (IUT) uključuju cistitis (infekcija mokraćnog mjerhura/donjeg urinarnog trakta) i pijelonefritis (infekcija bubrega/gornjeg urinarnog trakta). Patogeneza IUT počinje kolonizacijom vaginalnog ulaza ili uretralnog kanala uropatogenima iz fekalne flore, a zatim se širi uzlazno uretrom do mokraćnog mjehura. Pijelonefritis nastaje širenjem patogena do bubrega. Pijelonefritis također može nastati zahvaćanjem bubrega u bakterijemiji. Nekomplicirane IUT pretežno nastaju kod zdravih žena s normalnom anatomijom, a karakterizirane su simptomima cistitisa u odsutnosti vrućice, lumbalnim bolovima i ostalim znakovima sistemske bolesti. S druge strane, akutne komplicirane IUT definiraju se kao IUT koje su se proširile s mokraćnog mjehura (IUT s vrućicom ili drugim sistemskim simptomima). Komplicirane IUT povezane su sa zahvaćanjem gornjeg urinarnog trakta, anatomskim abnormalnostima, kamencima, prisutnošću katetera, tumorima ili imunosupresijom.Escherichia coli najčešći je uzročnik akutnih kompliciranih infekcija urinarnog trakta. Dijagnostičke radiološke pretrage obično nisu potrebne za IUT, osim ako postoji sumnja na druge bolesti ili komplikacije. Kompjuterizirana tomografija (CT) često se koristi za evaluaciju pacijenata s kompliciranim IUT. Ultrazvuk je također dijagnostička opcija, a idealna je jer ne uključuje zračenje. Temelj liječenja bakterijskih infekcija, uključujući IUT, antimikrobna je terapija. Opća je strategija liječenja eliminirati infekciju racionalnim korištenjem antimikrobnih lijekova, osiguranjem adekvatne hidracije te uklanjanjem moguće urinarne opstrukcije ili stranih tijela.

Abstract (english)

Urinary tract infections (UTIs) include cystitis (infection of the bladder/lower urinary tract) and pyelonephritis (infection of the kidney/upper urinary tract). The pathogenesis of UTI begins with colonization of the vaginal introitus or urethral meatus by uropathogens from the fecal flora, followed by ascension via the urethra into the bladder. Pyelonephritis develops when pathogens ascend to the kidneys via the ureters. Pyelonephritis can also be caused by seeding of the kidneys from bacteremia. Simple UTIs occur in healthy women with normal anatomy, characterized by symptoms of cystitis in the absence of fever, flank pain and other signs of systemic illness. In contrast, acute complicated UTI is defined as UTI that has possibly extended beyond the bladder (UTI with fever or other systemic symptoms). Complicated UTIs are associated with: involvement of the upper urinary tract, anatomic abnormalities, urolithiasis, the presence of catheters, malignancy and
immunosuppression. Escherichia coli is the most frequent cause of acute complicated urinary tract infections. Diagnostic imaging for UTI in adults is usually not necessary, unless there is concern about an alternative diagnosis or a complication. Computed tomography (CT) is frequently used for evaluation of patients with a complicated UTI. Ultrasound is another diagnostic option, and it is ideal because it does not involve radiation. The cornerstone of treatment of any bacterial infection, including a UTI, is antimicrobial therapy. General treatment strategies to eliminate an infection are the judicious use of antimicrobials, ensuring adequate hydration, and relieving any urinary obstruction or foreign bodies.

• Keywords: urinarna infekcija; antimikrobna terapija; komplicirana; Escherichia coli
• Keywords (english): urinary infection; antimicrobial therapy; complicated; Escherichia coli
• Language: croatian
• URN:NBN: urn:nbn:hr:105:384623
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-04-14 07:43:22