Understanding Urinary Tract Infection

What are the signs, symptoms and causes of UTI

The Urinary Tract Infection (UTI) is referred to as the infection of any part of the urinary system that includes the bladder, urethra, ureters and kidneys (Nicolle, 2019). The signs and symptoms of UTI include persistent and strong urge to urinate, burning sensation during urination, passing small amount of urine frequently, cloudy urine, presence of red or coal coloured pigment in urine and others (Nicolle, 2019). The causes of UTI include sexual intercourse with partners where during thrusting the bacteria may enter the urethra and affect the bladder creating increased risk of the condition (Zeng et al. 2020).

The presence of poor hygiene, bowel incontinence, kidney stones, presence of urinary catheter, menopause, pregnancy and others (Amarsy et al. 2019). The kidney stones leads to raise urinary tract infection because the stones block the urinary tract for increased amount of time during which urine backs up in the tubes present inside the kidney. Thus, inability to release the waste contents in the urine creates toxic impact on the kidney and urinary tract making the individual prone to develop infections (Shen et al. 2019). The catheter-related urinary tract infection develop due to capability of urethral catheter to introduce viral or bacterial organisms inside the bladder and enhances its colonisation by offering a effective surface for bacterial adhesion and irritation of mucosal membrane (Rezai et al. 2017).

References /Supporting Evidence

Amarsy, R., Guéret, D., Benmansour, H., Flicoteaux, R., Berçot, B., Meunier, F., Mougari, F., Jacquier, H., de Ponfilly, G.P., Clermont, O. and Denamur, E., 2019. Determination of Escherichia coli phylogroups in elderly patients with urinary tract infection or asymptomatic bacteriuria. Clinical Microbiology and Infection, 25(7), pp.839-844.

Nicolle, L., 2019. Symptomatic urinary tract infection or asymptomatic bacteriuria? Improving care for the elderly. Clinical Microbiology and Infection, 25(7), pp.779-781.

Rezai, M.S., Bagheri-Nesami, M. and Nikkhah, A., 2017. Catheter-related urinary nosocomial infections in intensive care units: An epidemiologic study in North of Iran. Caspian journal of internal medicine, 8(2), p.76.

Zeng, G., Zhu, W., Lam, W. and Bayramgil, A., 2020. Treatment of urinary tract infections in the old and fragile. World Journal of Urology, pp.1-12.

Whats the sepsis 6 bundle and why is it important to commence within 1h

The Sepsis 6 Bundle is referred to the collection of medical therapies which are designed to lower the mortality rate among patients suffering from sepsis (RCEM, 2014 Bentley et al. 2016). The bundle is required to be commenced within 1 hour because titrating oxygen to normal saturation level of 94% avoid hypoxaemia ensuring to avoid breathlessness which may lead to gradual death of the person (Shin et al. 2016). Moreover, the implication of the bundle is required to be within 1 hour so that appropriate intravenous antibiotic can be administered to restrict the spread of sepsis over the body. Further, the bundle implementation within 1 hour would lead the patient to effectively treat for septic shock through intravenous resuscitation which if delayed leads to heart failure and other organs making the person face slow death (Pickkers and Payen, 2017).

References

Bentley, J., Henderson, S., Thakore, S., Donald, M. and Wang, W., 2016. Seeking sepsis in the emergency department-identifying barriers to delivery of the sepsis 6. BMJ Open Quality, 5(1), pp.u206760-w3983.

Shin, T.G., Jo, I.J., Hwang, S.Y., Jeon, K., Suh, G.Y., Choe, E., Lee, Y.K., Lee, T.R., Cha, W.C. and Sim, M.S., 2016. Comprehensive interpretation of central venous oxygen saturation and blood lactate levels during resuscitation of patients with severe sepsis and septic shock in the emergency department. Shock: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches, 45(1), pp.4-9.

The Septic shock is referred to the condition in which the person suffering from sepsis develops persistent hypotension making them to require vasopressin in maintaining a mean blood pressure of 65mm Hg or higher along with the serum lactate level to be more than 2mmol/L irrespective volume resuscitation (Lee et al. 2016). The septic shock develops because of cytokines released from the spread of the infection that cause inflammation contributing to widen the blood vessels, increase capillary permeability, lower systematic vascular resistance and blood pressure. The hypotension in tissues is present in septic shock as it lowers blood pressure level causing tissue perfusion level to be decreased. The symptoms related to septic shock includes pale arms and legs, little or no urine, increased heart rate, restlessness and others (Singer et al. 2016). The septic shock is required to be immediately treated as it may lead to mortality.

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References

Lee, Y.C., Hsiao, C.Y., Hung, M.C., Hung, S.C., Wang, H.P., Huang, Y.J. and Wang, J.T., 2016. Bacteremic urinary tract infection caused by multidrug-resistant Enterobacteriaceae are associated with severe Sepsis at admission: implication for empirical therapy. Medicine, 95(20).

Singer, M., Deutschman, C.S., Seymour, C.W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G.R., Chiche, J.D., Coopersmith, C.M. and Hotchkiss, R.S., 2016. The third international consensus definitions for sepsis and septic shock (Sepsis-3). Jama, 315(8), pp.801-810.