Upper Urinary Tract infection (UUTI): Pathogenesis and Clinical Findings



Predisposing Factors:

 - Immunocompromised, Diabetes,

 - Elderly, Female (short urethra)

 - Stagnant urine (anatomical variant, obstruction, neurogenic bladder, urinary reflux, pregnancy)

 - Indwelling urinary catheter, stent, nephrostomy tube

->  Impairment of body's usual defense system, stagnant urine, iatrogenic growth surfaces allow bacterial accumulation



Lower Urinary Tract Infection (LUTI) -> Bacteria ascend ureters from lower tract: As a complication of asymptomatic bacteriuria or cystitis (see LUTI slide) -> Bacteria's unique pili allow them to adhere to renal parenchyma -> Bacterial proliferation



Usual Pathogens ("KEEPS"):

K — Klebsiella

E — E. coli

E — Enterococcus, Enterobacteriaceae

P — Proteus, Pseudomonas

S — Staph. saprophyticus, Serratia



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