URINARY TRACT INFECTIONS Edited by Peter Tenke Urinary Tract Infections Edited by Peter Tenke Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Dragana Manestar Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Linda Bucklin, 2011. Used under license from Shutterstock.com First published September, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Urinary Tract Infections, Edited by Peter Tenke p. cm. ISBN 978-953-307-757-4 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Clinical Manifestations 1 Chapter 1 A Review of Uncomplicated Urinary Tract Infections 3 Tze Shien Lo and Augusto Alonto Chapter 2 Current Management Strategies for Uncomplicated and Complicated Cystitis 15 Niall F. Davis and Hugh D. Flood Chapter 3 Urinary Tract Infections and Dysfunctional Voiding 35 Minardi Daniele, d’Anzeo Gianluca, Conti Alessandro and Muzzonigro Giovanni Chapter 4 Prostatitis: From Diagnosis to Treatment 51 Stylianos Kontos, Vasilis Migdalis, Stefanos Kachrilas and Athanasios G. Papatsoris Chapter 5 Complicated Upper Urinary Tract Infection 59 Nasser Shakhssalim, Mohammad Samzadeh and Seyed Mohammad Ghahestani Chapter 6 Asymptomatic Bacteriuria: Significance for Different Patient Population 91 Thomas Nelius, Stephanie Filleur and Jonathan S. Nelson Chapter 7 Urinary Tract Infections During Pregnancy 113 Anick Bérard, Fabiano Santos, Ema Ferreira and Sylvie Perreault Chapter 8 Reducing the Incidence of Catheter-Associated Urinary Tract Infections in the Acute Care Setting Using Evidence-Based Guidelines 133 Diane Gorman VI Contents Chapter 9 The Formation of Poly-Microbial Biofilms on Urinary Catheters 153 Veronika Hola and Filip Ruzicka Chapter 10 Urinary Tract Infections in Psychiatric Patients 173 Teresita Sáinz Espuñes, Maria Elisa Drago Serrano and Jaime Amadeo Bustos Martínez Part 2 Antibiotics and Other Strategies of Prevention/Treatment 191 Chapter 11 Antibiotic Resistance in Urinary Tract Infections: Current Issues and Future Solutions 193 David W. Hilbert Chapter 12 Identification and Antibiotic Sensitivity of UTI Pathogens Using Raman Spectroscopy 207 Evdokia Kastanos, Alexandros Kyriakides, Katerina Hadjigeorgiou and Costas Pitris Chapter 13 Natural Approaches for Controlling Urinary Tract Infections 227 Mary Anne Roshni Amalaradjou and Kumar Venkitanarayanan Chapter 14 Prevention Strategy of Urogenital Infections by Using Lactobacilli with Probiotic Properties 245 Liliana Pascual and Lucila Barberis Part 3 Urinary Tract Infections in Children 265 Chapter 15 Current Management of Urinary Tract Infection in Children 267 Yusuf Kibar Chapter 16 Urinary Tract Infection in Children – Onset of a New Era? 285 Tanja Kersnik Levart and Rajko B Kenda Chapter 17 UTI in Children 301 Samileh Noorbakhsh and Vida Zarabi Chapter 18 Post-Inflammatory Nephropathy 309 Beata Bieniaś, Małgorzata Zajączkowska, Halina Borzęcka, Przemysław Sikora, Marek Majewski, Ewelina Książek and Andrzej Borzęcki Chapter 19 Studies on Clinical Characteristics, Urovirulence Factor and Host Susceptibility Gene in Pediatric Acute Lobar Nephronia 337 Chi-Hui Cheng, Yong-Kwei Tsau and Tzou-Yien Lin Preface Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, with enormous financial implications. About 50 % of women will experience at least one UTI episode during their lifetime, and there are about 7 million out of office visits and 1 million emergency department visits due to UTI in the USA alone, resulting in 100 000 hospital admissions annually. UTIs are also the leading cause of hospital-acquired infections, being responsible for 40% of all such cases, causing a substantial burden of expenses with significant consequences to morbidity and mortality. Therefore, the appropriate management of UTIs is a major medical and financial issue. The aim of this book is to give a summary about the different aspects of the diagnosis, management and prevention of urinary tract infections for all medical disciplines. This book contains three main sections. In the first section the authors cover the different clinical manifestations of UTI, with special emphasis on some hard-to-treat diseases, such as recurrent UTIs, prostatitis or complicated upper UTIs. The authors also cover special conditions in respect to treatment, such as asymptomatic bacteriuria or pregnancy, and special patient groups, such as acute care settings or psychiatric patients. The traditional treatment for UTIs is antibiotic therapy. Since the rate of bacterial resistance to antibiotics increases worldwide, the up-to-date knowledge about antibiotic resistance is an issue of growing importance. The second section deals with antibiotics and the available alternative strategies for the prevention and treatment of UTIs. The third section deals with urinary tract infections in children, with emphasis on some special issues, such as the debates on the management of paediatric UTIs and acute lobar nephronia. Dr. Peter Tenke Department of Urology Jahn Ferenc South Pest Hospital Budapest, Hungary [...]... pregnancy, and urinary tract instrumentation In men, prostatic hypertrophy blocks the flow of urine and, because of this, there is also increased chance of developing UTIs in men with this condition Table 1 explains the most common terms used for urinary tract infections A Review of Uncomplicated Urinary Tract Infections Urinary tract infection Lower urinary tract infection Upper urinary tract infection... of antibiotics immediately 9 References Alonto, A (2007) Urinary Tract Infections In: Textbook of Diagnostic Microbiology C L Mahon, D Lehman & G Manuselis (eds.), pp 1010-1029 Sauders, 1-4160-2581-2, St Louis, MO, USA A Review of Uncomplicated Urinary Tract Infections 13 Alcaide, M and Lichtstein, D.M (2004) How Best to Treat Urinary Tract Infections in Adults: A Rational Approach Consultant (July... intravaginal estriol in postmenopausal women with recurrent urinary tract infections N Engl J Med 329(11) (September 1993) pp 753-6, 8350884 Sobel, J and Kaye D (2005) Urinary Tract Infections In: Principles and Practice of Infectious Diseases, Elsevier, Inc., 0-443-06643-4 (pp 875-901) Philadelphia, PA, USA Stamm WE (2010) Urinary tract infections, pyelonephritis, and prostatitis In: Harrison’s Infectious... recurrent urinary tract infections in elderly women British Journal of Obstetrics and Gynaecology 105(4) (April 1998) pp 403-407, 9609266 Dielubanza, E.J and Schaeffer A.J (2011) Urinary Tract Infections in Women The Medical Clinics of North America 95 pp 27-41, 0025-7125 Fihn S.D., Boyko, E.J., Normand, E.H., et al (1996) Association between use of spermicidecoated condoms and Escherichia coli urinary tract. .. Used for Specific Urinary Tract Infections 4 Infecting organisms Uropathogens have characteristics that enable them to be successful in causing infections of the urinary tract Adhesins enable the attachment to host membranes Capsular polysaccharides, hemolysins, cytotoxic necrotizing factor (CNF) protein, and aerobactins are other factors that enable uropathogens to invade the urinary tract Table 2 lists... Lactobacillus probiotics for bacterial genitourinary infections in women: a review Clinical Therapeutics 30(3) (March 2008) pp 453-68, 18405785 Brown, JS, Vittinghoff E, Kanaya AM, et al (2001) Urinary tract infections in postmenopausal women: effect of hormone therapy and risk factors Obstetrics and Gynecology 98(6) (December 2001) pp 1045-52, 11755552 Brusch, J (2010) Urinary Tract Infection in Females (Reference...Part 1 Clinical Manifestations 1 A Review of Uncomplicated Urinary Tract Infections Tze Shien Lo1,3 and Augusto Alonto2,3 1Veterans Affairs Medical Center and Health Organization 3University of North Dakota School of Medicine & Health Sciences Fargo, North Dakota, United States of America 2Sanford 1 Introduction Urinary tract infections (UTIs) can be classified as either uncomplicated or complicated... Prostatitis Renal abscess Bacteruria Pyuria 5 Microbial (bacterial, viral, fungal, etc.) infection that affects any part of the urinary tract Infection of either the bladder or the urethra Although the upper urinary tract is composed of the kidneys and ureters, upper urinary tract infection generally affects the kidneys Infection affecting the kidneys Infection affecting the bladder Infection affecting... the bladder into the urethra, which is a tube that excretes urine from the body Many different problems can occur within the urinary tract Aging can decrease the action of muscles within the urinary system and decrease excretion of urine; therefore, urine may 4 Urinary Tract Infections back up and an infection can develop Injuries from trauma or surgery can also cause infection In addition, other illnesses... formation Toxin production Lipopolysaccharides Capsular polysaccharide Hemolysins Biofilm Aerobactins Table 2 Virulence Factors in Uropathogens 6 Urinary Tract Infections The most common pathogen causing UTIs is Escherichia coli (E coli), causing 70-95% of urinary tract infections Other organisms that can be responsible for UTIs include Grampositive cocci, such as Staphylococcus saprophyticus and Enterococcus . Table 1 explains the most common terms used for urinary tract infections. A Review of Uncomplicated Urinary Tract Infections 5 Urinary tract infection Microbial (bacterial, viral, fungal,. affects any part of the urinary tract Lower urinary tract infection Infection of either the bladder or the urethra. Upper urinary tract infection Although the upper urinary tract is composed of. Lucila Barberis Part 3 Urinary Tract Infections in Children 265 Chapter 15 Current Management of Urinary Tract Infection in Children 267 Yusuf Kibar Chapter 16 Urinary Tract Infection in Children