100%(1)1 out of 1 people found this document helpful
This preview shows page 1 - 3 out of 7 pages.
Nurs 6501Week Ten DiscussionMain PostThe Pathophysiology of Lower and Upper Urinary Tract InfectionsA Urinary tract infection (UTI) is a condition whereby bacteria from the gut floramultiplies through the urinary epithelium (Huether & McCance, 2017). The urinary tractconsists of the urethra, prostate, ureter, bladder and kidney. There are various causes and riskfactors for UTI such as antibiotic use, prematurity of newborns, sexual intercourse, indwellingurinary catheter use, urinary obstruction amongst others. UTI can be complicated oruncomplicated, and they can either affect the lower urinary tract or upper urinary tract.Uncomplicated UTI refers to UTI that occurs is otherwise healthy individuals, while complicatedUTI refers to the infections of the lower or upper urinary tract that is refractory to therapy, andlinked to an underlying sequela (Najar, Saldanha, & Banday, 2009).Lower UTI (Acute Cystitis): Cystitis refers to the inflammation and infection of a portion orentirety of the lower urinary tract, which includes the bladder, urethra and kidneys. Commoninfecting microorganisms include E. coli, Staphylococcus, Pseudomonas and Klebsiella (McPhee& Hammer, 2014). It can be mild or more advanced, like in the case of ulcerative cystitis organgrenous cystitis. Initial bacteremia is usually triggered by back flow of gram-negative bacilliinto the urethra, which then travels through the urinary tract from the bladder, to the ureterand then the kidney (Huether & McCance, 2017). Furthermore, the type-1 fimbriae of theuropathic E. coli that are resistant to flushing during urination, binds to latex catheters andreceptors of the uroepithelium.
Upper UTI (Pyelonephritis): Pyelonephritis on the other hand refers to the infection of theupper urinary tract which involves the ureter, renal pelvis and interstitial space. It is commonlycaused by an obstruction such as kidney stones, or retrograde flow of urine from the bladder.The ascension of the bacteria is can also be facilitated by conditions such as pregnancy andureteral obstruction, as these conditions inhibit ureteral peristalsis (Davis & Flood, 2011).Furthermore, bacteria that reach the renal pelvis can penetrate the renal parenchyma throughthe collecting ducts and disrupt the renal tubules, causing inflammation, or leading to abscessformation and necrosis of the tubules in severe acute cases. In chronic cases, there is recurrentinfection and destruction of the tubules, leading to scarring of both kidneys.