Staphylococcus Saprophytics In Prostate

Leptospirosis

Leptospirosis is a disease in which the urinary system is infected from the bloodstream rather than by bacteria ascending from the urethra. It is probably the most widespread of all the zoonoses, diseases that are transmissible to humans but exist mainly in other animals. Leptospirosis occurs around the world in all types of climates, although it is more common in the tropics. One or two fatal cases occur in the United States each year, but most cases are mild, recover without treatment, and remain undiagnosed. It has not been a reportable disease since 1994.

Table 25.1 Bacterial Cystitis

Symptoms

Abrupt onset, burning pain on urination, urgency, frequency, foul smell, red-colored urine; with pyelonephritis, fever, chills, back pain, and vomiting

Incubation period

Usually 1 to 3 days

Causative agents

Most due to Escherichia coli; other enterobacteria, Staphylococcus saprophytics cause some cases; nosocomial infections with antibiotic-resistant strains of Pseudomonas, Serratia, and Enterococcus genera

Pathogenesis

Usually, bacteria ascend the urethra, enter the bladder, and attach by pili to receptors on urinary tract epithelium. Sloughing of cells and an inflammatory response ensue. Spread to the kidneys can occur via the ureters, causing pyelonephritis and potential kidney failure

Epidemiology

Bacterial cystitis is common in women, promoted by a relatively short urethra, use of a diaphragm, and sexual intercourse. Middle-aged men are prone to infection because enlargement of the prostate gland partially obstructs their urethra. Placement of a bladder catheter commonly results in infection

Prevention and treatment

Taking sufficient fluid to void urine at least four to five times daily, wiping from front to back. Single dose of antimicrobial medication with sexual intercourse may help prevent bacterial cystitis in women. Short-term antimicrobial therapy usually sufficient. Longer treatment for pyelonephritis

25.3 Urinary System Infections 637

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