Urinary tract infection and gynecological inflammation may cause vulvar itching, because the female urethra is close to the genitals, and urinary tract infection combined with poor cleaning can easily cause vulvar itching! I suggest you go to a regular hospital for a urine test! If you want to treat it without authorization, the consequences will be unimaginable! I looked up some information for you and looked at it myself. I hope it helps you!
urinary tract infection
References:
The path of urine, including renal pelvis, ureter, bladder and urethra, is called urinary tract infection because it is infected with bacteria such as Escherichia coli. Urethritis and cystitis are called lower urinary tract infection, and pyelonephritis is called upper urinary tract infection. It is common in women, especially during pregnancy and puerperium. Clinically, the frequency of urination is obviously increased, and when urinating, there is urgency, pain, chills, fever and low back pain. If infected repeatedly, it can become chronic.
Health guide:
1. Develop good hygiene habits and wash your lower body with warm water before going to bed and after defecation. The cleaning sequence should be to wash the external genitalia first, and then the anus to avoid cross infection. If conditions permit, it can be washed with warm water of 1/1000 to 2/1000 potassium permanganate, and the effect is better. Married couples should form the habit of cleaning every night. Towels, basins and foot cloths should be separated, and foot cloths for washing feet and vulva should also be separated. Sexual life should be properly controlled, because frequent or unclean sexual life will lead to urinary tract infection. If conditions permit, both men and women should take a bath or wash their private parts with warm water before sexual intercourse. After sexual intercourse, the woman should empty her bladder, which can flush the urethra and reduce infection.
2. Those who travel, take a bus or have a long meeting should urinate first, don't hold their urine, and urinate frequently. Excessive urination will cause urine concentration, stimulate bladder mucosa and lead to illness. To get into the habit of drinking a lot of boiled water, the daily consumption should be 1500 to 2000 ml. Drinking plenty of water can enhance the diuretic effect and the immune function of the kidney, and play a role in flushing the urethra, which is conducive to the discharge of bacteria and toxins. Eat more fresh fruits and juice drinks, so that urine is in an alkaline state, and it is difficult for bacteria to grow and reproduce. Try to avoid catheterization or urinary tract instrument examination.
3. In the acute stage, you should stay in bed 1 week, and you can exercise indoors after the symptoms are controlled. In the second week, you can gradually transition to half rest and half full. Usually pay attention to the combination of work and rest. Overwork or poor rest after illness will lead to the recurrence of infection and turn chronic.
4. The diet should be light, and eat more fresh vegetables and fruits rich in water, such as watermelon, wax gourd, cucumber, fresh lotus root, pear and red bean. Do not eat spicy food such as onion, leek, garlic, pepper and ginger. To reduce the irritation to the urethra. Quit smoking and drinking. Avoid warm food, such as mutton, dog meat, rabbit meat and fatty and greasy products.
Prevention of urinary tract infection in married women 2001March 13 Harbin Daily.
Married women are prone to urinary tract infection, which lasts for a long time and is difficult to cure. In severe cases, they can also develop into chronic pyelonephritis and eventually lead to uremia. How is the recurrence of female urinary tract infection? The reporter interviewed Shujie Wang, director of urology department of Harbin Red Cross Central Hospital. She believes that the human urinary tract is composed of kidney, ureter, bladder and urethra, and any part of it is infected with inflammation, which can be called urinary tract infection. Clinically, patients often have symptoms such as dysuria, frequent micturition and urgency, sometimes accompanied by mild abdominal pain and hematuria, and severe cases have symptoms such as low back pain and fever.
There is a reason for recurrent attacks.
Women with urinary tract infection should go to the hospital for ultrasound and urine routine examination of kidney and bladder. If necessary, do bacterial culture and choose effective antibacterial drugs for different bacteria. Urinary tract infection can generally be relieved by taking medicine for two days, but the condition is not completely cured. You should continue the treatment for one to two weeks, and stop taking the medicine after two or three consecutive routine urine tests are completely normal.
Urinary tract infection has become chronic for more than a year and is not easy to treat.
What is the reason why urine always turns yellow after urinary tract infection? 20001October 26th 10, 17: 46 Sina Life.
Q: I had a urinary tract infection before, but I got better later, but now I find that urine is always yellow urine. I don't know why. By the way, can I have sex? I'm very scared now. Can you help me?
Dr. Lin replied: I don't know if your urine has been yellow because of urinary tract infection. If there is, it can be ignored. If it appears after a urinary tract infection, you should first doubt whether the infection is cured, and then check your urine. If there are white blood cells, it means that they have not healed; If there are red blood cells and protein, it may be a kidney problem; If the urine urobilinogen or bilirubin is high, it means that jaundice should continue to check systemic diseases; If it is completely normal, it may be related to drinking less water, taking medicine (such as vitamin B and rifampicin), diet and "getting angry". If it's not an infection, there should be no problem having sex.
Pregnant women beware of urinary tract infection.
China healthy e-commerce network
Women, especially pregnant women, are prone to urethritis, cystitis, pyelonephritis and other diseases due to physiological reasons, which are collectively referred to as urinary tract infection. A hospital has investigated female urinary tract infection, and the results show that the incidence rate of pregnant women is as high as 1 1%.
Pregnant women suffer from urinary tract infection, especially after pyelonephritis. Most patients have symptoms of urinary tract irritation, such as chills, high fever, low back pain, frequent micturition, urgency and pain. What is more noteworthy is that some of these diseases are only manifested as backache, and there are no other symptoms, which are often ignored. Road infection will not only damage the health of pregnant women, but even cause shock and endanger the lives of patients. Moreover, due to high fever and improper use of certain drugs, it is easy to damage the fetus, resulting in miscarriage and premature delivery. High fever will also hinder the development of fetal neural tubes, such as anencephaly and congenital deafness.
Therefore, pregnant women should pay special attention to prevent urinary tract infection. The main method is to appropriately increase nutrition and enhance physical fitness; Restrain sexual intercourse, especially in the first three months after pregnancy and three months before delivery, and try to avoid sexual intercourse. Even if there is occasional sexual intercourse, both men and women should clean their sexual organs and vulva. Women should also urinate once after having sex, flush the urethra with urine to reduce the chance of urinary tract infection, and insist on cleaning the vulva every day and changing underwear frequently. Go to the hospital regularly for routine urine examination. Even if there are no symptoms of urinary tract infection, urine should be checked every two months, at most once a month, so that changes in urine can be found in time and treated. Once you get sick, you should choose appropriate drugs for active treatment under the guidance of a doctor in time.
Urinary tract infection during pregnancy is related to mental retardation in children.
Xinlang technology
American researchers have found that pregnant women with urinary tract infection (UTI) during pregnancy may increase the risk of mental retardation or developmental retardation if they are not treated.
Researchers suggest that pregnant women with urinary tract infections during pregnancy can be treated with antibiotics to reduce the risk of their children getting sick.
Previous studies have shown that in most countries, children with mental retardation account for about 2%, and half of them are unknown. This time, researchers from the University of South Carolina in the United States studied the medical records of more than 465,438+0,000 women during pregnancy and their children for three years, compared the incidence of mental retardation or stunting in the future between pregnant women with urinary tract infection and pregnant women without infection, and compared the incidence of pregnant women who took antibiotics with those who did not follow the doctor's advice. The results showed that about 2 1% of pregnant women diagnosed with UTI and 1.5% of all children suffered from mental retardation. 23.5% of UTI pregnant women did not complete antibiotic treatment within two weeks after diagnosis, and 9% of them had mental retardation or developmental retardation after birth. If UTI pregnant women are not completely treated with antibiotics, their children are more likely to get sick than those who are completely treated.
Previous studies have reported that pregnant women's diseases will affect the intellectual development of the fetus from the eighth week of pregnancy 16 weeks or the last stage of fetal brain development. (East)
Women should beware of urinary tract infection in the third stage.
June 2000 1 1 China Health E-commerce Network
The female urethra is only 3-5 cm long, straight and wide, with weak urethral sphincter and large urethral orifice. This special local structural feature makes women more likely to cause urinary tract infection than men. However, it is worth noting that bacteria do not always threaten women's urinary tract, and are most likely to invade and cause disease in the third stage of women.
1. Menstrual period: During the menstrual period, women's body resistance decreases due to menstrual blood stimulation, and the urethral orifice is prone to infection.
2. Pregnancy: Due to the increase of estrogen secretion, the flora around the urethra changes and the local immunity decreases, which can also cause the tension of ureteral smooth muscle to decrease and peristalsis to weaken. In the third trimester of pregnancy, the uterus expands and oppresses the ureter and bladder, resulting in poor urine flow. These factors will increase the incidence of urinary tract infection during pregnancy.
3. "Menopause": During this period, the female urethral mucosa showed degenerative changes, the secretion of immunoglobulin and organic acid decreased, the local immune function decreased, and the antibacterial ability weakened, which also constituted a high incidence period of urinary tract infection.
In view of the fact that the above three periods are the characteristics of high incidence of female urinary tract infection, in the prevention of female urinary tract infection, we must emphasize the health care in these three special periods to reduce the invasion opportunities of pathogenic bacteria and reduce the incidence rate.
First, we should pay attention to physical exercise and improve the body's resistance. Even if a small amount of pathogenic bacteria invade the urethra, the immune protection barrier of a healthy body can kill it without causing disease.
Second, developing good drinking habits is the simplest way to prevent urinary tract infection. Some people describe drinking water as washing the body, drinking more water and urinating more to wash the urinary tract, so that trace bacteria that invade urine fatigue from time to time are excreted with urine. It is generally better to urinate every 2-3 hours 1 time.
Third, a reasonable diet and increasing the intake of fruits and vegetables, mung beans, red beans and other foods will help reduce urinary tract infections.
Fourth, women should strengthen the health care of perineum on weekdays and clean it regularly. The general cleaning solution is 1: 1000, so it is advisable to use fresh cleaning solution or clean water. Alkaline liquids such as soap and soda are not allowed to be used, so as not to destroy the barrier function of acidic liquid secreted by urethral orifice.
Fifth, don't use bath or pool bath when taking a bath, and insist on taking a shower.
Sixth, the underwear worn is mainly cotton fabrics, avoiding chemical fiber fabrics.
In short, women should pay special attention to the prevention of urinary tract infection in the third stage, which can greatly reduce the chance of infection and reduce the incidence.
Professor Ding Xiaoqiang from the Department of Nephrology, Zhongshan Hospital, Fudan University School of Medicine, has urinary tract infection in the elderly.
The urinary tract of human body consists of kidney, ureter, bladder and urethra. Any part of it has infectious inflammation, which can be called urinary tract infection Patients often have frequent micturition (frequent micturition is obviously increased, but the amount of urine at a time is not much), urgency (urgency to go to the toilet as soon as they have the intention to urinate), dysuria (discomfort such as perineal burning pain when urinating), and sometimes accompanied by symptoms such as backache and fever. The disease is more common in women. 10%-20% of women have had urinary tract infections in their lives, especially during marriage and childbearing. However, both women and men are more likely to suffer from urinary tract infection when they enter old age. According to statistics, the incidence of urinary tract infection over 70 years old is as high as 33.3%, and that over 80 years old is as high as 50%. Once urinary tract infection occurs in the elderly, it is often lingering and difficult to cure. In severe cases, it will also lead to serious consequences such as renal failure and uremia. There's a reason why things happen again and again.
1. The defense function is gradually weakened. Normal people's urinary tract has a good defense ability against the invasion of foreign bacteria. Urine outflow can kill germs; In vivo and in vitro: some high-concentration substances in urine, such as urea, and the acidic environment in urinary tract have the effect of inhibiting bacterial growth. For the elderly, the defense mechanism of urinary tract has changed: ① With the increase of age, bladder contraction is weak, micturition reflex is gradually weakened, there is still more urine in bladder after micturition, and even urinary retention occurs. ② Men over the age of 60 are often accompanied by prostatic hyperplasia or hypertrophy, elderly women are prone to bladder neck obstruction, and elderly people are prone to urinary calculi and other diseases, which can lead to poor urination and sometimes need catheterization, thus increasing the chance of urinary tract infection. According to statistics, the infection rate of young people with first urethral catheterization is only 1%, while the infection rate of the elderly can reach 5%- 10%. ③ The elderly have degenerative diseases in kidney and urinary tract, and the local mucosal resistance is low. ④ The immune function of the elderly decreased, and their resistance to various bacteria decreased. Because of the above changes, the elderly suffer from urinary tract infection, which is not easy to cure or relapse.
2. The elderly with incomplete treatment of acute attack need sensitive antibiotic treatment because of their weak resistance. However, due to medical expenses, medical inconvenience and other factors, many elderly patients often cannot complete the whole course of treatment or follow-up in the hospital according to the requirements of doctors, resulting in incomplete treatment.
Two "regular" elderly patients with urinary tract infection should be "regular" in order to avoid recurrence.
1. Patients with urinary tract infection need to do some tests when they go to the nephrology department of a regular hospital. For example, common B-ultrasound can help to judge whether there is urinary tract obstruction, renal malformation and so on. Retrograde urography can tell whether there is ureteral and bladder reflux, and blood test can judge whether the patient has liver function and renal failure. Once the cause is found and treated in time, the occurrence of urinary tract infection can be significantly reduced. It is worth noting that nearly half of the elderly with urinary tract infection have no symptoms such as frequent urination, urgency and pain, and it is easy to misdiagnose or mistakenly think that the disease has been cured. Therefore, elderly patients with urinary tract infection should go to the nephrology department of a regular hospital for treatment, which is conducive to the radical cure of urinary tract infection.
2. Accepting regular antibacterial treatment mainly includes three aspects: First, choose sensitive antibiotics, and it is best to cultivate bacteria first. When you feel uncomfortable urinating and suspect urinary tract infection, you should keep a urine sample (do bacterial culture) before taking the medicine. If you take the medicine without authorization and then keep the urine sample, the bacteria will not grow easily, which will easily lead to "false negative". Second, the treatment time should be sufficient. The general treatment time of urinary tract infection is 10- 14 days. When the disease recurs, or the condition is serious, the antibacterial treatment time should be appropriately extended. Generally, the symptoms disappear in 5-7 days, the urine white blood cells are normal, and the drug is stopped after the urine bacterial culture is negative. In a few cases, if the symptoms are still not relieved after 2-4 weeks of treatment, long-term antibacterial treatment can be used. The third is to insist on follow-up after stopping the drug. After stopping the drug 1, 2, 4 and 6 weeks, the patient reviewed the urine white blood cells and urine bacterial culture. If the results are negative many times, it can be considered that the disease has been cured. If urinary leukocytosis and urinary bacterial culture are positive again, antibacterial treatment should be carried out again. If it recurs, long-term bacteriostatic therapy can be used. Its purpose is not to completely kill bacteria, but to inhibit the growth of bacteria, so that the number of bacteria in urine is controlled at a low level and does not cause recurrence.
Pay attention to hygiene and prevent urinary tract infection in the elderly. Since it is difficult to cure and easy to relapse, it is necessary to nip in the bud. Specifically, we should pay attention to the following aspects.
1. Life is regular. Take part in some physical exercises every day, such as playing Tai Ji Chuan, jogging and walking. To increase the body's immunity. If you have diabetes, hypertension, kidney disease, etc. You should actively treat it.
2. Drink plenty of water at ordinary times to increase urine output. Drink at least 1000 ml of water (about two cups) every day, and keep the daily urine volume at 1500-2000 ml to strengthen the flushing effect of urine flow.
3. Take a shower while taking a shower, or insist on cleaning the perineum every night. If necessary, use some potassium permanganate to clean or take a bath (potassium permanganate is commonly known as PP powder, and the dosage can be subject to the color of the water in the basin turning pink). Change underwear every day. Towels and underwear are best cooked and disinfected with boiling water. Urine once after the same room to expel bacteria from the urethra.
4. The decrease of estrogen in elderly women after menopause will easily lead to the thinning of urinary tract mucosa, the increase of vaginal PH value and the decrease of local resistance; The decrease of smooth muscle tension such as ureter can cause dysuria. Therefore, estrogen replacement therapy can be carried out under the guidance of doctors, which is helpful to prevent urinary tract infection.
5. The diet of the elderly should be light. Usually you should eat more fresh fruits and vegetables.
What is urinary tract infection?
Urinary tract infection (UTI) refers to urinary tract inflammation caused by the growth and reproduction of pathogens in the urinary tract and their invasion into urinary tract mucosa or tissues. Bacteria are the most common pathogens, and fungi, viruses and parasites can also cause infections.
According to the site of infection, urinary tract infection can be divided into upper urinary tract infection and lower urinary tract infection. Upper urinary tract infection mainly refers to pyelonephritis, that is, infectious inflammation of renal parenchyma and renal pelvis, which is caused by bacteria invading the kidney. Pyelonephritis is clinically divided into acute pyelonephritis and chronic pyelonephritis. Acute pyelonephritis is mostly caused by pathogenic bacteria reaching the kidney through bladder and ureter, which causes inflammation, mainly manifested as acute interstitial inflammation and necrosis of renal tubular epithelial cells in different degrees. With regard to the definition of chronic pyelonephritis, at present, most scholars believe that this kind of diagnosis was too abusive in the past, and chronic pyelonephritis should be limited to those with definite inflammation, fibrosis and deformation of renal pelvis and calyx. If this diagnostic criterion is used, most chronic pyelonephritis is caused by urinary tract infection on the basis of urinary tract infarction, poor urine flow or vesicoureteral reflux. Without the above situation, urinary tract infection often does not cause serious chronic kidney disease. Therefore, the differentiation of acute and chronic pyelonephritis should not be based on the length of its course or the number of recurrent attacks, but on whether the renal pelvis and renal calyx are deformed by imaging examination. Lower urinary tract infection is mainly urethritis and cystitis, and its infectious inflammation is limited to urethra and bladder.
Urinary tract infection can be divided into complex urinary tract infection and simple urinary tract infection according to whether there is abnormal urinary tract function or anatomy. Complex urinary tract infection refers to: ① organic or functional abnormality of urinary tract, causing urinary tract obstruction and poor urine flow; ② There are foreign bodies in the urinary tract, such as stones and indwelling catheters; ③ Intrarenal obstruction, such as urinary tract infection based on chronic renal parenchymal diseases, mostly pyelonephritis, can cause renal tissue damage. Chronic renal failure (CRF) can be caused by long-term repeated infection or incomplete treatment. Simple urinary tract infection does not exist in the above situation. If left untreated, its symptoms and bacteriuria can disappear or become asymptomatic bacteriuria. Pawlowski and others found only 3.65438 0% chronic pyelonephritis in 4596 autopsies, so he thought that adult pyelonephritis, if simple, rarely caused end-stage renal disease (ESRD) or pathological chronic pyelonephritis.
According to the medical history, urinary tract infection can be divided into primary and recurrent, and the latter can be divided into recurrent and reinfection. Primary urinary tract infection was the first; Recurrence refers to incomplete treatment, which often recurs within 6 weeks after drug withdrawal, and is the same strain and serotype as the original infected bacteria, which is more common in pyelonephritis; Reinfection means that the original infection has been cured and reinfected by different strains, which often occurs 6 weeks after the initial treatment stops, and is more common in cystitis. Frequent recurrence must find the reason.
Urinary tract infections studied clinically in the past mostly refer to infections caused by general bacteria, especially Escherichia coli. In recent years, with the development of medical research, we have a new understanding of the role of L-shaped bacteria, fungi, parasites and other special urinary tract infections in men, children, pregnancy and chronic renal failure. This book also introduces the general situation and progress of these special urinary tract infections.
What are the new opinions on clinical classification of urinary tract infection?
For many years, the classification of urinary tract infections has been based on anatomical location and duration of illness, such as acute cystitis and chronic pyelonephritis. Obviously, this classification can't provide the cause or guide the treatment. Because of the diverse clinical manifestations of urinary tract infection, scholars have given different names to the same lesion, so the words used in the literature are confusing. In order to facilitate scholars' research on bacteriuria and make all kinds of nomenclature more clear, the British Medical Research Council set up a special committee in 1979, instructing it to name all kinds of urinary tract infections uniformly. Although it has a name, it also has the function of classification. The Committee does not advocate the use of "asymptomatic bacteriuria"; Instead of "acute cystitis", the word "bacterial cystitis" was used instead of "frequent micturition and dysuria syndrome"; Replace "urethral syndrome" with "aseptic cystitis"; Instead of "chronic pyelonephritis", use "chronic interstitial nephritis". Because the scheme is also based on the fact that the number of bacteria in urine is greater than 105/ml, there are still different opinions on this.
The US Food and Drug Administration recommends the following classifications: infection without complications; Complicated infection; Repeated infection. It is very important to have concurrent infection, which is often serious and difficult to control with drugs. Patients often have obstructive lesions or foreign bodies, stones, urinary tract stenosis, neurogenic bladder, vesicoureteral reflux, diverticulum in different parts and long-term indwelling catheter. For this kind of patients, it is necessary to have a systematic urinary system examination. If complications are not removed, the infection will not disappear. Repeated infections can be divided into two types: one is "recurrence", after treatment, the symptoms disappear, but soon the symptoms reappear, and the pathogen is still the bacteria from the previous attack; The other is "reinfection", which is caused by a different kind of bacteria. As soon as possible, there should be a proper noun difference between these two concepts, and it is not appropriate to use the word "recurrence" to summarize them.
As early as 1975, Stamey proposed that urinary tract infections can be divided into four types:
Initial infection: It can often be treated in outpatient department, but the cause can't be found. Generally speaking, about 1/4 patients will relapse in the future.
Unresolved bacteriuria: The failure of bacteriuria to subside indicates insufficient treatment. The reasons are as follows: (1) Bacteria are drug-resistant and produce mutant strains during treatment; Infection is caused by two or more kinds of bacteria, which were not found at the initial diagnosis, and other bacteria were found after treatment; Another bacterium invades during the treatment.
Refractory infection: refers to the disappearance of urine bacteria after treatment, and soon reappears, which is common in infectious stones, unilateral atrophic pyelonephritis, infectious diverticulum and so on.
Reinfection: All infections after infection fall into this category.
Childs revised the classification of Stamey in 1988, and thought that the infected anatomical site should be combined as much as possible in clinic.
The above classification method is undoubtedly superior to the old classification method in the past, including the content of pathogenesis and prognosis, which is of guiding significance to the treatment, especially to the treatment of recurrent cases.
What are the pathogens that cause urinary tract infection?
Any bacteria invading the urinary tract may cause urinary tract infection. Escherichia coli is the most common, accounting for about 60% ~ 80%, followed by Escherichia coli, Proteus, Klebsiella pneumoniae, aerogenes, Alcaligenes, Streptococcus faecalis, Staphylococcus or Pseudomonas aeruginosa. Occasionally caused by fungi, viruses, parasites, etc. The pathogenic bacteria of the above urinary sensation mainly come from pathogenic bacteria existing in the intestine at ordinary times or conditional pathogenic bacteria parasitic in the intestine at ordinary times. The general rule of infection is that urinary tract infection first, asymptomatic bacteriuria, and its pathogen is often Escherichia coli. Acquired urinary tract infections during hospitalization include those with urinary tract obstruction, those who have used a variety of antibacterial drugs, and those who have received catheterization or cystoscopy. Most of them are infected by Streptococcus faecalis, Proteus and Klebsiella pneumoniae. Pseudomonas aeruginosa urine sensation is especially common after instrument examination, Proteus is more common in urinary calculi, while Staphylococcus aureus is often blood-borne infection. In recent years, it has been found that urinary tract infection of Staphylococcus aureus with negative plasma coagulase is more common in women of childbearing age, and its occurrence is mostly related to sexual life.
What are the causes of urinary tract infection?
There are many factors that cause urinary tract infection, and the reasons related to urinary sensation can be summarized as follows:
(1) Upper urinary tract infection is very common in women, mainly because the female urethra is short, and bacteria are easier to ascend than men. In addition, female urethral orifice has Escherichia coli, and sexual intercourse is an important cause of infection.
(2) It is reported that 4.5% of pregnant women generally have bacteriuria, and the incidence rate is higher than that of non-pregnant women of the same age, and the incidence rate of elderly pregnant women and puerperal pregnant women is higher. So pregnancy is an important cause of urinary sensation.
(3) Urinary tract obstruction is an important cause of upward infection of urine sensation. According to statistics, the incidence of urinary sensation in patients with urinary tract obstruction is 12 times higher than that in those without obstruction. Because of calculus, tumor, urethral stricture, prostatic hypertrophy, female bladder neck obstruction, phimosis, neurogenic bladder, bladder diverticulum's disease, nephroptosis and other reasons, urine flow is not smooth, bacteria are not easy to be excreted from the bladder and multiply in large quantities, and infection is easy to occur.
(4) Urinary tract malformations or functional defects, such as renal hypoplasia, polycystic kidney, medullary cystic lesions, horseshoe kidney and other kidneys, renal pelvis and ureter malformation or vesicoureteral reflux (that is, the abnormal phenomenon of urine flowing back from bladder to renal pelvis during urination), are prone to infection.
(5) Diabetes mellitus complicated with urinary tract infection is more likely, because glucose in urine provides nutrition for bacteria. Once such patients have a feeling of urine, it is easy to be complicated with pyelonephritis and even acute renal nipple necrosis. Therefore, for diabetic patients, urinary tract instruments should be avoided.
(6) Other factors: ① Systemic diseases, such as severe liver disease, chronic kidney disease, advanced tumor and long-term use of immunosuppressive drugs. , make the human body's resistance decline, easy to have a sense of urine. ② Gynecological inflammation, dermatitis and prostatitis are the most common causes of urinary sensation. ③ Patients with decreased renal blood flow caused by hypertension and vascular diseases are prone to infection. ④ Renal damage caused by hypokalemia, hypercalcemia and abuse of painkillers is also prone to urine sensation. ⑤ Urethral catheterization and urethral instrument examination can damage urethral mucosa, or directly bring bacteria into bladder from urethral orifice. According to statistics, even in the case of strict disinfection, the probability of urinary tract infection caused by one catheterization is about 2%, and the indwelling catheter can be as high as 90% for more than 4 days. Urinary tract infection will occur after continuous indwelling catheter 10 days. ⑥ Abuse of phenacetin can lead to renal papilla necrosis, and pathological renal tissue is more susceptible to infection, which may be due to impaired defense function.
How many ways are there for urinary tract infection?
It is generally believed that there are four ways of urinary tract infection: upward infection, blood-borne infection, lymphatic infection and direct infection.
(1) Upward infection: Most urine sensation is caused by upward infection. Under normal circumstances, there are bacteria in and around the urethral orifice, but generally it will not cause infection. When the body's resistance decreases or the urethral mucosa is slightly damaged, or the bacteria are highly toxic and have strong ability to adhere to the urethral mucosa and ascend, it is easy to invade the bladder and kidney and cause infection. Because the female urethral orifice is close to the anus, and the female urethra is much shorter and wider than that of men, the female urethral orifice is often polluted by feces, so it is more likely to cause disease.
(2) Blood-borne infection: Bacteria invade the blood stream from infected lesions in vivo (such as tonsillitis, sinusitis, dental caries or skin infection, etc.). ) and reach the kidney, first causing multiple small abscesses in the renal cortex, and then spreading down the renal tubules to the renal papilla, renal calices and renal pelvis mucosa. However, inflammation can also start from the nipple collecting duct, accompanied by mild renal nipple injury (such as lens injury in urine), and then spread up and down. Blood-borne infection is rare, less than 10%. Blood-borne infections are more common in newborns, or blood-borne renal infections occur in patients with Staphylococcus aureus septicemia.
(3) Lymphatic infection: There are many communicating branches between the lymphatic vessels in the lower abdomen and pelvic organs and those around the kidney, and there are also lymphatic communication between the ascending colon and the right kidney. When pelvic organ inflammation, appendicitis, colitis, bacteria can also infect the kidney from lymphatic channels. This route of infection is even rarer, and even the existence of this route of infection is controversial at present.
(4) Direct infection: During trauma or organ infection near the kidney, bacteria can directly invade the kidney and cause infection, but this situation is very rare in clinic.
What is the pathogenesis of urinary tract infection?
Urinary tract infection is mainly caused by bacteria, many of which are conditional pathogens. The urethra is a cavity communicating with the outside world. A considerable number of bacteria live in the anterior urethra of 65438±0cm in healthy adult women and 3 ~ 4 cm in the anterior urethra of men. Because urethra has defensive ability, maintaining the balance between urethra and bacteria, bacteria and bacteria usually does not cause urinary tract infection. When the human body's defense function is destroyed, or the bacteria are highly pathogenic, it is easy to have an ascending urinary tract infection. It is generally believed that the occurrence of urinary tract infection depends on the pathogenicity of bacteria and the body's defense function. In the process of onset, it is also related to the immune response of the body.
(1) Defensive function of urinary tract: The bladder urine of healthy people is sterile. Although a large number of bacteria live in the anterior urethra and urethral orifice, which can rise to the bladder, the bacteria that rise to the bladder can be quickly eliminated. After 4 days of indwelling catheter, more than 90% patients can have bacteriuria, but most patients can disinfect themselves after extubation. This shows that bladder has the function of inhibiting bacterial reproduction. It is generally believed that the defense function of urinary tract mainly includes the following aspects: ① Normal innervation, coordination and effective urination activities of all parts of urinary tract play an important role in preventing infection. The kidney constantly produces urine, which flows into the bladder from the ureter and plays the role of washing and diluting the bladder. Through the physiological activity of bladder periodic urination, the inoculated bacteria in urinary tract can be mechanically "washed out", thus preventing or reducing the chance of infection. The results of animal experiments show that this is a very effective mechanism. ② The more important defense mechanism is that urinary tract mucosa has the ability to resist bacterial adhesion. Animal experiments show that urothelial cells can secrete mucins, such as glucomannan, glycoprotein and mucopolysaccharide. , all have antibacterial adhesion. Scanning electron microscope observation: there is a white mucus-like substance on the urothelial cells, and bacteria can be attached to this substance. When urinating, if these mucins can be excreted, the invading bacteria will also be excreted. The mucin-like substance secreted by elderly women in urine is much less than that of young women, which may be one of the factors that make elderly women susceptible to infection. If dilute hydrochloric acid acts on bladder mucosa for only 1 min, the adhesion rate of bacteria can be increased, because dilute hydrochloric acid can destroy mucin and provide conditions for bacterial invasion. After 24 hours, the bacterial adhesion rate can be restored to the state before hydrochloric acid treatment. After the mucin layer is destroyed by dilute hydrochloric acid, if exogenous mucopolysaccharides such as synthetic pentosan polysulfate are infused into the bladder, the antibacterial adhesion function can be restored. ③ Animal experiments also prove that bladder mucosa has bactericidal ability. Bladder can secrete organic acids, IgG, IgA, etc. It inhibits pathogenic bacteria and kills bacteria by phagocytosis. ④ Low pH value of urine, high concentration of urea and organic acid, too low and too high urine tension are all unfavorable to the growth of bacteria. ⑤ If bacteria cannot be removed, bladder mucosa can secrete antibodies to resist bacterial invasion. ⑥ Male prostatic fluid has antibacterial effect on Gram-negative bacteria, and its antibacterial effect may be related to its zinc concentration.
(2) Pathogenicity of pathogenic bacteria: The main parasitic bacteria around the urethra of healthy people are Lactobacillus, Staphylococcus epidermidis, Streptococcus faecalis and Diphtheria. Before urinary tract infection, the strains there changed, mainly Escherichia coli. Escherichia coli is the main pathogen of urinary tract infection. However, not all intestinal Escherichia coli can cause infection. Through serotyping of O antigen (bacterial antigen of Escherichia coli) and isoenzyme typing of electrophoresis bacteria, it was observed that only a few strains could cause urinary tract infection, with 0 1, 04, 06, 08 and 075 as the most common strains.
Bacteria can colonize the urinary tract and cause