Recurrent urinary tract infections are common in young female patients, and common triggers of recurrent urinary tract infections in women include.
1. Urinary tract obstruction: seen in functional or anatomical abnormalities (e.g., neurogenic bladder, vesicoureteral reflux, urinary tract stones, malformations, etc.) and is the most common cause.
2, use of urinary tract instruments: bacteria can be brought into the bladder and/or damage the mucosa of the urinary tract.
3, poor general condition of the organism: such as old age, application of immunosuppressive drugs and diabetes mellitus.
4, genetic factors: some studies have shown that the urinary epithelial cells of non-secretory or P1 blood type positive female patients are more likely to adhere to bacteria and thus prone to recurrent urinary tract infections.
5, life behavior: excessive frequency of sexual intercourse and the use of spermicide-containing vaginal diaphragms or condoms for contraception.
Generally speaking, the most common causative agent of urinary tract infection is Escherichia coli, other causative agents include Enterococcus faecalis, Bacillus variegatus, Staphylococcus aureus, Pseudomonas aeruginosa, etc. Urine culture is an important tool to confirm the diagnosis of urinary tract infection, and a bacterial colony count of >105/ml in mid-stage urine culture or >102/ml in bladder puncture urine culture can confirm the diagnosis of urinary tract infection.
Patients with uncomplicated urinary tract infections with a clear outpatient diagnosis generally do not require urine culture testing and can be given empirical treatment directly; however, routine urine culture testing is required for patients with.
(1) Patients with recurrent urinary tract infections;
(2) Patients who have failed to respond to treatment;
(3) Patients with complicated urinary tract infections;
(4) Patients who develop urinary tract infections after hospitalization.
For patients who present with.
(1), (2) and (3) cases it is also necessary to periodically recheck urine culture to evaluate the efficacy of the drugs and whether the reappearance of urinary tract infection is a recurrence or a reinfection.
It is generally accepted that a recurrence of the same bacteria within two weeks of recovery from a urinary tract infection is considered a recurrence of the infection; conversely, a recurrence of the infection after two weeks of recovery from a urinary tract infection is diagnosed as a reinfection, regardless of whether the causative organism is the same as the previous one.
Clinically, routine urinary tract imaging is generally not required for patients with uncomplicated urinary tract infections such as young ones, but urological imaging (ultrasound or CT) should be done when the patient presents with the following manifestations:
(1) Those who present with renal colic or abdominal plain films showing urinary stones;
(2) Fever even after 3 days of reasonable antibiotic treatment;
(3) Those who relapse soon after stopping the medication.
Regarding the standard treatment of uncomplicated urinary tract infections: the current recommendation is to treat patients with lower urinary tract infections with three-day antibiotic therapy. One tablet of trimethoprim-sulfamethoxazole (each tablet contains 160 mg of trimethoprim and 800 mg of sulfamethoxazole) can be used twice a day; or ciprofloxacin 0.25 g/dose twice a day.
For patients with upper urinary tract infection can be treated with oral or intravenous antibiotics according to the condition, for female patients with upper urinary tract infection without underlying disease, without pregnancy, and without systemic toxic symptoms can be treated with oral quinolones or compound sulfamethoxazole in outpatient clinic for 7~14 days; otherwise, at least in the early stage of the disease, should be hospitalized intravenous quinolones or aminoglycosides combined/not combined ampicillin, for a total course of at least 14 days.
Prevention strategies for recurrent urinary tract infections include.
1. general measures.
(1) Drink more water, preferably with a daily fluid intake of 2000 ml or more.
(2) For patients with sex-related problems, urinate promptly after sexual intercourse. If necessary, consult an obstetrician and gynecologist and choose an appropriate form of contraception.
(3) Avoid the use of urinary tract devices as much as possible.
(4) Mango orange juice (Cranberry Juice), experimental studies have shown that Mango orange juice can prevent E. coli from adhering to the epithelial cells of the urinary tract, so it can help prevent urinary tract infections.
2, antibiotic prevention: antibiotic prevention can significantly reduce the chances of recurrence of urinary tract infections in women.