Complicated urinary traction infection (UTI) is an infection in either the upper or lower urinary tract in a patient that is at an increased risk for acquiring infection or failing treatment.
A complicated urinary tract infection (UTI) has relapsing and refractory characteristics, and is sometimes life-threatening because of patient predisposing factors as well as the recent worldwide spread of multi-drug resistant bacteria.
Risk factors for complicated UTI include both functional and structural abnormalities such as diabetes mellitus, immunocompromise, urinary catheterization, and urinary tract obstruction.
The most common form of UTI is cystitis (bladder infection) characterized by irritative symptoms such as urinary urgency, frequency, dysuria, hematuria, foul- smelling urine, and suprapubic pain.Symptoms associated with "upper urinary tract" infections, exemplified by pyelonephritis, may include those typical of cystitis, as well as fever, rigors, flank or abdominal pain, and frequently associated with nausea and vomiting.
The management of complicated urinary infection is individualized depending on patient variables and the infecting organism.The combination of clinical findings and urine evaluation is essential for diagnosis of UTI. Treatment is based upon pathogen identification and the type and degree of clinical illness, as well as the presence or absence of predisposing host factors. In general, the treatment consists of hydration, relief of urinary tract obstruction, removal of foreign body or catheter if feasible, and judicious use of antibiotics.
