Infectin of GUT课件.ppt

Infection of GUT  Chen Wei Associate Prof. Department of Urology The First Affiliated Hospital SUMS Introduction  Definition Pathogen stay and grow in any part of GUT causing inflammation Defense system in GUT Normal flora stay in meatal skin and mucosa of urethra, secrete bacteriocin, metabolic products, to suppress the growth of pathogen , compete nutrients Urothelium secrete mucin preventing bacteria adhesion Anti-reflux mechanism Predisposing factors Obstructive: as stones, tumor, stricture, BPH Body resistance, hypertension, diabetes, pregnancy, congenital immunodeficiency Iatrogenic: catherterization, cystoscopy Renal parenchyma diseases: renal injury, renal failure, interstitial nephritis Anatomical: female urethra Pathogen Gram-negative: 85% Bacillus coli Gram-positive: Staphylococcus aureus Chlamydia Mycoplasma Mode of infection retrograde blood lymph direct Diagnosis Clinical features Laboratory investigation Bacterial culture and colony counting: 105/ml Principles of treatment Select sensitive antibiotics Use at least two kinds of sensitive antibiotics to avoid production of drug resistant strain Use full dose as early as possible Administer lower nephrotoxin antibiotics Pyonephrosis Infection in parenchyma, pelvis or calyces cause broad parenchyma damage, pus accumulated in pelvis and calyces gradually, in the end the kidney becomes a pus containing cyst. It may be caused by bacterial pyelonephritis or specific infection as renal TB Pyonephrotic kidney:outer surface