PATGENOS CAUSANTES

ENTEROBACTERIAS (GRAM NEGATIVAS)

Escherichia coli .

cistitis y pielonefritis

Klebsiella.

Estreptococo faecalis.
GRAMPOSITIVAS
Estafilococo aureus.
Diseminacin hemoltica

Estreptococos
betahemoliticos del
grupo B. Infecciones en mujeres

Proteus.
Pseudomonas.
Serratia.
Citrobacter

embarazadas

Bibliografia
Translated from the Eighteenth English edition of: Smith & Tanaghos General Urology.
Copyright 2013 by McGraw-Hill Companies, Inc. Previous editions copyright 2008, 2004, 2001, 2000 by
the McGraw-Hill Companies, Inc. All Rights Reserved ISBN: 978-0-07-162497-8

PATGENOS CAUSANTES
Bacilos GRAM (-)
E. Coli80% a 90%
Proteus Mirabilis..
Klebsiela.
Enterobacteria
10%
Serratia
Pseudomona.. 1 a 2%

Bacilos GRAM (+)

Enterococo (RN)1%
Estreptococo grupo B (RN)
Estafilococo aureus, saprofitico,
epidermitis

REFERENCES
Naber KG, et al. EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI)
Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). Eur Urol, 2001. 40(5): p. 57688.

TECNICAS DE RECOLECCION DE ORINA

CHORRO MEDIO
PUNCION SUPRAPUBICA.
LACTANTES.
PACIENTES SONDADOS
DIFICULTAD TECNICA PARA OBTENER ORINA POR CHORRO MEDIO
GERMEN INUSUAL EN UROCULTIVO (CANDIDA).
CATETERISMO URETERAL O PUNCION DE LA PELVIS RENAL.
Bibliografia
Translated from the Eighteenth English edition of: Smith & Tanaghos General Urology.
Copyright 2013 by McGraw-Hill Companies, Inc. Previous editions copyright 2008, 2004, 2001, 2000 by
the McGraw-Hill Companies, Inc. All Rights Reserved ISBN: 978-0-07-162497-8

ANALSIS DE ORINA

VS

Las esterasas son un compuesto

producido por la descomposicin de
leucocitos en la orina
Los nitratos urinarios se producen
mediante la reduccin de nitratos
dietticos, de la dita por parte de
muchas bacterias Gram (-).
En una microscopia CFU >100000 y mas
de tres leucocitos por campo tenemos
sugerencia de infeccin.

UROCULTIVO

La muestra se puede almacenar hasta

por 24 para poder realizar el
urocultivo.
En vista de que las bacterias se agrupan
por colonias se cuanta la cantidad en
milmetro de orina (CFU/ml).
Depende el mtodo de recoleccin, el
genero del paciente y el tipo de
bacterias aisladas.

Bibliografia
Translated from the Eighteenth English edition of: Smith & Tanaghos General Urology.
Copyright 2013 by McGraw-Hill Companies, Inc. Previous editions copyright 2008, 2004, 2001, 2000 by
the McGraw-Hill Companies, Inc. All Rights Reserved ISBN: 978-0-07-162497-8

DIAGNOSTICO
UROCULTIVO
Siempre con tcnica de chorro medio o puncin suprapbica.
Significativo:
Por chorro medio: >100.000 UFC/ml.
Cateterismo: >100 UFC/ml.
Puncin suprapbica: todo cultivo positivo independiente del rto. de colonias
Bibliografia
Translated from the Eighteenth English edition of: Smith & Tanaghos General Urology.
Copyright 2013 by McGraw-Hill Companies, Inc. Previous editions copyright 2008, 2004, 2001, 2000 by
the McGraw-Hill Companies, Inc. All Rights Reserved ISBN: 978-0-07-162497-8

UROCULTIVO

TECNICAS MAS FRECUENTES PARA EVALAUAR

EL APARATO URINARIO
UROGRAMA EXCRETOR.
PERMITE IDENTIFICAR OBSTRUCCIONES O CUERPOS EXTRANOS\LITIASIS.
CISTOURETROGRAFIA MICCIONAL
PARA DIAGNOSTICO DE REFLUJO Y RESIDUO POSMICCIONAL.
URETROCISTOSCOPIA.
DETECTA OBSTRUCCIONES Y CUERPOS EXTRANOS EN EL APARATO URINARIO BAJO.
ECOGRAFIA.
POSIBILITA EL DIAGNOSTICO DE DILATACIONES DE LA VIA EXCRETORA , LITIASIS.
ESTUDIOS URODINAMICOS.
EVALUACION DEL APARTATO URINARIO INFERIOR

Estudios de localizacin
El cultivo de la muestra indica si existe infeccin
en las vias urinarias superiores. En hombres, es
posible diferenciar la infeccion en las vias
urinarias inferiores
1.

Se recolecta una muestra al principio de la

miccin y representa posible infeccin uretral.

2.

se recolecta una muestra del chorro medio que

representa posible infeccin vesical.

3.

se da masaje a la prstata y se pide al paciente

que vuelva a orinar; esta muestra representa
posible infeccin prosttica.
Bibliografia

Translated from the Eighteenth English edition of: Smith & Tanaghos General Urology.
Copyright 2013 by McGraw-Hill Companies, Inc. Previous editions copyright 2008, 2004, 2001, 2000 by the McGraw-Hill
Companies, Inc. All Rights Reserved ISBN: 978-0-07-162497-8

 Pathogenesis of UTIs Microorganisms can reach the urinary tract by haematogenous or lymphatic
spread, but there is abundant clinical and experimental evidence showing that the ascent of
microorganisms from the urethra is the most common pathway that leads to a UTI, especially
organisms of enteric origin (e.g. E. coli and other Enterobacteriaceae). This provides a logical
explanation for the greater frequency of UTIs in women than in men, and for the increased risk
of infection following bladder catheterisation or instrumentation. A single insertion of a catheter
into the urinary bladder in ambulatory patients results in urinary infection in 1-2% of cases.
Indwelling catheters with open-drainage systems result in bacteriuria in almost 100% of cases
within 3-4 days. The use of a closed-drainage system, including a valve to prevent retrograde
flow, delays the onset of infection, but ultimately does not prevent it. It is thought that bacteria
migrate within the mucopurulent space between the urethra and catheter, and that this leads to
the development of bacteriuria in almost all patients within ~ 4 weeks.

REFERENCES
Naber KG, et al. EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI)
Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). Eur Urol, 2001. 40(5): p. 57688.