Saturday, August 30, 2014

ឆ្លងមេរោគផ្លូវទឹកមូត្រ (Urine Tract Infection)


Ward Test/Simple Urine Test 


Understanding  Urine Tract Infection

Summary by Better Health Channel 

Urinary Tract Infections (UTIs) are very common in women, babies and the elderly. The most common cause is a bacteria called Escherichia coli (E. coli), which usually lives in the digestive system and bowel. Infection can target the urethra, bladder or kidneys.

Below is the Conclusions and Relevance from clinical review published in the Journal of the American Medical Association (JAMA).
Establishing a diagnosis of symptomatic UTI in older women requires careful clinical evaluation with possible laboratory assessment using urinalysis and urine culture. Asymptomatic bacteriuria should be differentiated from symptomatic UTI. Asymptomatic bacteriuria in older women should not be treated.


The clinical spectrum of UTIs

Asymptomatic bacteriuriais a significant number of bacteria in the urine that occurs without usual symptoms such as burning during urination or frequent urination (Medline Plus), Asymptomatic bacteriuria is transient in older women, often resolves without any treatment, and is not associated with morbidity or mortality (JAMA).

Asymptomatic bacteriuria: is when a patient has both clinical features and laboratory evidence of a urinary infection  (JAMA)

Observation

An urine test or ward test (as one may call it)  would randomly perform when a person had a fall, showed some changes in verbal or physical or both verbal and physical behaviours. Most of the time there were some but a lowtpretest probability of UTI - +1 or 2 leukocyte without any nitrites and the person concerned did not have a temperature. 

These days, there are many doctors who are reluctantly to prescribe any medication for this asymptomatic (though person concerned is shown behaviours mentioned above) - this would be in line with the Conclusions and Relevance mentioned above.

In such case, Doctors would normally request for urine specimen to be collected and sent off to laboratory, increase fluid intakes and continue to monitor for any changes in behaviours or unless the person concerned would have a temperature. 


Read more >>>> Urinary Tract Infections in Older Women A Clinical Review

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