Complicated urinary tract infections (cUTIs) are a major cause of hospital admissions and are associated with significant morbidity and health care costs. Knowledge of baseline risk of urinary tract infection can help clinicians make informed diagnostic and therapeutic decisions. Prevalence rates of UTI vary by age, gender, race, and other predisposing risk factors. In this regard, this book provides comprehensive information on etiology, epidemiology, immunology, pathology, pathogenic mechanisms, symptomatology, investigation and management of urinary tract infection. Chapters cover common problems in urinary tract infection and put emphasis on the importance of making a correct clinical decision and choosing the appropriate therapeutic approach. Topics are organized to address all of the major complicated conditions frequently seen in urinary tract infection. The authors have paid particular attention to urological problems like the outcome of patients with vesicoureteric reflux, the factors affecting renal scarring, obstructive uropathy, voiding dysfunction and catheter associated problems. This book will be indispensable for all professionals involved in the medical care of patients with urinary tract infection.

Urinary tract infections (UTIs) are among the most common bacterial infections in humans. Their frequency varies with age, gender and socioeconomic background. Authored by scientists especially selected for their expertise in the field, this book reviews the latest research data and presents current concepts of the pathogenesis, prevention and treatment of UTIs. Modern methods of diagnosis and new antibacterial agents are evaluated, and recommendations for the choice of antimicrobial and the duration of treatment in different conditions are provided. Besides acute cystitis and pyelonephritis, special attention is given to complicated UTIs, such as infections in renal transplant patients, patients infected with HIV or patients on anticancer drugs and glucocorticosteroid therapy. Finally, areas are identified in which well-designed clinical studies and more basic research could lead to cost-effective improvements in the management of UTIs. This book represents the latest international consensus on treatment and etiology of UTIs. As such, it will assist clinicians and health care professionals in curing their patients and should also be appreciated by basic and clinical researchers in urology, nephrology, microbiology and diabetes.

The causative organisms of Urinary Tract Infection are dynamic in terms of their virulence and resistance patterns, leading to challenges in the prevention and treatment of urinary infection. This is of relevance in both primary and secondary care, and many of the challenges are similar in both developed and developing countries alike. UTI is also associated with considerable cost in terms of morbidity, economic and research expenditure. Written by an exceptional and well-known team of clinical experts, the purpose of Urinary Tract Infections addresses key questions facing physicians about this condition. This book is written primarily for general physicians who wish to have a broad understanding of a number of important issues concerning infection in parts of the urinary tract. Specialists may also find the book useful as a quick reference guide.

Urinary tract infection (UTI) is a problem so common and so significant in routine clinical practice that accurate diagnostics are especially important. In particular, complicated UTI is associated with an increased rate of therapy failures, as a result of possible biofilm formation on foreign elements and antibiotic resistance, as well as the increased possibility of an infection recurrence. These are the arguments for the constant search for novel diagnostic tools and techniques. These and many other vital topics regarding UTI complications, management, and treatment, in addition to antibiotic resistance and bacterial virulence traits allowing us to mitigate or avoid antibiotic action, are presented in this book.

Backing up the pioneering medical researchers and experi menters are the phalanxes and cohorts of practising clinicians in district general hospitals and in general practice who may have to implement and apply any breakthroughs and advances in practical and realistic terms. This they cannot, and should not, be expected to do without careful consideration and analysis. It is essential, therefore, to have regular reviews of the growing points of medicine which are constructively critical as well as being enthusiastic and which can present the issues and implications clearly and fairly to clinicians. The Practical Clinical Medicine series is designed to provide such regular reviews on selected subjects. Each volume is under the charge of an invited editor who selects his team of 4-6 experts. Each contribution is an authoritative, detailed and referenced examination of his topic, is clearly presented in an understandable manner and is practical, relevant and applic able to everyday clinical practice. The series is intended as a means of communication between researchers and practising clinicians. It is dedicated to gener alists who provide primary health care in general practice and to generalists providing secondary medical care in district vii viii Series Editors' Foreword general hospitals. Both are involved in applying good general practical clinical medicine for their patients, but can only succeed in a climate of constant review and examination.

Urinary tract infection remains one of the most common reasons for an individual seeking medical advice. Although the associated morbidity varies widely in adults, such infections are less common but may constitute severe, life-threatening illness in children and in the elderly. Diagnostic tests and treatment have been rationalized in recent years but many practising doctors still have difficulty in appreciating the patho-physiological principles involved. Particular difficulty is often experienced when treating patients with recurrent urinary tract infections, covert bacteriuria, vesico-ureteric reflux, elderly patients and those with indwelling catheters. These topics are fully discussed in this volume. Each chapter has been written by a recognized expert and practical aspects of patient management have been emphasized. The information presented in this volume should prove of interest not only to nephrologists but to all practising clinicians. VII ABOUT THE EDITOR Professor Graeme R. D. Catto is Professor in Medicine and Thera peutics at the University of Aberdeen and Honorary Consultant Phy sician/Nephrologist to the Grampian Health Board. His current interest in transplant immunology was stimulated as a Harkness Fellow at Harvard Medical School and the Peter Bent Brighton Hos pital, Boston, USA. He is a member of many medical societies includ ing the Association of Physicians of Great Britain and Ireland, the Renal Association and the Transplantation Society. He has published widely on transplant and reproductive immunology, calcium metab olism and general nephrology.

Aimed at practicing clinicians and radiologists, this volume provides up-to-date, detailed information on potentially severe urinary tract infections (UTIs), which frequently require intensive in-patient antibiotic therapy, percutaneous or surgical treatment. UTIs are the most prevalent infectious illness, and account for hundreds of thousands of emergency and hospital admissions yearly. Furthermore, UTIs are the most common (almost 40%) type of hospital-acquired infections, with bladder catheterisation being the key risk factor. According to the European Association of Urology guidelines, complicated urinary tract infections (C-UTIs) are those associated with structural or functional genitourinary abnormalities or with conditions that impair the host’s defence mechanisms, leading to an increased risk of acquiring infection or therapy failure. Besides offering current perspectives from urologists, nephrologists, and specialists in infectious diseases, the book presents the techniques and highlights the role of ultrasound and contrast-enhanced ultrasound, nuclear medicine, multidetector computed tomography (CT) and magnetic resonance imaging (MRI) in providing comprehensive investigations of upper and lower tract UTIs, and of systemic infections from unknown sources. Cross-sectional imaging is currently recommended to confirm UTI, to assess severity and look for underlying treatable structural or functional abnormalities, in order to provide a consistent basis for a correct therapeutic choice. Furthermore, dedicated chapters illustrate the current status of UTI imaging in children and the expanding role and possibilities of interventional radiology in the treatment of severe urinary tract infections.

In this issue of Infectious Disease Clinics, guest editor Kalpana Gupta brings her considerable expertise to the topic of Urinary Tract Infection Challenges. This issue aims to serve clinicians and scholars well over the next decade, with the goal of helping the principles that are currently "beyond the basics" become part of everyday armamentarium. - Contains 11 relevant, practice-oriented topics including Reducing Treatment of Asymptomatic Bacteriuria; Diagnostic Stewardship for Urine Cultures; Urinary Tract Infection in Male Patients; Urinary Tract Infection Diagnostic and Management Considerations in People with Spinal Cord Injury and Neurogenic Bladder; and more. - Provides in-depth clinical reviews on UTI Challenges, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The thoroughly updated Eighth Edition of this classic three-volume work provides the most comprehensive, current, and authoritative information on diseases of the kidney and urinary tract. This clinically oriented reference focuses on diagnosis and treatment of specific diseases, disorders, and complications and incorporates the basic science practicing physicians need to evaluate and manage the disease process. Each of the fourteen sections is written by internationally renowned contributors and provides coverage comparable to a complete book. The first two sections review renal basic science and describe current diagnostic tools. The remaining twelve sections cover various types of diseases, including hypertension, urological problems, and urinary tract concerns. Each disease-oriented section begins with an up-to-date review of pathophysiology and then focuses on specific diseases. This edition has new lead authors for more than 25 chapters, and separate chapters on heart disease and the kidney, liver disease and the kidney, and the nephrotic syndrome.