URINARY TRACT INFECTIONS IN HUMANS AND COMPANION ANIMALS

摘要

Urinary tract infection or acute cystitis is one of the most common reasons that patients seek physician advice. This infectious disease affects primarily women and more rarely men, however in later years, urinary tract infections increase in men in association with surgical procedures, instrumentation and catheterization. Diabetes, being uncircumcised and having an enlarged prostrate are also risk factors for UTI. Despite this, UTI's remain primarily a female disease with up to 50% of women having at least one infection by age 30 and recurrent infections are common with upward of 25% of women experiencing a second infection within 6 months. Simple acute cystitis is an infection of the bladder and is different than upper tract infection or pyelonephritis or kidney infection.Acute cystitis is most often characterized by painful urination, urinary frequency and/or urgency in urination (Table 1). In contrast, pyelonephritis also may include flank pain, fever and nausea. Risk factors for UTI include a shorter urethra in femalepatients facilitating ascending infection, family history and/or sexual intercourse. For pyelonephritis, bladder infection may precipitate upper tract involvement or infection may result from haematogenous spread.In elderly patients, typical symptoms of UTI may be absent and replaced by symptoms of incontinence, changes in mental status or fatigue or in more advanced cases sepsis with or without fever. In younger patients (children) fever may be the only symptomand in others symptoms of incontinence may be the presenting symptoms ; however, in older children symptoms of dysuria, urinary frequency, hematuria, abdominal pain or new daytime incontinence may be present.The impact of UTIs should not be underestimated. Fox et al indicated the average episode of cystitis is associated with 6.1 days of symptoms, 2-4 days of restricted activity, 1.2 days of not working/attending school and 0.4 days in bed. While such similar information may be difficult to determine in companion animals, clearly social and financial impacts likely occur to pet owners related to therapy costs and possibly lost productivity due to absenteeism from work/school or altered plans while attending to a sick pet.