Features bacteriuria. Diagnosis of the disease. Asymptomatic bacteriuria in pregnancy. Methods of treatment and prevention measures
In medicine, bacteriuria is the state in which the bacteria are found in urine. Violation will tell the study urine with a microscope.
Completely healthy person produces a sterile urine. However, the microbes get into the bladder and multiply rapidly when there is kidney infection or urinary system.
Bacteriuria in pregnancy It is caused by bacteria entering throughkidney filter, which struck the pathological process. In the case where the number of colonies of bacteria not more than 105 per 1 ml, then talk about dirty urine. If these numbers are higher - began bacteriuria.
Features of the disease
The penetration of pathogens in urinein several ways - descending and ascending. In the first case, the contamination comes from the source of inflammation: kidney, bladder, prostate, urethra.
In the second case - by external interventions(Catheterization, cystoscopy, lithoclasty, probing). Probably getting from the intestines or genitals (lymphohematogenous path) and the foci of infection (hematogenous).
Distinguish true bacteriuria when germs multiply in the urinary tract, and false when the bacteria pass from the blood into the urine via the kidneys, but not multiply.
Bacteriuria detected in the urine during pregnancycan be triggered by: E. coli, staphylococcus, streptococcus, Proteus, Pseudomonas aeruginosa, etc. Often, this occurs when inflammation of the kidneys or urinary tract.. Most bacteria are found in people who have recently emerging infectious disease. It is also possible violation of those who suffer from frequent constipation, diseases of the colon, proctitis, anal fissures.
Basically, this phenomenon resembles cystitis or pyelonephritis: temperature rises to low grade, there are frequent urination, urine becomes cloudy, sometimes with sediment.
Diagnosis of the disease
Identify possible violation of several methods: pressure reducing glucose test nitrite test and Griess TTX-test.
The clinics use chemical conditionsresearch that can help you quickly get the result. Quantitative bacteriological methods can accurately determine the extent of the violation and the number of colonies of bacteria. The inaccuracy of the results possible with excessive drinking, use uroseptikov etc. When the diagnosis is confirmed, the next step is to determine the type of bacteria and their sensitivity to antibiotics and sulfonamides.
Asymptomatic bacteriuria in pregnancy
When the bacteria present in the urine, but the patient orwhat does not complain about it - asymptomatic bacteriuria. It can be diagnosed when the level of bacteria in the urine, which corresponds to the true bacteriuria is found in at least two samples. At the same symptoms completely absent.
But it is worth noting that most of itdiagnosed in healthy women and what they are older, the higher the risk of this condition. In males it is usually seen in the elderly. In some cases the disorder can be accompanied by diabetes.
Bacteriuria, which arose during pregnancyIt increases the risk of infection of the urinary tract and may cause pyelonephritis. Women are also in this period, subject to extension of the ureter and nephrolithiasis. Very often the pathology data developed in the last trimester of pregnancy.
If you do not treat the disease, it is possible the birthbaby with low birth weight or premature birth. With adequate and correct treatment, in most cases during pregnancy it is possible to prevent the development of complications.
There are several factors that influence thedevelopment of the pathology in the childbearing period. However, they all arise from the same cause - owing to the action of progesterone (hormone main pregnancy) on ureter muscle tone, as well as the pressure on their uterus, which is growing rapidly.
Among these factors is:
- Formation of the physiological hydronephrosis;
- Slow speed of passage of urine, provoked a decrease in motility of the ureters;
- Lowering the tone of the bladder;
- A large amount of residual urine;
- Changing the characteristics of urine, contributing to the growth of microbes.
Even in the early stages of pregnancy isidentify possible violations. It is worth to note that only 1% of cases, it occurs in later stages of pregnancy. Sometimes this condition indicates the presence of bacterial vaginosis, which is not found before pregnancy.
Diagnosis of asymptomatic bacteriuria
Is directed to the delivery of the analysis are usually thosepatients who have a high risk of developing complications. First of all - it is pregnant women. The optimal period for the study considered 16 weeks of pregnancy.
Should also be examined people who have hadinvasive urological procedures, with fever, immunosuppression, with unknown origin. The mandatory tests must take children to 6-year-old, who suspected urinary tract infection.
Treatment of asymptomatic bacteriuria in pregnancy
To eliminate the violation is not required in patients with diabetes mellitus, a urinary catheter, the elderly and students, who have organic changes in the urinary tract.
In the absence of immunosuppression per setreatment is also not required, but it is only if there is no structural changes in the urinary tract. It should be noted that in some situations, there is a replacement of normal flora on the passage of a pathogenic antimicrobial therapy.
Otherwise, the treatment must be complex. First you need to remove the focus of inflammation, increase the reactive forces of the body, to eliminate the violation of passage of urine. Sometimes patients prescribed spa treatment and diet.
In the absence of symptoms need to be addressedbacteriuria in newborn infants, preschool children, adolescents. At the same time eliminate chronic prostatitis. Women are usually prescribed single dose of an antimicrobial drug.
If necessary, the doctor may prescribe antimicrobials reception during the week. Often it is in need of such treatment of pregnant women.
When choosing a drug the doctor considersnot only the state of the mother, but also the possible impact of drugs on the fetus. Under no circumstances should not be appointed by the fluoroquinolones, which discharged the rest of the patients with urinary tract infections.
Often, for the treatment of pregnant women used amoxicillin, or a drug complex, consisting of amoxicillin and klavulanatoma. Duration - 7 days.
In the case where a large amount of detectedmicrobes, that is a violation of running too, the doctor may prescribe fosfomitsintrometamol (once). But in this situation it is advisable to use the drug if the benefit to the mother outweighs the potential risk to the fetus.
But in most cases, treatment of pregnant womenWomen are not performed using a single dose of drugs, as to achieve the desired effect it is very difficult in this situation. Therefore, for several days or weeks of a woman by a doctor can drink cephalosporins, nitrofurans, or ampicillin.
After the violation was able to fix it,It needs to be tested regularly to prevent recurrence of the disease. If bacteriuria is detected in the urine again, it is assigned to maintenance therapy, which lasts until the birth itself. After giving birth, she goes on another couple of weeks. The course of treatment is receiving antimicrobials and uroseptikov.
However, the complex includes not onlymedications. Women need to take measures to reduce the acidity of urine and enhance its passage. Mainly for this purpose in the diet are introduced corresponding products. Well-proven cranberry juice.
Pregnant women should take allpossible measures to prevent the development of bacteriuria. When registration at antenatal clinics woman delivers first biochemical and clinical blood and urine tests. In the future, it will take them regularly. It is mandatory to all pregnant women conducted bacteriological examination of urine.
If necessary, the doctor may sendan ultrasound of the kidneys. In some situations you need to take antimicrobial agents to reduce the risk of purulent pyelonephritis, fetal malnutrition and premature birth.