Urinary Tract Infection (UTI) is very common in the community and that there is a need to improve overall hygiene as part of its prevention. This was pointed out at a Continued Medical Education (CME) programme at the Liaquat National Institute of Kidney Diseases.
It was attended by over 200 doctors including GPs, trainee doctors and specialists. Professor Dr Iffat Yazdani, Director Liaquat Institute of Kidney Diseases and Consultant Nephrologist, stressed that bacteria in urine is not a disease and normal bacterial flora is beneficial and key part of host defence against infection.
She pointed out that bacteriuria alone is rarely an indication for antibiotic treatment in the general population.
Bacteriuria can only be an absolute indication for antibiotic treatment when there is convincing evidence that eradication of bacteriuria in immunocompromised, diabetic patients or pregnant women will lead to meaningful health gain at acceptable risk, Professor Iffat added.
Dr Fahimul Hassan, Consultant Nephrologist, said that identification of asymptomatic bacteriuria early in pregnancy is important because there is 30 percent risk of developing acute pyelonephritis later in pregnancy. He stated that women with either symptomatic or asymptomatic infection treated in early pregnancy should be followed with monthly urine culture.
If second episode occurs in pregnancy, then prophylactic antibiotic showed be continued for the rest of the pregnancy, Dr Fahim added. Dr Aziz Abdullah, Head Department of Urology Liaquat National Hospital, Karachi, pointed out that elderly people are more prone to get UTIs because of acquired anatomical abnormalities, decrease bladder defence mechanisms and frequent instrumentation and hospitalisation.
He further said that to prevent them from getting UTIs it is important to improve over all hygiene, socio-economic and aseptic method of instrumentation/procedures.
Dr Ishrat Saleem Consultant Urologist Liaquat National Hospital, Karachi, said that children are vulnerable to get urinary tract infections because of various congenital anatomic abnormalities like vesico-ureteric reflux, Ureterocele, Pelvic-ureteric junction obstruction and posterior urethral valves.
He emphasised that cause of the problem should be solved rather than just to treat UTI, which will recur in due course of time.
He also urged the family physicians to evaluate carefully especially children who presents with any urinary complain and refer them to appropriate person at the earliest to avoid long term damage to bladder or kidneys.