Overview of the epidemiology, etiology, clinic, diagnostics and treatment of urosepsis

Abstract

Rūta Marija Rainytė1, Agnė Šaltkauskaitė2, Bernadeta Kalvelytė1 1Lithuanian University of Health Sciences, Medical Academy, Faculty of medicine 2Department of Family medicine, Lithuanian University of Health Sciences Abstract Urosepsis is a term which describes a type of sepsis caused by infection in the urinary tract. This type of sepsis is one of the most common. The main reason of urosepsis is urinary tract obstruction. If urosepsis is suspected, patient’s condition should be assessed using qSOFA score and in case there are indications – blood culture and culture from suspected infection area (urine) should be taken. Survival rate depends on how fast the treatment by antibiotics begins. If a septic patient doesn’t get help fast, this state could lead to multiple organ dysfunction following respiratory failure, renal failure, hepatic impairment and disseminated intravascular coagulation. That is the reason why empirical antibacterial treatment should be given as soon, as the diagnosis of urosepsis is made. Also, it is important to monitor and correct vital signs such as blood pressure, heart and respiratory rate and saturation if it is needed. The aim of this publication is to review epidemiology, etiology, clinical manifestation, diagnostics and treatment options of urosepsis from scientific literature. Aim: to analyze factors which indicate and are used in urosepsis diagnostics and overview recommendations of urosepsis treatment. Methods: a systematic search of the literature was made using PubMed database. The keywords for this analysis were: urosepsis, etiology, symptoms, diagnostics, treatment, qSOFA. Over 90 articles were read of which 16 were selected for this review. Results. After the literature analysis was made, it came to conclusion that in urosepsis diagnostics there are not any specific biomarker which could help to detect sepsis. Urosepsis diagnosis should be formed using clinical evaluatian, laboratory results and visual imaging methods. The most important symptoms for urosepsis are increasd respiratory rate (more than 22 breaths per minute), impaired consciousness which is lower than 15 using Glasgow coma scale and decreased sistolic blood pressure (lower than 100mmHg). It is really important to asses C – reactive protein (CRP), procalcitonin, platelets, kreatinin and bilirubin. These factors if added duresis, evalutation of hemodynamics and PO2/FiO2mmHg could help to count SOFA score which indicates if a patient is septic or not. First choice imaging method for urosepsis is ultrasound. It is recommended to take blood and urine cultures before giving antibiotics for empirical treatment. Keywords: urosepsis, etiology, symptoms, diagnostics, treatment, qSOFA.