Spaceflight urinary tract infection - Revision history

Rossdonaldson1: /* References */

2025-01-29T18:39:08Z

References

← Older revision		Revision as of 18:39, 29 January 2025
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	==References==		==References==
	<references/>		<references/>

			[[Category:Space Medicine]]

Rossdonaldson1: /* Management */

2024-11-06T16:36:43Z

Management

← Older revision		Revision as of 16:36, 6 November 2024
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	**** Acute or prophylactic treatment of UTIs		**** Acute or prophylactic treatment of UTIs
	**** '''NOT''' available in ISS and Space Shuttle medical kits		**** '''NOT''' available in ISS and Space Shuttle medical kits
	*** Sulfamethoxazole and Trimethoprim ([[~~Bacterim~~ DS]])		*** Sulfamethoxazole and Trimethoprim ([[Bactrim DS]])
	**** Available on IISS and Space Shuttle medical kits		**** Available on IISS and Space Shuttle medical kits
	** 2nd-Line		** 2nd-Line

Rossdonaldson1: /* Management */

2024-11-06T16:36:21Z

Management

← Older revision		Revision as of 16:36, 6 November 2024
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	* Behavioral modifications, e.g. increased fluid intake, may be helpful.		* Behavioral modifications, e.g. increased fluid intake, may be helpful.
	* Topical estrogen therapy may be considered in peri-menopausal and postmenopausal women.		* Topical estrogen therapy may be considered in peri-menopausal and postmenopausal women.
	* De-orbit and intravenous treatment may be required if astronaut exhibits signs of shock or urosepsis (e.g. tachycardia, hypotension, tachypnea, flank pain, etc.).		* De-orbit and intravenous treatment may be required if astronaut exhibits signs of [[shock]] or [[urosepsis]] (e.g. tachycardia, hypotension, tachypnea, flank pain, etc.).

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2024-11-06T16:35:59Z

Management

← Older revision		Revision as of 16:35, 6 November 2024
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	**** Available in ISS and Space Shuttle medical kits		**** Available in ISS and Space Shuttle medical kits
	* Oral analgesia can provide additional relief.		* Oral analgesia can provide additional relief.
	** Acetaminophen (available in ISS and Space Shuttle medical kits)		** [[Acetaminophen]] (available in ISS and Space Shuttle medical kits)
	** Aspirin (available in ISS and Space Shuttle medical kits)		** [[Aspirin]] (available in ISS and Space Shuttle medical kits)
	** Ibuprofen (available in ISS and Space Shuttle medical kits)		** [[Ibuprofen]] (available in ISS and Space Shuttle medical kits)
	* Removal of indwelling catheters as the risk of developing a UTI increases each day one is left in the urinary system. <ref>Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-e50. doi:10.1093/cid/civ933</ref>		* Removal of indwelling catheters as the risk of developing a UTI increases each day one is left in the urinary system. <ref>Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-e50. doi:10.1093/cid/civ933</ref>
	* Behavioral modifications, e.g. increased fluid intake, may be helpful.		* Behavioral modifications, e.g. increased fluid intake, may be helpful.

Rossdonaldson1: /* Management */

2024-11-06T16:35:34Z

Management

← Older revision		Revision as of 16:35, 6 November 2024
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	* Empiric antibiotic treatment<ref>Barratt MR, Pool SL. Principles of Clinical Medicine for Spaceflight. Houston, TX: Springer; 2008.</ref>		* Empiric antibiotic treatment<ref>Barratt MR, Pool SL. Principles of Clinical Medicine for Spaceflight. Houston, TX: Springer; 2008.</ref>
	**1st-Line		**1st-Line
	*** Nitrofurantoin		*** [[Nitrofurantoin]]
	**** Acute or prophylactic treatment of UTIs		**** Acute or prophylactic treatment of UTIs
	**** '''NOT''' available in ISS and Space Shuttle medical kits		**** '''NOT''' available in ISS and Space Shuttle medical kits
	*** Sulfamethoxazole and Trimethoprim (Bacterim DS)		*** Sulfamethoxazole and Trimethoprim ([[Bacterim DS]])
	**** Available on IISS and Space Shuttle medical kits		**** Available on IISS and Space Shuttle medical kits
	** 2nd-Line		** 2nd-Line
	*** Amoxicillin (Amoxil) or Ceftriaxone (Rocephin)		*** [[Amoxicillin]] (Amoxil) or [[Ceftriaxone]] (Rocephin)
	**** Adversely affects indigenous normal flora		**** Adversely affects indigenous normal flora
	**** Available in ISS and Space Shuttle medical kits		**** Available in ISS and Space Shuttle medical kits
	*** Levofloxacin (Levaquin)		*** [[Levofloxacin]] (Levaquin)
	**** Reserved for more complicated or refractory UTIs		**** Reserved for more complicated or refractory UTIs
	**** Available in ISS and Space Shuttle medical kits		**** Available in ISS and Space Shuttle medical kits

Rossdonaldson1: /* Management */

2024-11-06T16:34:55Z

Management

Rossdonaldson1: /* Diagnosis */

2024-11-06T16:33:20Z

Diagnosis

← Older revision		Revision as of 16:33, 6 November 2024
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	* Urine Dipstick		* Urine Dipstick

	==Diagnosis==		===Diagnosis===
	* UTIs are primarily a clinical diagnosis that are supported by typical findings of pyruia (positive leukocyte esterase), bacteriruia (positive urinary nitrites), and occasionally hematuria on urine dipsticks available in pre-packaged ISS and Space Shuttle medical kits.<ref>Pahira JJ. Urinalysis: a comprehensive review [published correction appears in Am Fam Physician. 2006 Oct 1;74(7):1096]. Am Fam Physician. 2005;71(6):1153-1162.</ref>		* UTIs are primarily a clinical diagnosis that are supported by typical findings of pyruia (positive leukocyte esterase), bacteriruia (positive urinary nitrites), and occasionally hematuria on urine dipsticks available in pre-packaged ISS and Space Shuttle medical kits.<ref>Pahira JJ. Urinalysis: a comprehensive review [published correction appears in Am Fam Physician. 2006 Oct 1;74(7):1096]. Am Fam Physician. 2005;71(6):1153-1162.</ref>

Rossdonaldson1: /* Background */

2024-11-06T16:32:51Z

Background

← Older revision		Revision as of 16:32, 6 November 2024
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	* Simulations suggest that UTIs in female astronauts predisposes them to a greater likelihood of medical evacuation compared to men during 6-month and 2.5-year missions.<ref>Reyes DP, Masterova KS, Walton M, Kerstman EL, Antonsen EL. Assessment of Sex-Dependent Medical Outcomes During Spaceflight. J Womens Health (Larchmt). 2022 Aug.</ref>		* Simulations suggest that UTIs in female astronauts predisposes them to a greater likelihood of medical evacuation compared to men during 6-month and 2.5-year missions.<ref>Reyes DP, Masterova KS, Walton M, Kerstman EL, Antonsen EL. Assessment of Sex-Dependent Medical Outcomes During Spaceflight. J Womens Health (Larchmt). 2022 Aug.</ref>

			{{UTI types}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Differential Diagnosis */

2024-11-06T16:31:02Z

Differential Diagnosis

← Older revision		Revision as of 16:31, 6 November 2024
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	** Urethritis from sexually transmitted infections (e.g., Neisseria gonorrhoeae, Chlamydia trachomatis), Candida, or irritants		** Urethritis from sexually transmitted infections (e.g., Neisseria gonorrhoeae, Chlamydia trachomatis), Candida, or irritants
	** Tuberculous cystitis		** Tuberculous cystitis

	* Inflammatory		* Inflammatory
	** Drug-induced (e.g., cyclophosphamide, NSAIDs) or radiation-induced cystitis		** Drug-induced (e.g., cyclophosphamide, NSAIDs) or radiation-induced cystitis
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	** Prostatitis		** Prostatitis
	** Vaginitis		** Vaginitis

	* Other		* Other
	** Asymptomatic bacteriuria		** Asymptomatic bacteriuria

Rossdonaldson1: /* Differential Diagnosis */

2024-11-06T16:29:37Z

Differential Diagnosis

← Older revision		Revision as of 16:29, 6 November 2024
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	**Trauma		**Trauma
	** Urolithiasis		** Urolithiasis

			{{Space medicine}}

	==Evaluation==		==Evaluation==

← Older revision		Revision as of 16:34, 6 November 2024
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	*** Sulfamethoxazole and Trimethoprim (Bacterim DS)		*** Sulfamethoxazole and Trimethoprim (Bacterim DS)
	**** Available on IISS and Space Shuttle medical kits		**** Available on IISS and Space Shuttle medical kits

	** 2nd-Line		** 2nd-Line
	*** Amoxicillin (Amoxil) or Ceftriaxone (Rocephin)		*** Amoxicillin (Amoxil) or Ceftriaxone (Rocephin)
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	**** Reserved for more complicated or refractory UTIs		**** Reserved for more complicated or refractory UTIs
	**** Available in ISS and Space Shuttle medical kits		**** Available in ISS and Space Shuttle medical kits

	* Oral analgesia can provide additional relief.		* Oral analgesia can provide additional relief.
	** Acetaminophen (available in ISS and Space Shuttle medical kits)		** Acetaminophen (available in ISS and Space Shuttle medical kits)
	** Aspirin (available in ISS and Space Shuttle medical kits)		** Aspirin (available in ISS and Space Shuttle medical kits)
	** Ibuprofen (available in ISS and Space Shuttle medical kits)		** Ibuprofen (available in ISS and Space Shuttle medical kits)

	* Removal of indwelling catheters as the risk of developing a UTI increases each day one is left in the urinary system. <ref>Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-e50. doi:10.1093/cid/civ933</ref>		* Removal of indwelling catheters as the risk of developing a UTI increases each day one is left in the urinary system. <ref>Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-e50. doi:10.1093/cid/civ933</ref>

	* Behavioral modifications, e.g. increased fluid intake, may be helpful.		* Behavioral modifications, e.g. increased fluid intake, may be helpful.

	* Topical estrogen therapy may be considered in peri-menopausal and postmenopausal women.		* Topical estrogen therapy may be considered in peri-menopausal and postmenopausal women.
			* De-orbit and intravenous treatment may be required if astronaut exhibits signs of shock or urosepsis (e.g. tachycardia, hypotension, tachypnea, flank pain, etc.).
	* De-orbit and intravenous treatment may be required if astronaut exhibits signs of shock or urosepsis (e.g. tachycardia, hypotension, tachypnea, flank pain, etc.).

	==Disposition==		==Disposition==