Urosepsis is a systemic inflammatory response due to an infection affecting the urogenital tract.
Lower urinary tract infection presents with frequent urination, especially during the acute phase of the infection, which often results in urethra irritation. Furthermore, urination is painful due to the irritation and inflammation of the urethra, usually associated with a burning sensation as urine passes through the urethra itself. In the urine itself can be observed the presence of blood, indicating that the infection has reached upper parts of the urinary tract. In any case, the quantity of urine markedly decrease, as the kidneys become unable to perform their function.
When kidneys are reached by the inflammation, a severe sensation of pain begins to spread locally, which ends up affecting the area of the flank and the lower back. Fever, instead, may be seen since the onset of urinary tract infection, but when the infection spreads into the blood stream, fever becomes persistent.
As previously stated, after spreading through the circulatory system the infection ends up effecting the heart as well, which begins to increase its beating rate in a state of tachycardia. The breathing rate increases as well, in a general state of the subject characterized by hypotension and hypothermia. Furthermore, mental status can be impaired as consequence of thecirculation.
So, the major signs of UTI can be summarized as follows:
Moreover, it is possible to understand when urosepsis has begun due to the following signs:
It is important to determine the onset of the urinary tract infection, as it might spread to the blood stream causing urosepsis. An urinalysis is extremely useful in this regards, an urine sample is taken to be sent to the laboratory for testing. In the laboratory clinicians check for a series of parameters, such as the presence of key ions, traces of metals, proteins and enzymes, as well as blood cells and other molecules. The analysis can be performed through urine test strip, microscopic examination, and other methods like hemoglobin test. Apart from the presence of infection, urinalysis allows to detect clotting problems, impaired oxygen supplies, as well as imbalances in fluid and electrolytes.
A regimen of antibiotics is the primary choice in the treatment of urosepsis. The choice of the antibiotics should be based on the underlying lesion, the causative microorganism and its resistance pattern  . Furthermore, the therapy could be based on just one antibiotic or a combination of two or more of them . In addition to these, medications against increased blood pressure can be prescribed to reduced hypertension, as well as supportive measures like intravenous fluid administration, whose primary aim is to adjust fluid and electrolytes physiological imbalance.
Due to the danger involved, the worst cases have to be treated in hospital and placed in intensive care units, where subjects can be constantly monitored. If septic shock occurs, patients have to undergo mechanical ventilation or other life-saving measures like this, to stabilize breathing and organic functions in general.
Sepsis does not occur randomly and is generally associated with another underlying condition such as a perforation or the rupture of an intraabdominal or pelvic structure . As previously said, in the case of urosepsis the infection starts from the urinary tract to finally enter the blood stream and spread throughout the body. Usually, the infection has remained undiagnosed and untreated in the urinary tract for some time, before moving to other parts of the body. There are numerous risk factors implicated in the development of urosepsis, and these include:
The majority of the cases are due to gram-negative bacilli such as Escherichia coli (50%), Proteus spp. (15%), Enterobacter, Klebsiella spp. (15%), and Pseudomonas aeruginosa (5%). However, the cases due to gram-positive organisms, such as Enterococcus, are not negligible, as they are responsible for the 21,2% of all the cases of hospital-acquired urinary tract infections.
Urosepsis accounts for approximately 25% of all the sepsis cases. As previously stated, the risk of getting urosepsis multiplies in case of hospitalization and long-term care, due to the indwelling catheter treatment and the high risk of infection that this implies. According to a study conducted during 1990s, 23% of all cases of sepsis acquired in hospital were due to infections of urinary tract mostly seen in catheterized patients . In 2001 a pan-European study reported an incidence of hospital-acquired urinary tract infection of 3.55 cases over 1000 patients . According to two point-prevalence studies, instead, the Pan European Prevalence (PEP) study and the Pan EuroAsian Prevalence (PEAP) study, conducted in 2003 and 2004, the prevalence of the hospital-acquired urinary tract infection should range from 10% to 14%, 12% of which are accounted for by US .
Urinary tract infection (UTI) as infection can occur everywhere in the urinary tract. Once it starts spreading, the infection moves towards the upper urinary tract, spreading through the bladder, ureters, and kidneys. Here it affects nephrons causing pyelonephritis, a pathological condition consisting in an intense pain in the flank and lower back. After reaching the kidneys, the infection may further progresses towards the blood and the circulatory system, triggering the classical systemic response, sepsis. The involvement of further organs causes the wide range of signs and symptoms.
Preventive measures of urosepsis should largely be based on preventing the occurrence of infections in the urinary tract. Therefore, people at higher risk of developing UTI are recommended to frequently empty the bladder, and to avoid, at least as much as possible, holding urine for long periods of time. Furthermore, they should strictly follow hygiene measures, such as wipe and wash genitals after having bowel movement or a sexual intercourse.
The word sepsis refers to a whole-body inflammatory response caused by a particular infection  which then results into a systemic blood inflammation. The classical signs of this condition include fever, increased heart and breath rate as well as an impaired mental status , associated with a series of other signs which vary according to the particular infection. This condition is usually triggered by a bacterium, but sometime it can be caused by fungi, viruses and other parasites a well . The site of the primary infection generally include lungs, brain, urinary tract, abdominal organs, and skin.
In the case of urosepsis the systemic infection starts in the urinary tract to spreads into the bloodstream. In particular, the bacteria responsible for this infection producing toxins, begin to damage internal vascular side of endothelial vessels, the endothelium. This condition is clinically very serious, and if left untreated it might lead to death in a few days.
Urosepsis is an infectious condition due to an infection affecting the urogenital tract. The infection is usually caused by a bacterium, but sometime it can also be caused by fungi, viruses and other parasites a well. In urosepsis there is a spread from the urinary tract to the blood stream, causing a systemic infection that experts called sepsis.
Once inside the blood stream, the condition affects major systems such as the respiratory system and cardiovascular system. The major signs of urinary tract infection include:
When urosepsis has begun, it is possible to observe other signs such as:
When these are added by an extremely low blood pressure, a septic shock has started. The major treatment for urosepsis is an antibiotic therapy, which is usually planned based on the original site of infection, the nature of the pathogen responsible for the infection and its resistance to antibiotics.
Preventive measures of urosepsis should largely be based on preventing the occurrence of infections in the urinary tract. Therefore, people at higher risk of developing them are recommended to frequently empty the bladder, and to avoid, at least as much as possible, holding urine for long periods of time. Furthermore, they should strictly follow hygiene measures, such as wipe and wash genitals after having bowel movement or a sexual intercourse.