**6. Microbiology and microbial resistance in urosepsis**

Urinary culture is not specific for diagnosis, but it rules out the origin of urosepsis if it is negative. It should be obtained at midstream and procedure immediately. Blood cultures must also be taken before administrating the antimicrobial agent, can be ones results are available. Blood cultures can be positive in up to 41% of the cultures [23]**.** About 93% of the patients admitted with community-acquired urosepsis had *E. coli* growth, whereas 66% of the hospital-acquired urosepsis patients grow *E. coli*. Interesting factor is that the urinary catheter-associated urosepsis is associated with Gram-positive infections. *Candida* infections are common in patients with stents in the urinary tract. In female patients, the *E.coli* urosepsis is common as compared to the male patients (92 and 60%, respectively) [23] (**Table 3**).

**7.2 Acute pyelonephritis**

Acute pyelonephritis

*Urosepsis: Flow is Life*

Fournier's gangrene

*Complications of urosepsis.*

Renal abscess Prostatic abscess

**Table 4.**

Emphysematous pyelonephritis

Post-obstruction acute kidney injury

Septic shock with multi-organ dysfunction

*DOI: http://dx.doi.org/10.5772/intechopen.82262*

care [26]**.**

**7.4 Renal abscess**

supportive care [12]**.**

**7.5 Prostatic abscess**

outcome of these patients [27]**.**

**8. Management of urosepsis**

**7.6 Fournier's gangrene**

[28] (**Table 4**).

**183**

necrosis and perinephric and renal abscess.

**7.3 Emphysematous pyelonephritis**

It can occur with or without urinary obstruction, common in females. If not treated appropriately, it will progress into emphysematous pyelonephritis, papillary

A life-threatening necrotizing infection of renal parenchyma and perinephric area, if not treated, can be fatal. Common bacteria are *E. coli*, *Klebsiella pneumoniae*, *Proteus* and *Pseudomonas*, and rarely fungi are common in patients with diabetes mellitus. It can be managed by percutaneous drainage and antibiotic and supportive

It is common in patients with diabetes mellitus. The reflux and back pressure of the infected urine is the main aetiology for the renal abscesses. About 75% of renal abscesses is caused by *E. coli*. Treatments are percutaneous drainage, antibiotics and

It occurs exclusively in diabetic patients and immunosuppressed patients. Prostatic abscess can rupture into the urethra. Percutaneous drainage is key for better

It is the necrotizing fasciitis of genitalia. Prompt diagnosis and earlier antibiotics and surgical debridement are the essential factors for better outcome

Septic shock is the most severe complication of urinary tract infection.


#### **Table 3.**

*Bacteriology of urosepsis.*
