Urinary tract infections of the ICD 10. Infection of the urinary system in children. N92 abundant, frequent and irregular menstruation

12.09.2020 Analyzes

Urinary tract infection - This is an infection that occurs on any section of the urinary system - from perinephral fascia to the outer opening of the urethra. (Carolin P., Cacho M.D. 2001).

Infection urinary tract (IP) classified as follows (EAU, 2008):

1. Type of pathogen (bacterial, fungal, mycobacterial);

2. Localization in urinary tract:

a) diseases of the lower urinary tract (urethritis, cystitis)

b) diseases of the upper blade (acute and chronic pyelonephritis)

3. The presence of complications, Localization of imp and combinations:

a) uncomplicated infection of the lower departments of urinary tract (cystitis)

b) uncomplicated pyelonephritis

c) complicated imp with pyelonephritis or without pyelonephritis

d) Uruppsis

e) urethritis

e) special forms (prostatitis, orchitis, epidididimitis)

It is necessary to take into account age (elderly patients), the presence of concomitant diseases (including diabetes et al.), Immunity condition (immunocompromentized patients)

Uncomplicated impAs a rule, successfully treatable adequately selected antibacterial therapy.

Complicated imp It is more difficult to antimicrobial therapy and, in some cases, require the intervention of the urologist, since they can lead to severe mine-septic complications.

Classification of ICD 10.

N 10 - acute tubula-interstitial nephritis (includes acute pyelonephritis)

N 11.0 - chronic tubula-interstitial nephritis (includes unstructive chronic pyelonephritis, reflux-associated)

N 11.1 - Chronic obstructive pyelonephritis

N 11.8 - other chronic tubula-interstitial jade (includes the unstructive pyelonephritis)

N 11.9 - Chronic tubul-interstitial nephritis uncomfortable (includes unspected pyelonephritis)

N 12 - tubula-interstitial nephritis not defined as acute or chronic (includes pyelonephritis)

N 15.9 - Tubul-interstitial kidney disease Uncomfortable (includes the kidney infection unspected)

N 20.9 - Urinary stones Uncomfortable (calculous pyelonephritis)

N 30.0 - acute cystitis

N 30.1 - interstitial cystitis (chronic)

N 30.8 - Other Cystitis

N 30.9 - unspecified cystitis

N 39.0 - Urinary tract infection without localization

Diagnosis wording

In the formulation of the diagnosis, the International Classification of Diseases 10 of the revision is used indicating in chronic forms of the nature of the flow (recurrent, latent), phases of the disease (remission, aggravation) and kidney functions (stage chronic disease kidney).

Given the generally accepted international terminology, as well as the fact of a often occurring common ascending infection and the difficulties of a clear definition of the localization of inflammation, it is advisable to use the term "urinary tract infection (IP).

We give examples of the wording of diagnoses and the corresponding ICB-10 codes:

MainDs.: Imp, chronic pyelonephritis, recurrent, aggravation, HBP 1 tbsp. (N 11.8)

MainDs.: Imp, acute right-sided pyelonephritis. (N 10) Complication: Paranephrites on the right.

MainDs.: Imp, sharp cystitis. (N 30.0)

Epidemiology

Urinary infection remains one of the important causes of diseases in various age groups. Imp It is quite widespread, about 7 million outpatient appeals, more than 1 million hospitalizations on Imp are annually registered. Economic costs make up more than one billion dollars. 20-50% of women tolerate Impat least once in life. Risk Imp Women are more susceptible, but the risk increases with age Imp and its complicated flow and women, and in men (IDSA. 2001). In Russia, the most frequent disease Urinary tract is acute cystitis (OC) - 26-36 million cases per year, and men have only 68 episodes at 10,000 aged 21-50 years. Acute pyelonephritis (OP) is also more common in women, and in all age groups. The frequency of the OP is significantly higher than the OC and is 0.9 - 1.3 million cases annually. In women, the risk of PM is 30 times higher than in men, including in connection with a pregnancy from 4-10%. In postmenopausis Imp develops in 20% of patients. The incidence of the population of Irkutsk diseases urinary tract In 2007, amounted to 6022 per 100,000 adults,

and mortality - 8 per 100,000 permanent population

Currently identified the main at-risk groups, clinical formsThe diagnostic criteria of implies have developed effective ways to control infection in complicated and uncomplicated cases, including in risk groups.

The urinary tract infection often accompanies young people. But in modern society, all generations may suffer from this disease: from infant to the elderly.

What if there is such a disease? In our article we describe detailed instructions According to the recognition of the disease. We will also tell me how the treatment of pathology is carried out.

Item First: What are the infections?

Urine is formed in the kidneys by filtration, after it passes through the ureters and enters the bladder. From there, the liquid is pushed into the urethra and comes out.

A significant difference is observed in the urinary system of men and women. The urethra in women is straight and short, which causes a greater prevalence of infections in the urine among the female population.

What can affect this debugged system?

When hit infectious agent In any part of the tract there is inflammation. The international classification of diseases (ICD 10) lists the following nosology:

urethritis (the microbe multiplies in the initial tract);
cystitis (infection bladder);
pyelonephritis (inflammation of the kidney lochank);
abscess kidney (kidney tissue itself).

Also in the ICD, the urinary tract infection is distinguished by unknown etiology, when the source of inflammation is not installed.

Item Second: What causes the disease?

The infection of the urinary tract (IPP) may be caused by any agent, be it bacterium, virus or fungus. But we will focus on the most common pathogens. This is an intestinal wand, protea, stafilococcus (fecal, golden, saprofit). Less often meet Chlebseyella, candida (mushrooms) and pseudomonads.

It is worth noting that the modern flora is very resistant to antibacterial drugs. Therefore, treatment of urinary tract requires a competent choice antibacterial drug.

In the infection, infection in the urine is caused by the same Flora. In the first months of life, the boys sick more often girls.

Point Three: What does the disease look like?

What symptoms can be detected from a person with infection in the urine?

Painfulness. Pain syndrome depends on the localization of the process. At the pyelonephritis, the kidneys hurt (no longer under the ribs, positive symptoms of "Poching"). The bladder infection is accompanied by the pain in the downturn area. With inflammation of the urethra, pain gives into external genital organs.

The symptoms of "Poaming" or Pasternatsky are characterized by soreness when tapping a patient in the area of \u200b\u200baffected kidney and a short-term advent of blood in the urine. These symptoms are satellites of kidney stones. When pyelonephritis, only pain appears.

Observed frequent urges To urination. Symptoms appear not only during the day, but also at night. At the same time, urine is either not allocated at all, or stands out in small quantities.
The transparency and color of urine change. These symptoms are associated with the appearance of cells (leukocytes), mucus (liqueous epithelium), bacterial particles. As a result, urine becomes muddy, dark yellow, flakes are settled on the day. With active reproduction of bacteria, an unpleasant malware appear. Occasionally yellow, transparent.
Dysuria. These strong burning or pain during urination. Dysurium symptoms are characteristic of the damage to the urethra, less often for the inflammation of the bladder.

In addition to uretrite, the ICD allocates urethral syndrome. During this pathology, a woman appears painful urination and false urges to the toilet. At the same time, bacteria in the urine do not detect.

The appearance of blood in the urine.
Fever, chills, intoxication.

Clause Fourth: How to identify the disease?

Infection in the urine is not so simple. Initially held general analysis. Its result allows you to make a more specific study:

determine the number of leukocytes in the urine;
determine the number of bacterial particles;
crow crops on sensitivity to antibiotics.

In case of infection in the urine, the sensitivity of the bacteria is very important. The number of resistant forms increases the year from year. These knowledge helps to optimize treatment.

TO additional methods relate:

scraping from urethra to identify genital infections;
general blood analysis;
Ultrasound kidneys.

The diagnosis is made on the basis of a combination of three factors:

clear clinical picture (Dizuriy, false urges, painter pain, fever, back pain);
the presence of leukocytes in the urine (more than 104 in 1 ml of urine);
bacteriuria (infection in the urine) - more than 104 units per 1 ml.

Point Fifth: how to cure?

First of all, treatment must be started from getting rid of the causative agent of infection in the urine. For this need antibiotics. They are prescribed for a period of 10 to 14 days with mandatory control of urine sterility after the course of therapy. In the event of the disappearance of symptoms, the drug selection of the pathogen is changed and the treatment is resumed.

The drug is selected only by the doctor, taking into account the sensitivity of the pathogen, the experience of previous therapy and individual characteristics of the patient. Antibiotics of the first line with cystitis and urethritis - amoxiclav, phosphomycin, cefuroxime, nitrofuranstein, co-trimaxazole, fluoroquinolones (Norfloxacin, offloxacin). They are prescribed in the form of tablets. The bladder infection disappears soon, the visible result will be obtained only by 12-14 days. When pyelonephritis and other infectious kidney lesions, these drugs are prescribed intravenously.

Pyelonephritis is a reason for the hospitalization of the patient.

Treatment of infection in the urine is sometimes very difficult. To do this, it is recommended to use additional means that suppress inflammation and ensure the sterility of the discharge. Vegetable preparations I. medicinal fees - This is the best choice that will complement treatment and provide fast recovery.

One of the leading foundations of the classification of diseases, pathological injuries and the causal mortality factor is the system of statistical data - the ICD. The data of its registry is relevant for 10 years, after which, under the control of WHO, the register of legal regulations ensures the unity of statistical data, comparability of international regulatory documents and methodological developments.

After the last (10 revision) of the registry, the urinary tract infection, the ICB-10 code received under different numbers, according to the refined or not established genesis of infections.

What is the EVP.

The term itself - IMVP (urinary tract infection) means an infectious presence in the system of the urine of removal without explicit signs of damage to the structure of the renal tissues. At the same time, a huge number of pathogens are revealed in the bacterial analysis of urine. This condition is called bacteriuria, which means not only the constant presence of bacteria in the urethral paths, but also the fact that they actively multiply.

There are many options for the classification of pathology, but today is adapted to the medical practice CHAS Classification recommended by the Association of European Urols (EAU), which includes:

The form of uncomplicated implies, manifested by sporadic or recurrent infectious infection infections in the lower, or the upper part of the urinary system (uncomplicated cystitis clinic and / or pyelonephritis) in women of reproductive age, without the presence of anatomical disorders in the system of the urine of the removal and background pathologies.
The complicated form of the form of the patients constituting the increased risk group is all men, pregnant women, patients with functional and anatomical impairment in the urine system, patients with catheters, renal pathologies and background immunodeficiency states.
The recurring form manifested by two, three relapses of uncomplicated and complicated infections for six months.
The catheter is an associated form affecting patients with standing catheter or catheterization underwent in the last two days.
The development of the Ulosigesis - life-threshing state due to the development of systemic inflammatory processes, signs of organ dysfunction, hypotension, manifested as the response of the body to the infectious damage of the urinary system.

IF today

Despite the continuous improvement of antimicrobial therapeutic treatment, today there is a clear trend towards an increase in patients with IFP. According to statistics, the annual detection of primary patients with this pathology varies within 170 patients among 100,000 people. A total of episodes of infectious pathologies in urinary tracts, with the same population, there are almost 1 thousand patients.

Among the children, the original IMVP meets the same, both boys and girls, which is often due to the presence of congenital pathologies. By 15 years, the incidence of girls is diagnosed with nine times more often, which is explained by anatomical hormonal features. But, if by 35 years the incidence rate in men remains on the previous (small) level, then women increase 5 times.

This is due to the special vulnerability of the women's urinary system, sexual activity, pregnancy, childbirth or gynecological problems. According to numerous studies and consolidated statistics, the IMVP to 65 years old in both sexes are diagnosed almost the same - in 40% of women against the background of hormonal and post climatic dysfunctions and age genital involution, in 45% of men - against the background of the formation of adenomatous developments, followed by this Complications I. chronic flow Prostatitis.

Unified classification system

The ICD itself was created to streamline and systematize the registry of general scientific interpretations and comparing analytical data on existing diseases and analyzing causes of mortality, in all countries and individual regional areas during a certain period of time. Its task is to display verbal diagnostic final formulations of diseases and other pathologies to the identification code in the form of an alphanumeric display, which is due to a convenient organization of storage of information and rapidly extract the various kinds of analyzed data from the registry.

To date, this is the most informative international system of standardization of the diagnostic classification in general medical directions, controlled by the highest health authority. One of the initial tasks of the system is to draw up a general statistical analysis of the state of health in the regions and countries and communications with certain reasons. The ICD-10 appeared as a result of the last change in the results of the previous version, due to its expansion and removal of outdated data that has lost their significance.

Code of ICD 10 for strictly cystitis.
Chronic cystitis in the ICD-10.

The scene of the ISP in the registry of the ICD

According to the register of international classification of the diseases of the last revision, the identification code of the urinary tract infection is under various numbers, which is due to various problems of urological nature.

From No. 00 to №99 (inclusive) - various diseases of the urogenital system are registered.

Under No. 30 to №38 (inclusive) - other diseases of the urological nature.

In the ICD-10, the urinary tract infection is listed as a disease of non-localization under No. 39. Additional codes are used to clarify the infectious agent - from B95 to B97 (inclusive).

After the last (10 revision) of the registry, the ICB-10 code received under different numbers, according to the refined or not established genesis of infections.

There are many options for the classification of pathology, but today is adapted to the medical practice CHAS Classification recommended by the Association of European Urols (EAU), which includes:

The form of uncomplicated implies, manifested by sporadic or recurrent infectious infection infections in the lower, or the upper part of the urinary system (uncomplicated cystitis clinic and / or pyelonephritis) in women of reproductive age, without the presence of anatomical disorders in the system of the urine of the removal and background pathologies.
The complicated form of the form of the patients constituting the increased risk group is all men, pregnant women, patients with functional and anatomical impairment in the urine system, patients with catheters, renal pathologies and background immunodeficiency states.
The recurring form manifested by two, three relapses of uncomplicated and complicated infections for six months.
The catheter is an associated form affecting patients with standing catheter or catheterization underwent in the last two days.
The development of the Ulosigesis - life-threshing state due to the development of systemic inflammatory processes, signs of organ dysfunction, hypotension, manifested as the response of the body to the infectious damage of the urinary system.

IF today

Among the children, the original IMVP meets the same, both boys and girls, which is often due to the presence of congenital pathologies. By 15 years, the incidence of girls is diagnosed with nine times more often, which is explained by anatomical hormonal features. But, if by 35 years the incidence rate in men remains on the previous (small) level, then women increase 5 times.

Unified classification system

Urinary tract infections are always due to the active vital activity of the pathological microflora, which falls into the urethra and bladder, hitting ureters and kidneys through external genital organs or endogenous.

In urology, the urinary tract infection on the ICD 10 has the code N39.0, which implies the clarification of the etiological factor, to differentiate the ciphers in the B95-B97 range. Infectious processes in organs forming and rejecting urine are included in the large class of MKB 10 N00-N99. These ciphers assume etiology, pathogenesis and morphology for each, separately taken disease, which helps doctors to establish an accurate diagnosis and assign treatment.

Patomorphology

Infectious processes in the urinary tract most often affect women and children, by virtue physiological features.

There are several types of infections of the urinary system, relative to localization, that is, such:

characteristic pathology of the upper departments of the urinary system (pyelonephritis);
infection of the lower sections of urinary tract (cystitis, inflammation of the urethra, prostatitis in men).

The disease can occur in acute or chronic form. Certain ISP code in the international classification of diseases involves the presence of a diagnosis plan, treatment, preventive measures and special instructions Regarding the elimination of this problem in the child.

mkbkody.ru.

Urinary tract infection - treatment and symptoms

The urinary tract infection often accompanies young people. But in modern society, all generations may suffer from this disease: from infant to the elderly.

What if there is such a disease? In our article we describe a detailed instruction on the recognition of the disease. We will also tell me how the treatment of pathology is carried out.

Item First: What are the infections?

Urine is formed in the kidneys by filtration, after it passes through the ureters and enters the bladder. From there, the liquid is pushed into the urethra and comes out.

A significant difference is observed in the urinary system of men and women. The urethra in women is straight and short, which causes a greater prevalence of infections in the urine among the female population.

What can affect this debugged system?

If an infectious agent gets into any part of the tract there is inflammation. The international classification of diseases (ICD 10) lists the following nosology:

urethritis (the microbe multiplies in the initial tract);
cystitis (bladder infection);
pyelonephritis (inflammation of the kidney lochank);
abscess kidney (kidney tissue itself).

Also in the ICD, the urinary tract infection is distinguished by unknown etiology, when the source of inflammation is not installed.

Item Second: What causes the disease?

It is worth noting that the modern flora is very resistant to antibacterial drugs. Therefore, treatment of urinary tract requires a competent choice of antibacterial drug.

In the infection, infection in the urine is caused by the same Flora. In the first months of life, the boys sick more often girls.

Point Three: What does the disease look like?

What symptoms can be detected from a person with infection in the urine?

Pain. Pain syndrome depends on the localization of the process. At the pyelonephritis, the kidneys hurt (no longer under the ribs, positive symptoms of "Poching"). The bladder infection is accompanied by the pain in the downturn area. With inflammation of the urethra, pain gives into external genital organs.

The symptoms of "Poaming" or Pasternatsky are characterized by soreness when tapping a patient in the area of \u200b\u200baffected kidney and a short-term advent of blood in the urine. These symptoms are satellites of kidney stones. When pyelonephritis, only pain appears.

There are frequent urge to urination. Symptoms appear not only during the day, but also at night. At the same time, urine is either not allocated at all, or stands out in small quantities.
The transparency and color of urine change. These symptoms are associated with the appearance of cells (leukocytes), mucus (liqueous epithelium), bacterial particles. As a result, urine becomes muddy, dark yellow, flakes are settled on the day. With active reproduction of bacteria, an unpleasant malware appear. Occasionally yellow, transparent.
Dysuria. These strong burning or pain during urination. Dysurium symptoms are characteristic of the damage to the urethra, less often for the inflammation of the bladder.

In addition to uretrite, the ICD allocates urethral syndrome. During this pathology, a woman appears painful urination and false urges to the toilet. At the same time, bacteria in the urine do not detect.

The appearance of blood in the urine.
Fever, chills, intoxication.

Clause Fourth: How to identify the disease?

Infection in the urine is not so simple. Initially, a general analysis is carried out. Its result allows you to make a more specific study:

determine the number of leukocytes in the urine;
determine the number of bacterial particles;
crow crops on sensitivity to antibiotics.

In case of infection in the urine, the sensitivity of the bacteria is very important. The number of resistant forms increases the year from year. These knowledge helps to optimize treatment.

Additional methods include:

scraping from urethra to identify genital infections;
general blood analysis;
Ultrasound kidneys.

The diagnosis is made on the basis of a combination of three factors:

a clear clinical picture (dizuriy, false uiles, pain over the pubic, fever, pain in the lower back);
the presence of leukocytes in the urine (more than 104 in 1 ml of urine);
bacteriuria (infection in the urine) - more than 104 units per 1 ml.

Point Fifth: how to cure?

Pyelonephritis is a reason for the hospitalization of the patient.

Treatment of infection in the urine is sometimes very difficult. To do this, it is recommended to use additional means that suppress inflammation and ensure the sterility of the discharge. Plant preparations and medicinal fees are the best choice that will complement treatment and will provide fast recovery.

Kanefron. As part of grass rosehip, lovers, rosemary. Drops and Dragee Kanefron well remove spasm accompanied by bladder infection. Treatment by this drug accompanies receiving antibiotics. It enhances the impact on bacteria and helps to relieve inflammation. In addition, plant components have diuretic properties. Frequent emptying of the bubble promotes rapid evacuation of bacteria and accelerates treatment.

The urological collection of Lerosite birch leaves, parsley root, nettle, elderberry and other herbs. It is accepted daily. Remove inflammatory process, anesthetics and has an additional diuretic effect. Treatment lasts 2 weeks. In some cases, the course can last 1 month.

infekc.ru.

Classification and diagnosis

Urinary tract infection is an infection that occurs on any section of the urinary system - from perinephral fascia to the outer opening of the urethra. (Carolin P., Cacho M.D. 2001).

The infection of urinary tract (IPP) is classified as follows (EAU, 2008):

1. Type of pathogen (bacterial, fungal, mycobacterial);

2. Localization in urinary tract:

a) diseases of the lower urinary tract (urethritis, cystitis)

b) diseases of the upper urinary tract (acute and chronic pyelonephritis)

3. The presence of complications, Localization of imp and combinations:

a) uncomplicated infection of the lower departments of urinary tract (cystitis)

b) uncomplicated pyelonephritis

c) complicated imp with pyelonephritis or without pyelonephritis

d) Uruppsis

e) urethritis

e) special forms (prostatitis, orchitis, epidididimitis)

It is necessary to take into account age (elderly patients), the presence of concomitant diseases (including diabetes mellitus, etc.), state of immunity (immunocompromentized patients)

Uncomplicated imparts are usually successfully treating adequately selected antibacterial therapy.

Complicated FLCs are more difficult to avoid antimicrobial therapy and, in some cases, require the intervention of the urologist, since they can lead to severe mine-septic complications.

Classification of ICD 10.

N 10 - acute tubula-interstitial nephritis (includes acute pyelonephritis)

N 11.0 - chronic tubula-interstitial nephritis (includes unstructive chronic pyelonephritis, reflux-associated)

N 11.1 - Chronic obstructive pyelonephritis

N 11.8 - other chronic tubula-interstitial jade (includes the unstructive pyelonephritis)

N 11.9 - Chronic tubul-interstitial nephritis uncomfortable (includes unspected pyelonephritis)

N 12 - tubula-interstitial nephritis not defined as acute or chronic (includes pyelonephritis)

N 15.9 - Tubul-interstitial kidney disease Uncomfortable (includes the kidney infection unspected)

N 20.9 - Urinary stones Uncomfortable (calculous pyelonephritis)

N 30.0 - acute cystitis

N 30.1 - interstitial cystitis (chronic)

N 30.8 - Other Cystitis

N 30.9 - unspecified cystitis

N 39.0 - Urinary tract infection without localization

Diagnosis wording

In the formulation of the diagnosis use International Classification Diseases 10 revision indicating in chronic forms of the nature of the flow (recurrent, latent), phases of the disease (remission, aggravation) and kidney functions (stage of chronic kidney disease).

We give examples of the wording of diagnoses and the corresponding ICB-10 codes:

The main DS: imp, chronic pyelonephritis, recurrent, exacerbation, HBP 1 tbsp. (N 11.8)

The main DS: imp, acute right-sided pyelonephritis. (N 10) Complication: Paranefrit Right.

The main DS: imp, sharp cystitis. (N 30.0)

Epidemiology

Urinary infection remains one of the important causes of diseases in various age groups. It is widely distributed quite widespread, about 7 million outpatient appeals, more than 1 million hospitalizations on Imp are annually registered. Economic costs make up more than one billion dollars. 20-50% of women tolerate imp at least once in life. The risks of the efforts are more susceptible to women, but with age increases the risk of imp and its complicated flow and in women, and in men (IDSA. 2001). In Russia, the most frequent urinary tract disease is acute cystitis (OC) - 26-36 million cases per year, and men have only 68 episodes at 10,000 aged 21-50 years. Acute pyelonephritis (OP) is also more common in women, and in all age groups. The frequency of the OP is significantly higher than the OC and is 0.9 - 1.3 million cases annually. In women, the risk of PM is 30 times higher than in men, including in connection with a pregnancy from 4-10%. In postmenopausis Imp develops in 20% of patients. The incidence of urkutsk diseases of urinary tract in 2007 amounted to 6022 per 100,000 adults,

and mortality - 8 per 100,000 permanent population

Currently, basic risk groups, clinical forms, IMP diagnostic criteria have been identified, developed effective ways to control infection in complicated and uncomplicated cases, including in risk groups.

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Code of ICD: N00-N99

Home\u003e ICB

Tubulinistial kidney disease Other kidney diseases and ureterals Other diseases of the urinary system of the male genital organs Inflammatory diseases of women's pelvic organs Non-inflammatory diseases of female genital organs