1: Urinary Tract Infection Flashcards
10^2- 10^4 CPU per mL would indicate infection if…
- sample is taken by suprapubic aspiration
- sample is drawn from renal pelvis or ureter
- sample is drawn using an indwelling catheter
Significant bacteriuria
10^5 colony forming units (CFU) per mL
from a midstream urine sample “clean catch”
Acute sx UTI and asymptomatic bacteriuria for >50yrs men
due to BPH
Classification of UTI- UpperUT
- Pyelonephritis
- Perinephric abscess
Classification of UTI- LowerUT
- Cystitis
- Urethritis
- Prostatitis
- Epididymitis
Post-menopausal Recurrent UTI
- Decreased colonization with Lactobacilli
- Changes in vaginal pH
- Vaginal colonization with E. coli
Asymptomatic bacteriuria in adults- dx
Dx can be made by 2 successive urine cultures showing >10^5 CFU per mL
Indication for use of antibiotics in Asymptomatic bacteriuria in adults
- Pregnancy
- Urologic surgery
- Immunosupression
Asx Bacteriuria in Pregnancy
- Short term therapy (7 days)
- Increase risk of pyelonephritis and spontaneous abortion
Asx bacteriuria in Pregnancy- tx
- 2nd Gen cephalosorins: Cephalexin, Cefuroxime
- Sulphonamides: caution in late pregnancy-> cause kernicterus in the newborn
- Avoid fluoroquinolones and aminoglycosides during pregnancy
- Tx pyelonephritis for 14 days and test of cure is necessary (Urinalysis)
Lower UTI manifestations
- Frequency
- Dysuria
- Urgency
- Suprapubic pain/ Incontinence
Urine culture
Not routinely indicated
indicated in diabetics, recurrent UTI, use of contraceptive diaphragm, age over 65 yrs.
-for pts who are indicated for urine culture, normal tx should be extended for 7 days**
Urinalysis
Pyuria: positive leukocyte esterase test
Nitrite
Bacteriuria
Acute uncomplicated cystitis in Women- tx
- Nitrofurantoin (5days) or TMP/SMX (3days)- DOC*
- Cotrimoxazole
- Fluoroquinolones
UTI in Children- dx
for First Timers, all -Urinalysis -Urine culture -U/S should be done
