11.6 Urinary Tract Infection and Urosepsis Flashcards
Definition/aetiology of UTI
Inflammatory repsonse of urothelium to pathogenic (bacterial/fungal) invasion, usually associated with bacteriuria and pyuria
Complicated vs uncomplicated UTI
- Uncomplicated: most
- Complciated: all UTIs in men, pregnant women, anatomical/functional abnormalities, renal disease or immunocompromised (greater risk of complications)
The quantitative threshold for UTIs is…
- 3 in 12 months
- OR: 2 in 6 months
Most common pathogenesis of UTI. How does the disease spread through the body after this?
- Rectal contamination
- Spreads from urethra upward, where it can eventually reach the blood and cause urosepsis
UTI risk factors
- Being a woman
- Previous UTI
- Sexual activity
- Pregnancy (why is this bad?)
- Older age
- Structural problems causing urinary obstruction (stasis)
- Immunocompromised (such as in diabetes)
Most common causative agent for UTIs is ____. Others include:
- Usual suspect is E Coli
- Other guys include staph saprophyticus
Symptoms and signs of UTIs (ex UroSepsis)
- Symptoms: dysuria, frequency, urgency. Less commonly haematuria, suprapubic pain
- Signs: Febrile, flank pain (pyelo), cloudy urine, foul odor
Symptoms and signs of Urosepsis (ex UTI)
- Febrile
- Hypotension
- Oliguria/anuria
- Mottled skin
- Tachy
What are we looking for on dipstick to confirm UTIs? What is the downfall?
- Pyuria (white cells)
- Nitrites (bacterial waste products)
Downfall is we don’t know what kind of bacteria is present. We follow this up w/ urine/blood culture
What are the benefits/drawbacks of urine MCS in suspected UTIs?
- Advantage: accurate, tells us drug sensitivities
- Drawback: slow (1-4 days)
Why might we use in imaging in UTIs?
- Check for salient anatomical variants
UTI (no sepsis) management
- Antibiotics (empiric, then targeted once MCS is back)
- Prevent the cause (such as BGL control, education, etc.)
- Cranberry juice (why?)
- Frequent voiding -
