4 UTI Flashcards
What is the term used for “bacteria in the urine”?
Bacteriuria
What is acute cystitis?
Bacterial infection of the bladder (therefore confined to lower urinary tract)
What is acute pyelonephritis?
bacterial infection of UPPER urinary tract (ureters, renal pelvis, kidney)
What three criteria does someone have to meet to be considered as having an uncomplicated UTI?
not being pregnant, normal urinary anatomy, no co-morbidities (healthy/outpatient)
A male having a UTI would fall under (complicated/uncomplicated) UTI.
Complicated UTI
In healthy individuals in the absence of infection, which bacteria typically colonizes the lower UT? S. aureus,Proteus spp., or E. coli?
None of them because bacteria don’t colonize the healthy urinary tract
What gram stain of bacteria cause 85% of UTIs?
Gram (-) colonizers normally found in the GI tract
**(E. coli, P. mirabilis, K. pneumoniae)
Why do women get more UTIs than men?
their urethra is shorter, their urethra is closer to the anus, and men have antibacterial properties in their prostatic fluid
Do most untreated lower UTIs progress to pyelonephritis?
No
What are some symptoms of Cystitis?
Dysuria, increased frequency and urgency of urination, and suprapubic pain
What are some symptoms of Pyelonephritis?
fever/chills, flank or vertebral angle pain, nausea, and some symptoms of cystitis
What three things do you need to diagnose a UTI?
Symptoms, urine culture greater than 10^5 CFU of bacteria, and inflammation on urinalysis
What is the diagnosis for a positive urine culture without any symptoms?
Asymptomatic bacteriuria
What would you see in an abnormal urinalysis?
cloudy urine with increased specific gravity, presence of nitrites, hematuria and pyuria present
Should there be nitrites in healthy urine?
No
What is the single most important clinical factor for diagnosing a UTI?
symptoms with inflammation
Cystitis generally resolves with/without antibiotics?
without - they’re used to provide symptom relief
What are three drugs that can be used to “treat” uncomplicated cystitis?
Nitrofurantoin, Cotrimoxazole, or Fosfomycin
What drugs could be used to treat uncomplicated pyelonephritis?
Ciprofloxacin, Levofloxacin, Cotrimoxazole, or β-lactams
For asymptomatic bacteriuria, there is NO need for antibiotics unless…
Pt is pregnant, pre-urology procedure, renal transplant, neutropenic
A Pt is admitted with an indwelling bladder catheter. Urine culture reveals >10^5 Cfu E. coli. There are no urinary symptoms and Pt feels well. What is the best management?
Remove the catheter if possible with no other Tx
Absence of pyuria rules out what kind of UTI?
Catheter-associated UTIs
