Clinical Practice Guidelines - UTI Flashcards
Children _____ with T _____ can be suspected of UTI.
< 2 y.o., > 38° C
UTI Symptoms in Neonates
septic temperature instability poor feeding vomiting lethargy or irritability jaundice fever poor weight gain failure to thrive frequency dribbling urgency dysuria
UTI Symptoms in Infants
vomiting fever poor weight gain failure to thrive diarrhea abdominal pain frequency dribbling urgency dysuria
UTI Symptoms in Adolescents
fever poor weight gain failure to thrive diarrhea abdominal pain weak urinary stream malodorous urine enuresis
_____ is the foundation of UTI work-up.
Urinalysis
Proper Urine Collection:
< 1 y.o.
suprapubic tap
Proper Urine Collection:
Cooperative Patients
midstream urine
_____ on an uncentrifuged urine specimen has the best sensitivity.
Gram Stain
_____ has a sensitivity of 0.88 for the presence of leukocyte esterase or nitrate.
Urine Dipstick Test
Pyuria in Centrifuged Urine
> 5 WBC/hpf
Pyuria in Uncentrifuged Urine
> 10 WBC/mm3
_____ is the gold standard for diagnosing UTI.
(+) growth on Urine CS
A suprapubic tap is done with a _____ puncturing _____.
3 cc syringe with a g. 25 needle
1 cm above the symphysis pubis, midline
Diagnosis of UTI:
Suprapubic Tap
growth of any urinary pathogen
*except 2-3 x 10^3 CFU/ml of CONS
Diagnosis of UTI:
Catheterization
50,000 CFU/ml of a single pathogen
Diagnosis of UTI:
Midstream Urine - Symptomatic
10^5 CFU/ml of a single urinary pathogen
Diagnosis of UTI:
Midstream Urine - Asymptomatic
10^5 CFU/ml of a single urinary pathogen
*2 specimens on different days
_____ is the most common abnormality in patients with UTI.
Vesicoureteral Reflux (30-40%)
_____ evaluates the presence of vesicoureteral reflux.
Voiding Cystourethrography
Oral Treatment of UTI:
Amoxicillin
20-40 mkday x 3 doses
Oral Treatment of UTI:
TMP-SMX
6-12 mg TMP + 30-60 mg SMX kday x 2 doses
Oral Treatment of UTI:
Sulfisoxazole
120-150 mkday x 4 doses
Oral Treatment of UTI:
Cefixime
8 mkday x 2 doses
Oral Treatment of UTI:
Cephalexin
50-100 mkday x 4 doses
