Cm2 Flashcards
What is a community-acquired urinary infection?
Infection occurring in the community, outside healthcare facilities
Also known as a community-acquired infection.
What is a nosocomial urinary infection?
Infection associated with healthcare, occurring during or after hospitalization
It is not present at the time of admission.
What is the most frequent site of community infections?
Urinary infections, following respiratory infections
This highlights the high prevalence of urinary infections.
Which demographic is most affected by urinary infections?
More frequent in women, particularly at the onset of sexual activity and post-menopause; in men, especially after age 50
Also occurs in children, often indicating a malformation of the urogenital system.
What normally characterizes the urinary tract?
The urinary tract is normally sterile, except for the distal urethra, which is colonized by perineal flora
Infections arise from the digestive, cutaneous, or pelvic bacterial flora.
What are the main factors that help avoid urinary infections?
- Length of the urethra
- Frequency of urination
- Urinary flow
- Integrity of mucous membranes
- Biochemical characteristics of urine
These factors contribute to maintaining urinary tract health.
What are the common routes of infection for urinary infections?
- Ascending route
- Hematogenous route (via bacteremia)
The latter is rare and can involve bacteria such as staphylococcus or Candida.
What are some anatomical factors that can predispose to urinary infections?
- Stenosis of the meatus
- Ectopia of the meatus
- Bladder emptying disorders (e.g., cystocele)
Other factors include menopause and hygiene practices.
What is the risk of infection associated with urinary catheters?
5 to 10% risk of infection per day of catheterization
Infections can occur via endoluminal or exoluminal contamination.
List the common pathogens responsible for community-acquired urinary infections.
- Escherichia coli (70%)
- Proteus (5-10%)
- Enterococci
- Klebsiella
- Serratia
- Enterobacter
Enterobacteriaceae account for 80% of cases.
What clinical signs are associated with urinary infections?
- Pollakiuria
- Burning during urination
- Cloudy or bloody urine
- Dysuria or incontinence
- Fever with parenchymal involvement
Additional signs include lumbar, pelvic, or testicular pain.
What is the significance of the urinary dipstick test?
It precedes the urine culture (ECBU) and has a negative predictive value greater than 95%
It detects nitrites and leukocytes in urine.
What is the recommended procedure for collecting a urine sample for culture?
Collect mid-stream urine in a sterile container after disinfecting the vulvar area
Sample should be analyzed within one hour or stored at 4 degrees for a few hours.
What defines acute cystitis?
The most common type of urinary infection in women, characterized by urinary syndrome without fever
Symptoms include burning, frequent urination, and pelvic sensitivity.
What are the treatment options for uncomplicated acute cystitis?
- Increased fluid intake
- Frequent urination
- Balanced diet
Avoid tight clothing and practice proper hygiene.
What is recurrent cystitis?
Defined as four episodes of uncomplicated acute cystitis in one year
Requires evaluation for underlying causes.
What is the treatment for acute uncomplicated pyelonephritis?
- Amoxicillin: 1 g three times a day for 10 days
- Cotrimoxazole: 800 mg/160 mg twice a day for 10 days
- Amoxicillin-clavulanic acid: 1 g three times a day for 10 days
Other antibiotics may include ciprofloxacin or ceftriaxone.
What is the follow-up protocol for pyelonephritis treatment?
Systematic reevaluation after 72 hours; no control urine culture unless clinical worsening occurs
This ensures effective treatment response.
What should be excluded in cases of acute pyelonephritis?
Exclude urinary infections in males and assess for risk factors for complications
This includes pregnancy and severe renal insufficiency.
What is the initial diagnostic test for acute cystitis?
Réalisation d’une BU, et en cas de positivité, d’un ECBU.
What biological assessment should be performed in acute cystitis?
Bilan biologique : CRP, créatinine.
What imaging is indicated in cases of acute cystitis?
Un uroscanner est indiqué, le plus souvent en urgence, et au plus tard dans les 24 heures.
What is the alternative imaging method if a uroscanner is contraindicated?
Échographie rénale.
What is the duration of antibiotic treatment for acute cystitis if the evolution is favorable?
Durée de 10 jours.
What is the follow-up procedure for acute cystitis after 72 hours?
Réévaluation clinique à 72 heures ; pas d’ECBU de contrôle si évolution clinique favorable.
What defines acute complicated pyelonephritis?
Infection plus sévère qui peut mettre en cause le pronostic vital par le risque de septicémie.
What are common causes of obstruction leading to acute complicated pyelonephritis?
- Lithiase
- Compression
- Vessie neurologique
- Corps étranger (sonde urinaire…)
What type of antibiotic therapy is often required for complicated pyelonephritis?
Double antibiothérapie IV.
What is a potential complication of acute pyelonephritis?
Infection suppurative.
What percentage of urinary infections in pregnancy are asymptomatic bacteriurias?
5%.
What is the prevalence of acute cystitis in pregnant women?
80%.
What changes in bacteria are observed during pregnancy regarding urinary infections?
Augmentation des cocci gram + (streptocoques, staphylocoques).
What urinary changes occur during pregnancy?
- Dilatation des cavités urétéro-pyélocalicielles surtout à droite
- Diminution du péristaltisme des voies excrétrices
- Moins bonne vidange vésicale = résidu
What is the risk associated with urinary infections during pregnancy?
- Prématurité
- Retard de croissance in utéro
- Risque infectieux périnatal
What is the definition of urinary colonization?
Présence de microorganismes sans manifestations cliniques.
What is the treatment approach for urinary colonization?
Aucun traitement n’est nécessaire.
True or False: Antibiotherapy is required for changes of urinary catheters.
False.
What should be suspected if a patient with a urinary catheter is febrile?
Problème de drainage.
What is the recommended action if there is an obstruction in a urinary catheter?
Antibiothérapie car risque de choc si persistance de l’obstacle.
What is a common underlying issue in pediatric urinary infections?
Uropathie malformative congénitale.
What defines a urinary infection in men?
IU compliquée car la cystite n’existe pas chez l’homme.
What is the most common cause of febrile urinary infections in men?
Prostatite dans > 90 % des cas.
What are the symptoms of febrile urinary infection in men?
- Signes fonctionnels bas
- Fièvre et frissons
- Douleur ou pesanteur pelvienne
What is the recommended duration of antibiotic therapy for uncomplicated cystitis?
Prise unique.
What is the duration of antibiotic therapy for acute prostatitis?
3 semaines.
What are some prevention strategies for urinary infections related to care?
- Traquer les sondages abusifs
- Éviter les sondages en aller retour
- Favoriser l’auto-sondage
What should be done before treating urinary infections, except for acute cystitis?
Prélever avant de traiter.
What is the necessary diagnostic test for simple cystitis?
BU suffisante.
