CPRS 85: Urinary Tract Infection Flashcards
Which gender has the higher prevalence of Urinary Tract Infection?
Female
Male has rare Urinary Tract Infection Prevalence until obstruction from _______
Benign Prostate Hyperplasia
What is the most common type of Hospital Acquired Infections
Urinary Tract Infection
Name 2 pathogens for UTI
Escherichia coli
Proteus mirabilis
Name 3 virulence factors for E. coli
Type I & P Fimbriae
Toxins
Lipopolysaccharide capsular polysaccharides
What factors will make people more prone to UTI in terms of bacterial entry?
- length
- immunocompromised
- Hormonal effect
Length of Urethra (shorter = easier infection)
Immunocompromised = Easier infection
Hormonal Effect: Post-menopausal woman has higher chance of infection, as oestrogen and progesterone are important in maintenance of healthy urothelium and mucosa
What factors will make people more prone to UTI in terms of bacterial spread?
- R
- P
- O
- I
Reflux
Pregnancy
Obstruction from stones (Much harder for urine to flow)
Immunocompromised
How does urease lead to stone formation
Urea becomes _____ by _____
Raises the ____ of urine
Facilitates ________
Reduces ______ and increases chance of UTI
Urea becomes ammonia by urease
Raises the pH of urine
Facilitates precipitation
Reduces urine flow and increases chance of UTI
Host defense of UTI
Name 3
- ______ of urine
- ______ immunity
- ______ immunity
Flushing effect of urine
Humoral immunity
Cell mediated immunity
Uncomplicated UTI VS Complicated UTI
- What type of Urinary Tract do they infect?
- What type of people are involved?
Uncomplicated UTI VS Complicated UTI
- What type of Urinary Tract do they infect- Normal Urinary Tract VS Compromised Urinary Tract
- What type of people are involved- Non pregnant healthy women VS Infection in men/ pregnant women
Name 5 syndromes of UTI
- Asymptomatic bacteriuria
- ________ (Inflammation of the kidney)
- ________ (Inflammation of prostate gland)
- ________ (Inflammation of urinary bladder)
- ________ abscess, common in which type of disease?
Name 5 syndromes of UTI
- Asymptomatic bacteriuria
- Acute pyelonephritis (Inflammation of the kidney)
- Prostatitis (Inflammation of prostate gland)
- Cystitis (Inflammation of urinary bladder)
- Perinephric abscess- common in Diabetes Mellitus
Relapse and reinfection
What is the difference
Relapse VS Reinfection
Infection by the same bacterial strain VS Infection by a different organism
What are the 2 microbiological diagnosis of UTI?
Pyuria- Sample of Urine under Microscope showing increased WBCs in urine
Significant bacteriuria
Urine dipstick test for UTI
What 2 things will there be an increased level?
Nitrite
Leukocyte Esterase
In Urine Dipstick test for UTI, there will be an increased level of Nitrite and Leukocyte Esterase. Why will there be increased nitrite?
E. Coli and Proteus mirabilis reduces nitrate in urine to nitrite
What is the limitation of using nitrite level increase as the indicator of UTI
Some bacteria may not have the enzyme to reduce nitrate to nitrite
Urine may not be staying in the bladder for long enough
How to detect bacteriuria
Use a standard loop
Culture urine on _____ agar that inhibits ______
What bacterial counts are higher than the specific number that will indicate bacteriuria
How to detect bacteriuria
Use a standard loop
Culture urine on CLED agar that inhibits swarming
What bacterial counts are higher than the specific number: 10^5 that will indicate bacteriuria
During urine collection, we should avoid cleaning the area with _______ because it may cause contamination of the urine which leads to _______ results
During urine collection, we should avoid cleaning the area with antiseptic because it may cause contamination of the urine which leads to false negative results
When does Asymptomatic Bacteriuria require Treatment? Name 3 scenarios
- P… women
- Before…
- C…
- Pregnant women
- Before urological operation
- Children smaller than 5 years of age
Acute Bacterial Prostatitis Name 3 clinical presentations - D - H F - Urinary...
Dysuria
High fever
Urinary retention common
What are the 3 risk factors for Acute Bacterial Prostatitis
Unprotected anal intercourse
Indwelling urinary catheter use
Prostate biopsy
Name 2 Pathogens for Chronic Bacterial Prostatitis
E. coli
Pseudomonas aeruginosa
Urine collection method (4 cups)
VB1 VB2 \_\_\_\_\_\_\_ for 1 minute EPS VB3
Urine collection method (4 cups)
VB1: 1st voided 10mL (discarded) VB2: Midstream from urinary bladder Prostate massage for 1 minute EPS: Prostatic secretion VB3: 1st voided 10mL after massage
Urine collection method (2 cups)
VB1: 1st voided 10mL (pre-massage)
Prostatic massage
Pro-massage collection
