Diebel UTIs Flashcards
E. coli
gram - bacilli catalase + oxidase - reduces nitrates --> nitrites urease -
surface adhesins
e. coli
facilitate binding to epithelial cells (colonization
P fimbriae
e. coli
interacts with receptor on renal epithelial cells (impt for pyelonephritis)
Type 1 pilus
e. coli
binds to uroplakins on luminal surface of bladder uroepithelial cells (impt for cystitis)
*not always expressed
urease + organisms
Klebsiella pneumoniae
Proteus mirabilis
staph saphrophyticus
gram +
cocci
klebsiella pneumonia
gram - bacilli lactose fermenting facultative anaerobe capsule urease +
proteus mirabilis
gram -
bacilli
facultative anaerobe
urease +
enterococcus
gram +
bacilli
catalase -
urease -
citrobacter species
can cause some uncomplicated and complicated UTIs ok sure
1 cause uncomplicated UTI
e. coli
1 cause complicated UTI
e. coli
2 cause of UTIs in sexually active young women
staph saphrophyticus
5-15% cases of UTI
3 cause of uncomplicated UTI
klebsiella
acinetobacter species
can cause some complicated UTIs ok sure
weirdo causes of complicated UTIs
klebsiella pneumoniae proteus mirabilis citrobacter acinetobacter morganella pseudomonas aeruginosa
UTIs caused by what type of bacteria
enteric
gold standard for UTI dx
urine culture
first line tx for uncomplicated UTI in females
nitrofurantoin or TMP/SMX
first line tx for uncomplicated UTI in males
fluoroquinolones or TMP/SMX
tx of complicated UTIs
should be personalized and guided by urine culture results
infection barriers
- acidity of urine
- act of urination
- immunological barriers
- physical barriers (mucosal lining of urinary tract and urethral sphinctrer)
> 90% of infections result from ________
bacteria ascending the urethra to bladder
critical initial step in infection (in women)
colonization of vaginal introitus and periurethral area from gi tract organisms
predisposing factors
urinary stasis
kindey stones
catheters
family hx (UTIs and pyelonephritis)
definition of complicated UTI
underlying factors that predispose individuals to ascending bacterial infection –>
- catheters
- anatomic abnormalities
- obstrux of urine/flow/poor bladder emptying (calculi, tumor, neurogenic, preg, prostatic enlarge, uterine prolapse, cystocele)
risk factors in women
- sex
- hx of UTIs
- diaphragm/spermicide use
- abx (alter normal vaginal flora –> allows overgrowth of e. coli)
