Genitourinary Tract Infection Flashcards
For pyuria we consider:
10 leucocytes per microscopic field or 5–10 perhigh-powered field in centrifuged sample
For Bacteriuria we consider
10^5 colony-forming units per mL
and in two consecutive samples in women, or a single sample in men.
Criteria for cystitis or lower tract infection
dysuria, urinary frequency,
urinary urgency ± objective sign of suprapubic tenderness
Symptoms for acute Pyelonefritis
flank pain ± dysuria, urinary frequency and urgency
Symptoms for acute prostatitis
Subjective complaint of peroneal or suprapubic pain ± dysuria, urinary frequency and urgency
and can present with signs of sepsis including fever, usually significant prostatic tenderness on examination
Typically a complication of bacteremia;
also increasingly a recognized complication of ascending
infection including pyelonephritis.
Intrarenal abscess
Urinary pathogen by Hematogenous infection
Staphylococcus aureus
bacteremia and fungemia with Candida species.
Factors on E. coli cell surface include:
Adhesins and α-hemolysin toxin
Uropathogens that produce urease include
Proteus, Klebsiella, Pseudomonas spp.,
Staph aureus, Corynebacterium urealyticum
UTI in adults ——- impacts renal function
rarely
is associated with a 10% risk of subsequent development of UTI.
Catheterization
Risks in posmenopausal women
estrogen deficiency, incontinence, postvoid residual, catheterization.
Screening not recommended:
Premenopausal women, nonpregnant women.
* Diabetic women.
* Elderly subjects
* Spinal cord injury.
* Catheterized subjects
Flank pain that suggests a stone.
with radiation to the groin
Some quick tests for UTI can be:
Leucocyte esterase.
Nitrite
Nitrites aren´t useful for what type of bacteria
staphylococci or enterococci
Gram positives that can cause a UTI
Staphylococcus
Enterococcus
Corynebacterium urealyticum
Viral etiologies for UTI
Adenovirus AND BK virus
Relapse happens when:
1–2 weeks after stopping antibiotics
Lower tract should be treated with
nitrofurantoin or fosfomycin sufficient
Upper tract should be treated with
TMP–SMX), aminoglycosides.
Cystitis should be treated with
Nitrofurantoin 5 days, TMP–SMX 3 days, or
Fosfomycin 3 g × 1 dose.
Pyelonephritis should be treated with
Ciprofloxacin or 5 days with levofloxacin is adequate.
Some relapsing causes that should be considered are:
Deep-seated renal parenchymal infection.
Anatomical abnormality, e.g., stone.
Foreign body, e.g., stent.
In male, prostatic infection
