IC13 Flashcards
In which two populations should ASB be screened?
Pregnant women & Patients going for urologic procedure in which mucosal trauma/bleeding is expected
ASB vs UTI
No symptoms of UTI vs has urinary symptoms
Note that BOTH have Isolation of significant colony counts of bacteria in the urine
When to screen pregnant women?
Screen at one of the first visits (1216 weeks gestation)
Tx of ASB in pregnant women
If bacteriuria, treat with active antibiotics (based on AST), duration 4 to 7 days
Tx of ASB in patients going for urologic procedure in which mucosal trauma/bleeding is expected
Use antibiotics based on SAP
If a patient has signs of systemic infection and delirium, ______ may be warranted.
empiric antibiotic therapy
Factors determining the development of (UT) Infection
- Competency of the natural host defense mechanisms
- Size of the inoculums
- Virulence/pathogenicity of the microorganism
Ascending vs descending route of infx
Ascending: Colonic/ fecal flora colonise periurethra area/ urethra -> ascend to bladder & kidney
Descending: Organism at distant primary site (eg heart valve, bone) -> bloodstream (bacteremia)-> urinary tract -> UTI
Common organisms causing ascending vs descending route of infx
Ascending: E. coli, Klebsiella, Proteus
Descending: Staph aureus, Myco tuberculosis
Normal host defense against UTIs
- Micturition
- Anti-bacterial ppty of urine & prostatic secretion
- Anti-adherence mechanisms of bladder
- Phagocytosis by polymorphonuclear leukocytes
Which microorganisms adhere well to the bladder?
bacteria with pili (eg E. coli) resistant to washout or removal by anti-adherence mechanisms of bladder
