IC13 UTI Flashcards
What are the factors determining UTI development? (3)
- Host defence mechanisms
- Size of inoculum
- Virulence / Pathogenicity (E. coli with pilli hard to washout)
What are host defence mechanisms in UTI? (4)
- Diuresis in bacteria presence
- Antibacterial properties of urine and prostatic secretions
- Anti-adherence mechanisms in bladder wall
- Inflammatory response with PMN (phacogytes)
What are the risk factors for UTI? (10)
- Sex
- Urinary tract abnormalities
- Neuro dysfunction
- Use of anti-cholinergics
- Catheterisation
- DM
- Pregnancy
- Spermicidal or diaphragm use
- UTI history
- Female
What are the counselling points for UTI? (7)
- Drink more water (6-8 cups)
- Pee upon urge
- Pee after sex
- Wear cotton underwear and loose fitting clothes
- Wipe front to back
- Try other methods of contraceptives
- Try not to use unlubricated condoms as they can irritate
What are the two testing methods for UTI?
UFEME and dipstick test
What does UFEME assess?
Pyuria, hematuria and UUTI (from casts)
What does the dipstick test assess?
Nitrite and Leukocyte esterase
What does nitrite positive mean?
Gram negative bacteria
What does LE positive mean?
Leukocytes present in urine, pyuria
When should you culture urine? (5)
Pregnant women
Recurrent UTI
Pyelonephritis
Catheter-associated UTI
UTI in men
Main pathogen for uncomplicated or CA-UTI?
85% E. coli
Pathogens for complicated or HA-UTI?
E. coli, GN bacilli and Pseudomonas
What are the HA-UTI risk factors? (4)
- Past hospitalisation in the last 90 days
- Current hospitalisation 2 or more days
- Residence in nursing home
- Current abx use
When to treat UTI? (3)
- Pregnant women
- Urologic procedure where mucosal damage is expected
- Symptomatic UTI
Treatment for Cystitis in Women
(first line)
PO Co-trimoxazole 800/160mg BD x 3 days
PO Nitrofurantoin 50mg QDS x 5 days