Infectious Disease: Genitourinary

Question 1

Lower UTI Laboratory Tests

Answer 1

Bacturia, Pyuria, Nitrate (+)
Leukocyte Esterase (+)

Question 2

Upper UTI Laboratory Tests

Answer 2

Leukocytosis, Hyaline Casts (UA)

Question 3

Uncomplicated UTI Criteria

Answer 3

Females of childbearing age
Age 15-45
No structural/neurological abnormalities interfering w/ urine flow

Question 4

Complicated UTI Criteria

Answer 4

Don’t meet any of the uncomplicated criteria

Question 5

Community Acquired Microbiology Uncomplicated
Gram-Negatives

Gram-Positives

Answer 5

E.coli
Klebsiella pneumoniae
Proteus spss

Staphylococcus saprophytiicus
Enterococcus

Question 6

Community Acquired Microbiology Complicated
Gram-Negatives

Gram-Positives

Answer 6

E.coli
Proteus spss.
other GN

Staphylococcus saprophytiicus
Enterococcus

Question 7

Nosocomial Microbiology
Gram-Negatives

Gram-Positives

Fungal

Answer 7

E. Coli
Proteus spss.
Enterobacter
Acinetobacter
Pseudomonas aeruginosa

Enterococcus

Candida

Question 8

Cystitis Uncomplicated Treatment

Answer 8

SMZ/TMP 3d
Trimethoprim 3d
Fluoroquinolones (Cipro, Levo) 3 d
Nitrofurantoin 3d
Fosfomycin 1 dose
B-lactams (Amox/Clav) 3d

Question 9

Pyelonephritis Treatment
Consider hospitalization if?

Answer 9

pt is unable to tolerate PO
Has severe symptoms: high temp, elevated WBC, severe pain, dehydration
No improvement on outpatient therapy

Question 10

Uncomplicated Pyelonephritis Treatment
Treat empirically with:
If the organism is susceptible -?
If the organism is susceptible -?
If gram-positive is the causative agent?
Duration?

Answer 10

PO cephalosporins
SMZ/TMP
Amoxicillin or Amox/Clav
14d

Question 11

Complicated Pyelonephritis Treatment
Nosocomial Infections
1st line?
Consider what if no improvement?

Answer 11

Ciprofloxacin or Levofloxacin

Pseudomonas or Enterococcus coverage

Question 12

Complicated Pyelonephritis Treatment
Agents and Duration?
Gram-positive organisms?

Answer 12

Levofloxacin or Ciprofloxacin 14d
Aminoglycoside +/- Ampicillin 14d
Extended spectrum Cephalosporin 14d

Amp/Sublact +/- AG

Question 13

Complicated Pyelonephritis Treatment
Possible Alternative Regimens
PCN allergic?
Others?

Answer 13

Aztreonam
B-lactam/B-lactamase inhibitors
Carbapenems

Question 14

GU Infections
Relapse:
Failed Short course (3 days) treatment is?
Failed Longer course (10-14d) treatment is?

Answer 14

continue same therapy for 14d

continue same therapy for 6 weeks

Question 15

GU Infections
Re-infection:
Different Pathogen involved treatment is?

Answer 15

treat for 14 days

Question 16

GU Infections: Catheter Associated Infections
Do we need to treat?
Remove what?
Bags should be drained how often?
Start abx only if? (Treat as what?)
Administering abx to prevent infection is or is not recommended?

Answer 16

the catheter
q4-6h
only if symptomatic; complicated cystitis
not recommended

Question 17

Genitourinary Infections: Asymptomatic Bacturia
Only time this is treated is in who?
20-40% of this population w/ asymptomatic bacturia will develop what?
Duration for ASB is?
Safest agents/agents of choice is?

Answer 17

pregnant women
pyelonephritis
3-7d
B-lactams