IOD Flashcards
Asymptomatic bacteriruia
A condition where there is bacteria in urinary tract which is normally sterile but there are no symptoms
Can predispose to pyelonephritis
Cystitis symptoms
Frequency
Dysuria
Haematuria
Suprapubic discomfort
2 x these 90% success rate with diagnosis
Cystitis complications
Can lead to pyelonephritis
Can also lead to septicaemia potentially fatal
Urethral syndrome
symptoms of UTI without evidence of infection
give a range of non antibiotic treatments
Pyelonephritis symptoms
Pain
Fever
Rigors
This arises from direct invasion of the renal tissue
Course of pyelonephritis
Can develop from symptomatic cystitis or from asymptomatic bacteriuria
may go on to give septicaemia
Uncomplicated UTI
young woman
not pregnant
no underlying problem
Complicated UTI
Congenital abnormality - obstruction or neuro Acquired abnormality - obstruction or neuro Catheter Young male Pregnancy --- worry for pyelonephritis
may give septicaemia
recurrent infections can arise == give ABx and resistance builds up
Bacterial causes of uncomplicated UTI
E. coli (80%) Staph S Klebsiella Enterobacter Enterococcus
These are the normal gut flora
Bacterial causes of complicated UTI
E coli still
Klebsiella
Enterobacter
Pseudomonas aeruginosa
Often these will be resistant to ABX
Pathogenesis of UTI
Organisms usually from gut flora Ascend urethra from perineum Females shorter urethra Vesico-urteric reflux - can lead to pyelonephritis
Urinary dipsticks
Nitrite detection - bacteria convert nitrate == nitrite e acceptors RBC WBC Protein
Assess if it is turbid
MCS
Microscopy can help detect
- WBC, RBC, bacteria and casts
Culture 10^4 is arbitrary cut off
often lower number in early stages of UTI
Sensitivity
- detects which ABx the organism is sensitive to
Urine sample
Mid stream urine is important to collect
Catheter
Suprapubic aspirate Newcastle sterile urine collection pads
Symptomatic treatment of UTI
hydration
analgesia
alkalisation of urine - potassium citrate
