L5 Urinary Tract Infections Flashcards
Range of symptoms
- Cystitis: Bladder inflammation
- Pyelonephritis: Kidney parenchyma infection
- Urethritis: Urethra inflammation
Type of infection commonly
Ascending infection (route of entry via urethra) but can be descending
Defences against UTIs
- urine: osmotic stress/ pH/ organic acids
prostate secretion (increase zinc) - urine flow: expel microorganisms (normal results of retention)
- urinary tract mucosa: IgA/ Lactoferrin/ defensives/ glycosaminoglycan/ Tamm-Horsfall protein
Risk factors
Sex Age Structural abnormalities Diabetes Catheterisation
Community caused UTIs
E.coli 80% Coagulase -ve staphylococci 7% Other gram -ve 4% Other gram +ve 3% Proteus mirabilis 6%
Hospital patient UTIs
E.coli 40% Coagulase -ve staphylococci 3% Other gram -ve 25% Other gram +ve 16% Candida albicans 5% Proteus mirabilis 11%
What does UPEC stand for?
Uropathogenic E.coli
How does UPEC cause disease?
Pathotypes have the ability to develop into pathogenicity islands
Pathogenicity of UPEC (kidney)
UPEC lack P type pills which are needed for:
Pyelonephritis (adhesion/ suppression of IgA secretion)
Pathogenicity of UPEC (bladder)
Enters bladder via adhesion (type 1 pilli adhesion)
Induce cytoskeletal arrangement and taken up by host increase cAMP (normally pump bacteria out but convinces cell not to)
Pathogenicity of proteus (bladder)
Organism is introduced via catheter
Urease production = change pH = crystal formation = struvite stones (difficult to eradicate)
Urgency
Overwhelming need to urinate
Frequency
Abnormally frequent urination
Dysurla
Pain/ burning during urination
Pyuria
Pus in urine
