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MICRO 121 > Lecture 14: Urinary Tract Infections > Flashcards

Lecture 14: Urinary Tract Infections Flashcards

1
Q

Cystitis

A

Infection of the bladder

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2
Q

Pyelonephritis

A

Infection in the Kidney - fever, flank tenderness (upper urinary tract infection)

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3
Q

Urethritis

A

Inflammation of the urethra

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4
Q

Organisms from the perianal region to the urethra -
Normal flora includes:

A
  • Lactobacillus
  • Staphylococcus (skin flora)
  • Corynebacterium (skin flora)
  • Enterococcus (gram +’ve cocci in chains, found in gut)
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5
Q

What are catheters prone to?

A

Biofilm formation - lead to continuous seeding + urine is contaminated with bacteria from the catheter
-> Id catheter infected - fix catheter before taking urine sample otherwise just getting catheter bacteria

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6
Q

What can happen if UTI’s are untreated?

A

Can lead to urosepsis, meaning leaking into blood (causes bad outcomes)

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7
Q

What are symptoms of a UTI?

A

Urgency, frequency, pyuria (WBC’s in the urine), pain (abdominal, lower back, upon urination [dysuria]), occasional fevers (not with cystitis - more associated with upper urinary tract infections)

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8
Q

Uncomplicated UTI age + gender risk factors

A

Female gender - very prone
Older age - most prone
Younger age - least prone for females

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9
Q

Nonspecific mechanism

A

Urine - if prevented then bacteria builds up quickly because cannot be washed out

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10
Q

Complicated UTI Risk factors

A

Indwelling catheters, immunosuppression, urinary tract abnormalities, antibiotic exposure
*Males automatically go to

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11
Q

Getting a sample (common) steps of a UTI diagnoses

A
  1. Take sample
  2. Dipstick
  3. Dipstick +’ve
  4. Hangs out in nursing station + bacteria growing (2-4 hours)
  5. Goes to lab, # of bacteria significantly increased from when nurse took the swab
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12
Q

How many bacteria constitute a UTI

A

10-100 x 106 /mL (107-108/L)

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13
Q

Variables that make it hard to diagnose UTI’s

A

Hydration, time urine is in the bladder, antibiotic use, collection method and storage conditions
- Majority of uncomplicated UTIs (90%) are mono microbial while urine cultures in catheterized patients tend to be poly-microbial (could indicated colonization on catheter
- Urine colonized by bacteria without leading to an inflammatory response…defined as “asymp bacteriuria”
- Rapid screening tests are not great for the diagnosis of UTI’s
- Organisms that cause UTI’s are the same ones that are seen in individuals with asym bacteriuria

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14
Q

Dipsticks

A

Rapid tests to test for pyuria (cells) and nitrites (bacteria metabolize nitrate to nitrites)

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15
Q

Uncomplicated UTI definition

A

Defined as occurring in healthy adult non-pregnant women

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16
Q

Which gender more often gets UTI’s + why

A

Females, bc shorter urethra than men (more common in elderly

17
Q

Complicated UTIs (cUTI’s)

A

Occur in all sexes and age groups and are frequently associated with structural or functional urinary tract abnormalities

18
Q

More Risk factors of UTI’s

A
  • Male vs Female
  • Altered Vaginal Flora
  • Sex
  • Diaphragm / spermicide
  • Mechanical obstruction
  • Catheters (lack of usual symptoms, fevers are often the only sign)
  • Age (prostate)
19
Q

Asymptomatic Bacteriuria

A
  • Not an infection - colonization, treatment indicated only in pregnancy or for those undergoing urinary instrumentation
  • Treatment: selecting for resistant organisms. (Trimethoprim sulfamethoxazole, ciprofloxacin, and ampicillin are most commonly used drugs for therapy)
20
Q

What happens to catheterized patients colonized with bacteria

A
  • Catheterized patients - colonized with bacteria - change the catheter and re-collect urine
21
Q

Contamination vs UTI

A
  • Midstream urine specimen, In/out catheter
  • Transport sample within 2hrs to lab, otherwise store in fridge and transport within 24 hrs
  • Educate patients on collecting a clean catch midstream urine
22
Q

Treatment/Prevention of UTI’s

A
  • Decent evidence cranberry juice can reduce UTI’s
  • Frequent urination
  • Increased risk after first infection of relapse
  • Treatment; typically high dose antibiotics x3 days in uncomplicated infections
23
Q

Urine Dipstick

A
  • Nitrite levels are specific for gram -‘ves that metabolically convert nitrate to nitrite
  • Leukocyte esterase produced by neutrophils
  • Clinical symptomatic have better sensitivity results
24
Q

How fast can bacteria in urine double?

A

Every 20 min

25
Q

Vaginitis

A
  • Increased vaginal discharge
  • Painful intercourse
  • Pain on urination
26
Q

Bacterial Vaginosis

A
  • Minimal irritation
  • Thin discharge
  • Often no sexual contact
  • Increase in pH in the vagnial tract
  • Caused by alterations in the vaginal flora or microbiota
  • Usually good bacteria (Lactobacillus - gram +’ve) outnumbered bad (anaerobes - gram -‘ve) then there is a shit in the microbial environment
  • Thin, white-green vaginal discharge, foul smelling vaginal odour, vaginal itching and burning during urination
  • Clue cells are a way to diagnose BV
27
Q

Candidiasis/Yeast Vaginitis

A
  • Infection associated with overgrowth of Candida albicans
  • Most common
  • Itching or irritation
  • Watery or thick white odor free discharge
  • Caused by overgrowth of yeast in the vaginal tract
  • Most common is Candida albicans
28
Q

Trichomas Vaginitis

A
  • Infection with Trichomonas vaginalis
  • Sexually transmitted infection
29
Q

Douching

A

The practice of rising your vagina with water or anther type of cleanser - this upsets the natural balance of the vagina.

30
Q

Risk Factors with BV

A
  • Multiple sex partners
  • Douching
  • Lesbos
  • Natural lack of lactobacilli in the vagina.
31
Q

Complications of BV

A
  • Pre-term birth
  • More susceptible to other STI’s
  • Pelvic inflammatory disease (PID)
32
Q

Risk factors for yeast vaginitis

A
  • Antibiotic use changes the pH of vag
  • Preggo
  • Uncontrolled diabetes
  • Immunocompromised
  • Oral contraceptives or hormone therapy (changed estrogen levels)
  • May occur after sex (all kinds) but can also occur from non sexual things

MICRO 121 (19 decks)

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