Lecture 16-UTI Flashcards
What are the host factors that can increase the risk of UTI?
- shorter urethra in females so more likely to have UTIs
- obstruction eg enlarged prostate, pregnancy
- neurological problems
- ureteric reflux
What are the bacterial factors that can increase the risk of UTI?
- fimbriae allow attachment to host
- polysaccharide capsule
- haemolysins damage host membranes and can cause renal damage
- urease breaks down urea -> nitrites
What are the clinical signs and symptoms of lower UTIs?
- dysuria
- frequency
- urgency
- low grade fever
What is cystitis?
Bladder inflammation
What are the clinical signs and symptoms of upper UTIs?
- fever
- loin pain
- may have dysuria and frequency
What is uncomplicated UTI?
Infection by usual organism of the patient with normal urinary tract and normal urinary function, occurs in males and females of any age
What is complicated UTI?
UTI with one or more factors that predispose person to persistent infection, recurrent infection/treatment failure eg UTI with abnormal UT, virulent organism, impaired host defences
True or false: infection in children and men may be uncomplicated but most in children, men and pregnant women are complicated
TRUE
Which investigations can be used to diagnose UTI?
- urine culture (complicated)
- urine sample
- screening (turbidity)
- dipstick: leucocyte esterase, nitrite, haematuria, proteinuria
- culture
- imaging
When is a dipstick test useful?
In excluding UTI in children over 3, men with mild symptoms and elderly women
In which gender and age group does asymptomatic bacteriuria occur?
Elderly females
True or false: asymptomatic bacteriuria is associated with pyuria
TRUE
What can cause asymptomatic bacteriuria?
Unnecessary antibiotics
What is the treatment plan for simple cystitis?
- trimethoprim or nitrofurantoin
- 3 day course
What is the treatment plan for complicated lower UTI?
- trimethoprim (for upper and lower UTI)
- nitrofurantoin (only bladder)
- cephalexin
- 5 to 7 day course
