Lecture 4 - UTI's

Question 1

what are some important bacterial virulence factors?

Answer 1

1. motility
2. adhesion molecules
3. capsular antigens which inhibit phagocytosis
4. urease production which damages the uroepithelium
5. hemolysis and iron-chelating agents

Question 2

what are important host defenses?

Answer 2

1. normal micturition
2. anatomy
3. mucosal defense barriers
4. antimicrobial properties of urine

Question 3

what are the clinical signs of a LUTI?

Answer 3

1. stranguria
2. pollakiuria
3. +/- hematuria
4. normal attitude and appetite
5. strong odor

Question 4

clinical signs of an upper UTI?

Answer 4

1. anorexia, lethargy
2. back pain
3. PU/PD
4. fever
5. depressed

Question 5

importance of UA in UTI

Answer 5

UA: if azotemic AND dilute urine - suggests renal involvement + LUTI

Question 6

importance of culture and sensitivity when running diagnostics for UTI

Answer 6

culture & sensitivity: must do if recurrent or if animal was on abx

Question 7

importance of CBC when running diagnostics for UTI

Answer 7

if leukocytosis (increased WBC) or left-shift, something else is going on

Question 8

importance of chemistry when running diagnostics for UTI

Answer 8

should be normal for LUTI!

Question 9

what are the 4 clinical forms of a UTI?

Answer 9

1. asymptomatic bacteriuria: + culture, - CS; seen in immune imparied
2. uncomplicated bacterial cystitis or simple urethrocytosis: typical lower UTI signs, otherwise normal
3. uncomplicated pyelonephritis: signs attributable to kidneys like fever, lethargy, anorexia, etc. can also have LUTI
4. complicated UTI (cystitis, pyelonephritis): predisposing factor present which must be corrected first (like ectopic ureters)

Question 10

what are the 4 potential outcomes of a UTI

Answer 10

1. cure - eradication of microorganisms, resolution of CS, proven neg by culture
2. persistence - failure to eradicate microorganisms, + culture of same bug 3-5 days after abx started
3. relapse - + culture 1 - 2w after end of therapy with same strain. likely inadequate duration of therapy. must tx for 4 - 6 weeks!!!
4. reinfection - + culture with a NEW and DIFFERENT organism. look for pre-disposing cause

Question 11

duration of treatment for
uncomplicated UTI
complicated UTI

Answer 11

uncomplicated UTI = 1 - 2 weeks
CS resolve in 48 - 72 hours

complicated UTI = 4 - 6 weeks

Question 12

what does infection depend on?

Answer 12

bacterial virulence and host’s defenses