Microbiology of the Urinary Tract Flashcards
What is Cystitis?
A bladder infection
What is Pyelonephritis?
A kidney infection
What are the two routes of acquisition for a UTI?
Ascending
Haematogenous
Give two examples of lower UTIs
Cystitis
Urethritis
What is a nosocomial infection also known as?
Hospital acquired infection
What is the most commonest bacteria which causes UTIs?
Escherichia coli
Aside from E.Coli, state other common bacteria which cause UTIs
Coagulase-negative staphyloccoci Proteus mirabilis Candida Kiebsella Enterobacter
Which virus is associated with hemorrhagic cystitis?
Adenovirus
State 3 viruses which cause UTI
Adenovirus
BK virus
JC virus
State 4 host defences against UTIs
- Urine flow / micturition
- Urine chemistry
- Secretory factors i.e. IgA / Lactoferrin
- Mucosal defences i.e. GAGs
Why are females more likely to acquire UTIs than males? 3 reasons
- Shorter urethra
- Urethra opens to introitus
- Anus closer to urethra
Why are anatomical abnormalities i.e. congenital / diverticula etc a risk factor factor UTIs?
Risk of urine reflux, stagnant urine or residual urine after incomplete emptying
Why is catheterisation a risk factor for UTIs? 3 reasons
- Catheters bypass host defences
- Are a foreign body
- Lead to biofilm formation
Why is pregnancy a risk factor for UTIs? 3 reasons
- Dilation of ureters
- Incomplete bladder emptying
- Gestational glycosuria
Why are foreign bodies such as stones a risk factor for UTI? 2 reasons
- Mucosal damage
- Host defences are less accessible to bacteria
What symptoms could one expect to see in patients with Cystitis?
What about elderly patients?
- Polyuria / dysuria / urgency / fever / suprapubic discomfort
In elderly:
- Patient may be asymptomatic
- Sudden onset of confusion
What symptoms could one expect to see in infants?
- Failure to thrive
- Poor feeding
What symptoms could one expect to see in patients with Pyelonephritis?
- Symptoms of cystitis
- Loin pain
- Fever
- Rigors
- Renal angle tenderness
What is likelihood of bacteruria with catheter use?
5-10% increase with each day catheter is used
How can doctors prevent catheter-associated UTIs? 5 examples
- Do not catheter if unnecessary
- Limit duration of catheter
- Aspect insertion
- Closed drainage system
- Ag++ bonded catheter use
Give 4 examples of anti-microbials to be used for management of an uncomplicated UTI
- Trimethoprim
- Nitrofurantoin
- Ampicillin / Amoxicillin
- Quinolones
