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Kidney function and failure > Microbiology of the urinary tract > Flashcards

Microbiology of the urinary tract Flashcards

1
Q

Ex of lower urinary tract infection:

A

Cystitis

Urethritis

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2
Q

Places of acquisition of UTIs

A

Community acquires

Nosocomial

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3
Q

Route of acquisition:

A

Ascending

Haematogenous

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4
Q

Risk factors for UTIs:

A
  • Female sex
  • Sexual activity
  • Diabetes mellitus
  • Urinary stasis
  • Urinary retention
  • Not fully emptying bladder
  • Urinary catether
  • Congenital abnormalities
  • Reflux
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5
Q

Most common bacterial cause of UTI:

A

E.coli

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6
Q

E.coli:

A

Gram negative, rod shaped

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7
Q

Other bacterial causes:

A

Proteus species
Enterobacter
Staphlococci

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8
Q

Fungi causes:

A

Candida

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9
Q

Viral causes;

A
  • Adenoviruses

- BK, JC viruses

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10
Q

Adenoviruses are associated with:

A

Haemorrhagic cystitis

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11
Q

BK and JC viruses:

A

Associated with infection and graft failure in patient following kidney transplant

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12
Q

Parasitic infection that can cause UTI:

A

Schistosoma haematobium

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13
Q

Ex of upper urinary tract infections:

A

Pyelonephritis

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14
Q

Innate host defences against UTI:

A
  • Urine flow and mictuition

- Urine pH, osmolarity and urea

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15
Q

Active host defences against UTI:

A
  • Secretory IgA

- Mucosal defences

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16
Q

Why are females more likely to get UTIs?

A

Shorter urethra

Urethra closer to anus

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17
Q

Bacteria and lower UTI in pregnancy can cause:

A
  • Lower birth rate
  • Premature delivery
  • Increased perinatal morbidity
  • Increased risk of developing pyelonephritis
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18
Q

Pyelonephritis in pregnancy:

A
  • Lower birth weight
  • Prematurity
  • Foetal loss
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19
Q

What is screened for during pregnancy?

A

Asymptomatic bacteriuria

20
Q

Common symptoms of cystitis:

A

Frequency
Urgency
Dysuria

21
Q

What is usually absent or low in cystitis?

A
  • Systemic symptoms

- Fever

22
Q

Symptoms of UTI in infants:

A

Fussy, reduced feeding, failure to thrive

23
Q

Symptoms of UTI in elderly:

A

Normal signs may be absent, sudden onset of confusion

24
Q

Symptoms of pyelonephritis:

A
  • Frequency, urgency, dysuria
  • Loin pain
  • Fever
  • Rigors
  • Renal angle tenderness
  • Nausea, vomiting
25
Q

Diagnosis of UTI:

A
  • Urinealysis
  • Urine microscopy
  • Urine culture
26
Q

Urinealysis to look for:

A

Protein, blood leukocyte esterase, nitrites

27
Q

Leukocyte esterase may be … due to …

A

False negative

Taking antibiotics, high glucose in urine

28
Q

Nitrites are formed by:

A

Gr- bacteria

29
Q

Why might nitrities be falsly negative?

A
  • Some bacteria don’t product

- Low numbers of bacteria

30
Q

Urine microscopy looks for:

A

WBCs, epithelial cells, red cells, casts

31
Q

Gold standard for diagnosis:

A

Urine culutre to look for organism and sensitivities

32
Q

Urethral syndrome:

A

symptoms with negative urine cultures

33
Q

Why might someone have clinical features but negative urine cultures?

A
  • Too few bacteria
  • Culturing wrong organisms
  • Non-infective inflammation
  • STI (chlamydia, gonorrhoea)
34
Q

Uncomplicated UTI:

A

Lower UTI in young, otherwise fit woman

35
Q

Management of uncomplicated UTI:

A
  • Good hydration

- Short course of antibiotics if indicated

36
Q

Antibiotics used for UTI:

A

Trimethoprim: cheap, active against most uropathogens of uncomplicated UTI
Nitrofurantoin: high urine conc

37
Q

Nitrofuratoin cannot be used on:

A

Proteus species

Upper urinary tract infection

38
Q

Amoxicillin and uncomplicated UTIS:

A

High rates of resistance

39
Q

Recurrent UTI:

A

> 3 UTIs annually

40
Q

Management of recurrent UTI:

A
  • voiding post-intercourse
  • Double voiding
  • HRT
  • Prophylactic antibiotics
41
Q

Way of getting a sterile urine sample:

A

Suprapubic aspirate

42
Q

Diagnosing UTI in children:

A

<3mnths: less reliance on dipstick
3mnths-3yrs: microscopy and culture like adult
3 yrs+: lukocytes esterase and nitrites

43
Q

What does a UTI in a child may indicate?

A

Congential abnormality, should image

44
Q

Treatment of lower tract infections in a child:

A
  • Amoxicillin, trimethoprim, cephalexin
45
Q

Treatment of mild UUTI in child:

A

Co-amoxiclav

46
Q

Treatment of severe UUTI in child:

A

Cefotaxime, gentamicin

Kidney function and failure (9 decks)

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