Microbiology of UTI Flashcards
Define:
a) MSSU
b) upper UTI
c) lower UTI
d) cystitis
e) bacteriuria
a) mid-stream sample of urine
b) renal pelvis infection (pyelonephritis)
c) urethra, bladder, prostate infection
d) inflammation (not necessarily infection) of the bladder
e) presence of bacteria in the urine, which may or may not be symptomatic
What is the main causal organism associated with UTI?
E.coli (about 70% in the community)
What other bacteria may be causal?
Proteus sp.
Staph. saprophyticus
Pseudomonas
How might a UTI present? What symptoms suggest involvement of higher structures?
Dysuria, frequency, nocturia, haematuria, suprapubic pain/discomfort
Fever, loin pain, rigors
Which dipstick measurements might indicate UTI?
Leukocytes and nitrites
Maybe protein and blood
How many bacteria need to be present for a urine culture to be “significant”?
> 10^5
How should a mixed growth of 10^5 be regarded?
Probably non-significant
How is non-complicated UTI in females treated?
Three days course of trimethoprim or nitrofurantroin
How is complicated UTI/pyelonephritis treated?
Co-amoxiclav or co-trimoxazole (14 days)
The use of which antibiotic is associated with C. difficule infection?
Ciprofloxacin
How is UTI in men treated?
Trimethoprim or nitrofurantroin (14 days)
What is the traditional definition of recurrent UTI?
Two within 6 months; or three within a year
For patients who suffer from recurrent infections what can be offered in general practice?
Standby prescription
What are the antibiotic prophylaxis rules for recurrent UTI
a) related to sexual intercourse
b) unrelated to sexual intercourse?
a) 100mg trimethoprim, one to be taken within 2 hours of sexual intercourse
b) six-month course of low-dose nitrofurantoin or trimethoprim
When should referral for imaging or cystoscopy be considered?
Persistent non-responders to treatment
History of renal disease or anomaly
Have haematuria
What can ascending infection lead to? (6)
Pyelonephritis Perinephric and intrarenal abscess Hydronephrosis Pyonephrosis AKI Sepsis
