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Renal > Microbiology of UTIs > Flashcards

Microbiology of UTIs Flashcards

1
Q

Define UTI.

A

Presence of microorgansims in the urinary tract that are causing clinical infection

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2
Q

Define lower UTI.

A

Infection of the bladder

Cystitis

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3
Q

Define upper UTI.

A

Infection involving the ureters +/- the kidneys

pyelonephritis

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4
Q

Define complicated UTI.

A

UTI ccimplicated by systemic sepsis or urinary structura abnormalities or stones.
Requires a longer course of antibiotics

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5
Q

What is bacteriruria?

A

Bacteria in the urine

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6
Q

Who is predisposed to UTI?

A

Female (short wide urethra, proximity of anus to urethra)
Catheterised patient
Abnormality of the urinary tract (congenital posterior urtheral valves, double ureter, horseshoe kidney etc)
Post general anaesthetic
Rena calculi

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7
Q

What are the 2 routes of infection of a UTI?

A

Ascending infection

From the bloodstream

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8
Q

What organisms may cause UTI?

A 
E. coli 
Klebsiella sp. 
Enterobacter sp. 
Proteus sp.
Staphylococcus saphrophyticus 
Staphlococcus aureus - uncommon 
Pseudomonas aeruginosa
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9
Q

A UTI caused by proteus causes what and is associated with what?

A

Causes foul smelling urine

Assocciated with stone formation

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10
Q

What 2 species of Enterobacter cause UTI? Which one is harder to eradicate?

A

Enterococcus faecalis

Enterococcus faecium - more resistant to AB so harder to treat

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11
Q

A UTI caused by Staphylococcus saphrophyticus usually affects what group of people?

A

Women of child bearing age

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12
Q

A UTI caused by Pseudomonas aeruginosa is associated with what commonly?

A

Catheters

UT instrumentation

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13
Q

Which AB would be use to treat a UTI caused by Pseudomonas aeruginosa?

A

Ciprofloxacin

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14
Q

What are the symptoms and signs of a UTI?

A 
Dysuria 
Increased frequency 
Nocturia 
Haematuria 
Fever 
Loin pain - groin pain 
Rigours 
Vomiting
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15
Q

What is the ideal urine specimen?

A

Mid-stream specimen of urine (MSSU)

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16
Q

Which container should be used for urine samples?

A 
Boricon container (red top) 
Contain boric acid which is a preservative
17
Q

A genuine UTI in a non-catheterised patient will usually e caused by how many organisms?

A

1

18
Q

What does ESBL stand for?

A

Extended spectrum beta-lactamase

19
Q

If a bacteria produced ESBL then how does this change the management?

A

Bacteria is resistant to all cepahlosporins and almost all penicillins

20
Q

What AB may be used for ESBL producing bacteria?

A

Ntrofurantoin
Pivemcillinam
Temocillin
Meropenem

21
Q

What is considered the last choice AB?

A

Meropenem

22
Q

A carbopenemase-producing enterobacteriacae is resistant to what antibiotic?

A

Meropenem

23
Q

What is the empirical AB treatment for a female lower UTI?

A

Trimethoprim or Nitrofurantoin orally

3 days

24
Q

What is the empirical AB treatment for a male lower UTI?

A

Trimethoprim or Nitrofurantoin orally

7 days

25
Q

What is the empirical AB treatment for a complicated UTI or pyelonephritis in the GP?

A

Co-amoxiclav or co-trimoxazole

14 days

26
Q

What is the empirical AB treatment for a complicated UTI or pyelonephritis in the hospital?

A

Amoxicillin and Gentamicin IV

3 days

27
Q

What is the empirical AB treatment for a complicated UTI or pyelonephritis in the hospital in a penicillin allergic patient?

A

Co-trimoxazole and gentamicin IV

3 days

28
Q

What is asymptomatic bacteriuria? Does it require antibiotics?

A

Significant bacteriuria >10tothe5 orgs/mL
Pateint is asymptomatic
NO AB given

29
Q

If asymptomatic bacteriuria occursin pregnancy are AB given?

A

Yes

30
Q

If aysmptomatic bacteriuria in pregancy is not treated what may occur?

A

20-30% progress to pyelonephritis

May lead to intra-uterine growth retardation or premature labour

31
Q

When should AB be given in a UTI of a catheterised pateint? Why?

A

If they are symptomatic

Giving unnecessary AB results in more resistant organisms colonising the catheter

32
Q

What can cause abacterial cystitis?

A

Early phase of UTI
Urethral trauma (“honeymoon cyctitis”)
Urethritis caused by chlamydia, gonorrhoea

33
Q

What maya help in abacterial cystitis?

A

Alkalanising the urine with sodium bicarbonate

Renal (9 decks)

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