Microbiology - UTIs Flashcards
How are UTIs classified?
Uncomplicated Vs Complicated
- Complicated = functionally, structurally abnormal tract, men, catheters, pregnancy, immunocompromised
Lower Vs Upper/Pyelonephritis
- Lower = Bladder only (Cystitis)
- Upper/Pyelo = Kidney infection (systemically unwell)
What is pyelonephrosis?
Pyelonephrits + Obstruction
When do you treat asymptomatic bacteriuria?
Only in pregnancy
What are some pathogens that cause UTIs and when do they arise?
- E. coli: MOST COMMON (Adhesion with fimbriae)
- Staphylococcus saphrophyticus: Common in young women
- Proteus + Klebsiella: Common in abnormal urinary tracts
- Staphylococcus aureus: If due to haematogenous spread
What are some general Sx of a UTI?
- Frequency
- Dysuria
- Abdo pain
What are some UTI Sx in the elderly?
- Non-specific
- Delirium
- Falls
What are some Sx of pyelonephritis?
- Systemically unwell
- Fevers
- Rigors
- Loin pain
What is urospesis?
Sepsis due to UTI
What are the investigations for a UTI and how is it diagnosed?
- Dx: IF typical Sx
- Urine Dip: +ve Nitrites, +ve Leukocytes +/- Haematuria
Leukocytes non-specific, Nitrites = specific - Urine MC+S: Culture of >10^4 colony forming units/ml (OR >10^3 for E. coli/S. saprophyticus)
CONTAMINATION: Mixed growth, squamous cells
What is the manafement of a UTI?
CHECK TRUST GUIDELINES
- 7d if complicated/male
- Trimethoprim/Nitrofurantoin/Cephalexin
What is the management of Pyelonephritis?
- Admit
- IV Co-Amoxiclav
- IV Gentamicin
What Abx can be given in pregnancy and when?
Cephalexin = throughout
Trimethoprim = 2nd/3rd trimester ONLY (folate antagonist)
Nitrofurantoin = 1st/2nd trimester ONLY (causes haemolytic anaemia in baby)
