Pyelonephritis, Cystitis and Asymptomatic Bacteriuria Flashcards
Acute complicated UTI/pyelonephritis is an infection where
kidney/ upper urinary tract
Acute uncomplicated cystitis is an infection where
bladder/lower urinary tract
What is the etiology of cystitis
- more common in women
- gram (-) bacteria
Most common pathogens that cause cystitis
- e coli (most common)
- klebsiella
- proteus
When you see what bacteria you should suspect contamination
- lactobacilli
- group B strep
- enterococci
What are some risk factors for cystitis
- sex
- hx
- spermicide coated condoms
- diaphragms
- indwelling catheters
- diabetes
- obesity
- structural abnormalities
Clinical manifestations of cystitis
- dysuria
- frequency
- urgency
- suprapubic pain
- hematuria
What do urine dipsticks detect
- leukocyte esterase
- nitrites
- WBC
- RBC
- protein
What does leukocyte esterase reflect
pyuria
Nitrites shows the presence of
enterobacteria
What are the treatments for cystitis
- macrobid
- bactrim
- cipro
What are risk factors for UTI in men
- insertive intercourse
- uncircumcised men
Common pathogens that cause pyelonephritis
- e coli (most common)
- klebsiella
- proteus
- pseudomonas
Pathogenesis of pyelonephritis
starts with colonization of the vaginal introitus with fecal flora–> ascends into bladder, ureters, kidney
Clinical manifestations of pyelo
- dysuria
- frequency/urgency
- suprapubic pain
- hematuria
- fever/chills
- flank pain/ CVA tenderness
- nausea/ vomiting
CBC will be what in pyelonephritis
elevated with left shift
When do you hospitalize patients with pyelo
- sepsis
- persistent fever
- unable to maintain oral intake
- urinary tract obstruction
Treatment for pyelo
- cirpo or levoflox (recommended)
- bactrim
- augmentin
- cefpodoxime
Treatment for cystitis in pregnancy
- macrobid
- augmentin
- cefpodoxime
- fosfomycin
Treatment for pyelo in pregnancy
- admission to hospital
- IV PCN/cefazolin/ceftriaxone
Who is most commonly affected by asymptomatic bacteriuria
pregnanct women
What is aymptomatic bacteriuria
isolation of bacteria without signs or symptoms
Treatment of asymptomatic bacteriuria. When and with what?
treat in pregnant and pts undergoing urologic procedures
-abx same as cystitis
