Renal Flashcards
What bacteria is in the normal urinary tract?
Kidneys, ureters and bladder are sterile
Lower end of urethra - coliforms and enterococci
What is cystitis?
Lower UTI (bladder)
What is pyelonephritis?
Upper UTI i.e. ureters and kidneys
What is a complicated UTI?
UTI with systemic sepsis/ anatomical abnormality/ stones
What are the routes of infection for UTIs?
Ascending infection
From the bloodstream
What bacteria cause UTIs?
Coliforms (gram -ve coliforms) e.g. E. coli Klebsiella Proteus Enterobacter
What bacteria is associated with the formation of stones?
Proteus
What are the 2 types of entercoccus?
Faecalis
Faecium
What gram classification are entercocci?
Gram +ve non-haemolytic strep
What is the organism that causes UTIs in women of child bearing age?
Staphylococcus saphrophyticus
What is the organism that causes UTIs in people with catheters and UT instrumentation?
Pseudomonas aeruingosa
What antibiotics can be used to treat a pseudomonas aeruingosa UTI?
Ciprofloxacin
Resistant to most others
What symptoms suggest involvement of upper UT?
Fever
Loin pain
Rigors
How do you collect a urinary speciment?
MSSU
Mid-stream specimen of urine
What organisms give a negative nitrite test?
Enterococcus - because they can reduce nitrates to nitrites
What criteria is used for UTI classification?
Kass’s Criteria
What is ESBL?
Extended spectrum beta-lactamase
What is the significance of ESBL-producing bacteria?
Makes bacteria resistant to all cephalosporins and almost all penicillins
What is CPE?
Carbapenamase-producing enterobacteriaceae
What are CPE resistant to?
Meropenem i.e. all current antibiotitcs
How long should you give an antibiotic to treat a uncomplicated lower UTI in women?
3 days
What are the first line antibiotics for UTI?
Amoxicillin
Trimethoprim
Nitrofurantoin
Gentamicin
How does trimethoprim work?
Inhibits bacterial folic acid synthesis
Can you give trimethorpim in pregnancy?
Avoid in 1st trimester
Due to folic acid disruption
What organisms does trimethoprim treat?
Most coliforms Staph aureus (MRSA)
Not pseudomonas
Why is nitrofurantoin only useful in lower uncomplicated UTI?
Only reaches effective concentrations in bladder uring
Can you give nitrofuranoin in pregnancy?
No can cause neonatal haemolysis
What antibiotic is very effective in severe gram negative sepsis?
Gentamicin (IV)
What antibiotic is useful agains ESBLs?
Pivmecilinam
What antibiotics are used in female lower UTI?
Trimethoprim
Nitrofurantoin
3 days
What antibiotics are used in uncatherterised male lower UTI?
Trimethoprim
Nitrofuratoin
7 days
What antibiotics are used in complicated UTI/ pyelonephritis? In GP land
Co-amoxiclav
Co-trimoazole
14 days
What antibiotics are used in complicated UTI/ pyelonephritis? In hosp
Amoxicillin AND gentamicin IV 3 days
