Section 13 - UTIs Flashcards
Which gender has the higher risk of contracting a UTI?
Women
Does pregnancy increase or decrease the risk of getting a UTI?
Increase
What are 4 things that increase the risk of contracting a UTI?
- Co-morbid conditions (diabetes)
- Spinal cord injuries
- Catheters
- GI tract abnormalities
What is the difference between relapse and reinfection?
- Relapse is an infection by the same agent after about 2 weeks of no symptoms
- Reinfection could be caused by the same or a different pathogen, but it must be at least 1 month between infections
Which group do uncomplicated UTIs affect the most?
Healthy women
What is the treatment for uncomplicated UTIs?
Antibiotics
What are the key risk factors for complicated UTIs?
- Underlying diseases
- Kidney stones
- Urinary tract abnormalities
- Catheters
What are 5 contributing factors to UTIs?
- Urethra length
- Sexual activity
- Uncircumcised male infants
- Blockage
- Catheterization
What are the common symptoms of urethritis?
- Dysuria
- Frequency
What is cystitis?
Bladder infection
What are the symptoms of cystitis?
- Dysuria
- Frequency
- Urgency
- Pain over bladder area
What are signs of cystitis?
- Bloody urine
- Cloudy urine
- Bad odour
What are the symptoms of acute urethral syndrome?
Same as cystitis but lower CFU/mL
What is the key symptom of pyuria?
8 leukocytes/mm^3 of uncentrifuged urine
What is pyelonephritis?
Infection of kidney and renal pelvis
What is prostatis?
Infection involving prostate
What is cervicitis?
Inflammation of cervix
What does prostate enlargement lead to?
Poorer bladder emptying, which means increased UTI incidence
What are the important virulence factors for microorganisms that cause UTI?
- Adherence (bacterial adhesins)
- Calculi formation
- Toxin and enzyme production (hemolysins and LPS)
- Capsular polysaccharide
- Biofilms
What are host defences against UTIs?
- Flushing action of urinary flow
- Growth inhibitory properties of urine (low pH, osmolarity, high urea, organic acids)
- Mucopolysaccharides
- Preventing reflux
What is the normal microflora of the urethra in newborns?
Sterile
What is the normal microflora of the urethra in babies 1-3 days old?
- Staph
- Enterococci
- Diptheroids
What is the normal microflora of the urethra in babies 3 days to many weeks old?
Lactobacillus acidophilus
What is the normal microflora of the urethra in prepubescent children and postmenopausal women?
- Micrococci
- Streptococci
- Coliforms
- Diptheroids
What is the normal microflora of the urethra in adults?
- Lactobacillus acidophilus
- Staph. edipermidis
- Streptococci (alpha and non-hemolytic)
- E. coli
- Diptheroids
- Yeasts
What is the normal microflora of the urethra in pregnant women?
- Increased L. acidophilus
- Yeasts
- S. epidermidis
What are the most common etiologic agents of UTIs (general groups)?
- Gram-neg bacilli
- Gram-pos cocci
- Gram-pos bacilli
- Fungi
What can fecal E. coli cause?
Uncomplicated UTIs
What are the common causes of acute polynephritis?
- Enterobacteriaceae
- Staph aureus
What are symptoms of acute polynephritis?
- Fever
- Lower UTI symptoms
Which groups does subclinical pyelonephritis generally affect?
- Pregnant women
- Young children
- Patients undergoing instrumentation in UT
- Elderly
- Diabetics
Urine with over ______ organisms/mL is considered significant bacteriuria
10^5
What happens if organisms are found in urine from a catheter?
It is considered significant because the urine is avoiding being contaminated by flora
Why are collection and transport methods critical for urine samples?
Because urine is a good growth medium
What are the culture and storage methods for urine samples?
- Cultured within 1 hour of collection
- Stored at 4 C for no more than 18 hours
What is the treatment for uncomplicated UTIs?
- Antibiotics to ensure complete eradication
- Follow up recommended
- Drink lots of fluids
What is the treatment for complicated UTIs?
- Systemic IV treatment until symptoms subside
- Oral therapy afterwards
- At least 10 days to sterilize kidneys
