Urinary tract conditions Flashcards
What is cystitis
Inflammation of the bladder
What are the causative pathogens of UTI
E. coli
Proteus
Pseudomonas aeruginosa
Enterococcus faecalis
What is the most common causative pathogen of UTI
E. coli
What is the most common causative pathogen of UTI in an immunosuppressed patient / patients with catheters
Pseudomonas aeruginosa
What is the most common causative pathogen of UTI acquired in hospitals
Enterococcus faecalis
Risk factors of UTI in adults
Female
Catheterised patients
Why are females more susceptible to UTI
Shorter, wider urethra
Urethra close to anus
What are the risk factors of UTI in children
Girls
Incomplete bladder emptying
Poor hygiene
Vesicoureteric reflux
What can cause incomplete bladder emptying in children
Infrequent peeing
Obstruction due to constipation
Neuropathic bladder
What is vesicoureteral reflux
Condition in which urine flows backward from the bladder to the ureters
What are the 2 routes of spread of infection for UTI
Ascending
Haematogenous
Describe the ascending route of UTI infection
Bacteria from bowel -> perineal skin -> enter the lower urethra -> spread into the bladder -> ureter -> kidneys
Describe the haematogenous route of UTI infection
Bacteraemia / septicaemia affecting the kidneys
What is considered as uncomplicated UTI
Anatomy of the urinary tract is normal, renal imaging is normal
No underlying condition causing the infection
What is considered as complicated UTI
Occurs in urinary tracts with stones
Recurrent infection + stone can cause kidney damage
Symptoms of UTI in adults
Dysuria (pain when urinating)
Urinary frequency
Urinary urgency
cloudy / offensive smelling urine
Haematuria
Lower abdominal pain
What symptoms may suggest lower UTI spreading to upper urinary tract
Loin pain
Fever
Investigations for UTI
Midstream specimen of urine (MSU)
Urine dipstick if indicated
Urine culture if indicated
When is urine dipstick indicated
Women <65
who do not have risk factors for complicated UTI
When is urine culture indicated
Women >65
Recurrent UTI (2 episodes in 6 months)
Pregnant women
Men
Visible / non-visible haematuria
What urine dipstick result can suggest UTI
positive for nitrite or leukocyte and red blood cells
What are the symptoms of UTI in children
Abdominal pain
Dysuria
Haematuria
Urinary frequency
What symptoms of UTI may show in infants
Fever (less common in above 1 year old)
Poor feeding
Vomiting
Irritability
Investigations for UTI in children
Urine dipstick
Urine culture with appropriately collected urine