Urinary tract infection

Question 1

What is a UTI?

Answer 1

Infection of the urinary tract (at any point)

Question 2

What is the aetiology of UTI?

Answer 2

Escherichia coli is the cause in 70% to 95% of uncomplicated cases, and Staphylococcus saprophyticus is the cause in 5% to 20% of cases.

Other causative pathogens in uncomplicated UTIs include Enterobacteriaceae such as Proteus mirabilis and Klebsiella species, enterococci, group B streptococci, Pseudomonas aeruginosa, and Citrobacter genus.

Question 3

What are risk factors for a UTI?

Answer 3

Sexual activity

Spermicide use

Post-menopause

Positive family history of UTIs

History of recurrent UTI

Presence of a foreign body

Question 4

Summarise the epidemiology of UTIs.

Answer 4

Lifetime incidence of UTIs is 50% to 60% in adult women. The prevalence of UTI increases with age, and in women aged over 65 is approximately double the rate seen in the female population overall.

Question 5

What are the signs and symptoms of a UTI?

Answer 5

Dysuria

New nocturia

Cloudy-looking urine

Risk factors

Fever

Question 6

What are the investigations for a UTI?

Answer 6

Urine dipstick

Urine culture and sensitivity

Question 7

What is the management for UTI in women?

Answer 7

Nitrofurantoin 7 days in pregnancy/3 days otherwise

Cefuroxime 7 days in pregnancy/3 days otherwise

Trimethoprim in later trimesters only

Question 8

What are complications of UTI?

Answer 8

Sepsis

Renal and peri-renal abscess

Acute kidney injury

Emphysematous pyelonephritis

Xanthogranulomatous pyelonephritis (XGP)