Urinary Tract Infection Flashcards
What is Pyuria?
increased number of white blood cells in the urine
What makes bacterial cystitis sporadic as opposed to recurrent?
Sporadic indicates it happens less than 3 times a year whereas recurrent suggests more than 3 episodes a year or more than 2 in 6 months
What increases a patients likelihood of getting a UTI?
Give 3.
Sex (females more likely than males)
Increasing age
Obesity (fat pads cause hooded vulva and creates a breeding ground for bacteria)
Anatomical abnormalities of the urinary tract
Inability to empty the bladder
Urinary incontinence
Urolithiasis
What is the pathogen mainly responsible for UTI’s in large animals?
Corynebacterium spp.
[often progresses to pyelonephritis]
Why are UTI’s sometimes harder to treat than normal bacterial infections?
Lots of UTI causing pathogens have a biofilm that allows the bacteria to adhere to the uroepithelium and offers protection from the immune system and antimicrobials
What is the gold standard for urinalysis sample collection?
Cystocentesis
What is the best way to identify individual pathogens in a sample?
Biochemical tests such as MALDI-TOF is the best way
Can also use Agar plates or Immunoassays
How are Antimicrobial Susceptibility tests interpreted?
Using a breakpoint which is the concentration of antibiotic used to define whether an infection by a particular bacterial strain/isolate is likely to be treatable in a patient
What can we do whilst pending culture and susceptibility results in a patient with sporadic bacterial cystitis?
Prescribe NSAIDs to reduce inflammation and/or Prescribe an empirical first line antimicrobial
When is it acceptable to use empirical therapy in patients with sporadic bacterial cystitis? (2)
if there’s no comorbid conditions (other diseases)
if the patient has not had any other recent exposure to antibiotics
What are the first line antimicrobial agents used in sporadic bacterial cystitis? (3)
Amoxicillin
Amoxiclav
Trimethoprim sulfa
The ideal Anti microbial choice for treating sporadic bacterial cystitis will have.. (4)
- good penetration of the urinary tract
- bacteriocidal
- have the ability to be excreted in the urine in high concentrations
- have an easy administration
When would we expect clinical signs to resolve if the antibiotics are working?
within 48 hours
What is different about the treatment for recurrent cystitis compared to sporadic?
Recurrent cystitis requires further investigation into the cause and then management of the cause/ predisposing factors after the cystitis has been eradicated
