Urinary Tract Infection Flashcards
What is bacteriuria?
Bacteria in the urine
Can be asymptomatic or symptomatic
What is UTI?
Presence of pure growth of >10(5) organisms per ml of fresh MSU
Lower UTI
Urethra (urethritis) bladder (cystitis) prostate (prostatitis)
Upper UTI
Renal pelvis - pyelonephritis
Uncomplicated vs complicated UTI
Uncomplicated = normal renal tract and function Complicated = Abnormal renal/GU tract, voiding difficulty/obstruction, impaired renal function, impaired host defences
Risk factors for UTI
Female Sex Exposure to spermaticide in females Pregnancy (screening done because asymptomatic often) Menopause Decreased host defences
Urinary tract obstruction
Main organism in UTI
E coli
Symptoms of acute pyelonephritis x5
High fever, rigours, vomiting
Loin pain and tenderness
Oliguria - if AKI
Symptoms of cystitis x5
Frequency Dysuria Urgency Haematuria Suprapubic pain
Symptoms of prostatitis x4
Flu-like symptoms
Low back ache
Few urinary symptoms
Swollen or tender prostate on PR
Signs of UTI
Foul-smelling urine
Nitrites and leukocytes in urine
Tests in UTI
Send urine for MC&S - if symptomatic but dipstick negative, if male, child, pregnant or immunocompromised
Causes of sterile pyuria?
Treated UTI
Management of bacterial UTI in non-pregnant woman
Treat for presumed E coli - trimethoprim or nitrofurantroin
3- 6 days
If UTI + itch, discharge management
Vaginal exam and swabs for STIs
Upper UTI in non-pregnant woman management
Urine culture
Treat with co-amoxiclav or sensitivity - full 7 days
Nitrofurantoin avoid!!
Bacterial UTI in pregnant woman management
Expert help
Antibiotic treatment - specific
UTI in men management
If fail to respond to antibiotics, upper UTI or recurrent UTI - refer to urologist
May need 2 week of quinolone eg. levofloxacin
