Urinary tract infection

Question 1

What is the difference between a complicated/uncomplicated UTI?

Answer 1

Complicated = functionally/structurally abnormal urinary tract

Question 2

Why are UTIs more common in women than men?

Answer 2

Shorter urethras

Question 3

Describe the aetiology of UTIs

Answer 3

Contamination of the urethral meatus, eg from the rectum.
Bacteria have features to enable adhesion to mucosal/urothelial cells (eg proteus fimbriae, klebsiella k antigen)

Urinary catheters

Question 4

Which organism is the most common cause of UTI?

Answer 4

E coli

Question 5

Other than E coli, list 3 organisms that frequently cause lower UTIs

Answer 5

Proteus
Klebsiella
Staph saprophyticus

Question 6

How do UTIs commonly present?

Answer 6

Frequency
Dysuria
Abdo/flank pain

Question 7

How do UTIs present in the very young?

Answer 7

Non-specific eg fever, malaise

Question 8

How do UTIs present in the very old?

Answer 8

Asymptomatic - can be incidental finding

Question 9

How are UTIs diagnosed?

Answer 9

Clinically - symptoms/demographic
Dipstick (nitrite, leucocytes +ve)
MSU - M,C&S (microscopy, culture & sensitivities)

Question 10

What is the usual empirical treatment for UTI?

Answer 10

Trimethoprim
OR
Nitrofurantoin

(But increasing resistance)

Question 11

What is the treatment if a UTI has progressed to the kidneys (pyelonephritis)?

Answer 11

Broad spectrum IV antibiotics eg co-amoxiclav +/- gent
OR
cefuroxime +/- gent