Urinary Tract infection Flashcards
What are the three types of lower urinary tract infections
cystitis (bladder), urethritis, prostatitis
What is the main upper urinary tract infection
pyelonephritis
T/F: Most urinary tract infections are lower urinary tract and they are not systemic compared to upper urinary tract infections
True
What is the difference between complicated and uncomplicated urinary
Uncomplicated UTIs are defined as women who have a UTI at the childbearing age of 15-45 years old
What is asymmtomatic bacteriuria, symptomatic abacteriurua
No symptoms and no bacteria in the urine, symptoms are present but no bacteria in the urine
What varies prevelance of UTIs
Gender, age and co-morbidities
What organism usually causes uncomplicated UTIs, what other organisms cause uncomplicated UTIs
E. coli, Staphylococcus saprophyticus, enterococcus faecalis, Klebsiella, Proteus, Pseudomonas
What organism usually causes complicated UTIs, other organisms
E. coli, Klebsiella, Enterobacter, staphylococci
What are organisms that may be in the urine but usually do not cause UTIs, why are they in the urine
Staph epidermidis: contaminates the test, S. aureus: usually a systemic infection, Candida species: common in critically ill and chronically catheterized patients
T/F: A majority of UTIs are caused by many organisms
False: Majority of UTIs are caused by a single organism
What are the host defense against UTI
urine,bacteria in the bladder stimulates urination, antiadherance mechanism to prevent bacterial attachment to the bladder
What are predisposing factors for UTIs
Obstruction, nueurological malfucntions not allowing uriniation, urine is forced up the ureter to the kidney, catheters, pregnancy
What are signs and symptoms of lower tract UTIs
Dysuria, urgency and frequency, discomfort in genital area
What are signs and symptoms of upper tract UTIs
Abdominal pain, fever, rigors, nausea and vomiting, malise
What is a symptom of UTIs that is usually only seen in the elderly
Mental status changes
What are the diagnostic tests done to see if a UTI is present
Urinalysis and Urine Culture
List the methods of urine collection from least invasive to most invasive
Midsteam clean-catch, catheterization, suprapubic bladder aspiration
What is being monitored for in a urinalysis
Bacteria and WBCs
T/F: WBCs found in the urine automatically mean there is a UTI
False: UTIs can mean there is an infection but not necessarily a UTI
T/F: Urine culture is used to find a bacteria and grow it to find susceptibility
True
What is a non-specific therapy for UTIs
Cranberry juice
What is the most common type of UTI
acute uncomplicated cystitis
What is the first line antibiotic treatment for a UTI, second line
Nitrofurantoin 100 mg by mouth BID for 5 days, Bactrim 160/800 by mouth BID for 3 days
What are two reasons that a patient may have symptomatic abacteriuria
small numbers of E. coli or other coliforms, patient may have chlamydia
What short course therapy would be given to someone if they have symptomatic abacteriuria
Nitrofurantoin 100 mg by mouth BID for 5 days OR Bactrim 160/800 BID for 3 days
What should be done if symptomatic abacteriuria does not resolve when given UTIs antibiotics
Suspect chlamydia and give either Doxycycline 100 mg BID for 7 days or Azithromycin 1 gram by mouth once
T/F: If any patient has asymptomatic Bacteriuria they will not be treated with antibiotics
False: Most patients with asymptomatic Bacteriuria will not be treated with antibiotics. The patients that will be are Children, pregnant women and patients who will get a catheter
If a patient has acute pyelonephritis with MILD to MODERATE symptoms what antibiotics should be given for how long
Bactrim 160/800 BID for 14 days or Ciprofloxacin/Levofloxacin for 14 days
If a patient has acute pyelonephritis with MILD to MODERATE symptoms what antibiotics should be given if it is identified as enterococci
Ampicillin or Amoxicillin for 14 days
If someone has acute pyelonephritis with SERIOUS symptoms in the ICU what antibiotics should be taken
Aminoglycosides with beta-lactam OR quinolone +/- beta-lactam
When effective therapy for acute pyelonephritis is used when should the patient be stabilized,reduction in urine colony, continue parenteral therapy until what
12-24 hours, 48 hours, patient is afebrile 24 to 48 hours
When should follow up cultures be obtained for acute pyelonephritis
2 weeks
T/F: UTIs in males are always considered complicated and should be for 14 days
True
What is the difference between relapse and reinfection
Relapse: same bug, reinfection: different dug
How long should treatment be if the patient has a relapse after 2 weeks of therapy
Treat for another 2-4 and if there is a relapse after 6 weeks treat for 6 months or longer
If a patient is pregnant with significant bacteriuria what antibiotic regimens can be given
Cephalexin 500 mg QID for 7 days OR Amoxicillin 250 mg TID for 7 days
If a patient has a cathetheter when should they be treated, how and how long
ONLY treat those who are SYMPTOMATIC, Bactrim 14 days or Cirproloxacin/Levofloxacin for 14 days
What is acute prostatitis, chronic prostatitis
Inflammation of the prostate with severe illness with fever and urinary and constitutional symptoms, relapse but not as serious
What are the organisms that cause prostatitis
E. coli, klebisella, proteus, pseudomonas, and enterobacter
What are the antibiotics for acute prostatitis treatment
Aminoglycoside (Gentamicin, Tobramycin or Amikacin) PLUS a beta lactam (Pip-Taz, Aztreonam or generation 3 cephalosporin)
T/F: Acute prostatitis should always start parenterally and then be transitioned to PO after 10 days and duration should be 4-6 weeks including the time of IV
False:Acute prostatitis should always start parenterally and then be transitionted to PO after 5-7 days and duration should be 4-6 weeks NOT including the time the patient was given antibiotics IV
If treating for chronic bacterial prostatitis what antibiotics should be given and for how long
Cirpofloxacin 500 mg every 12 hours OR Levofloxacin 500 mg every daily or Bactrim 180/600 mg BID, AT LEAST 6 weeks
