Urinary Tract Infection Flashcards
What is bacteruria?
Bacteria in the urine
Bacteria is usually asymptomatic. T/F?
True
What is an uncomplicated UTI?
A lower UTI with normal structure and neurology
What is a complicated UTI?
Upper UTI with systemic signs and symptoms
or catheter associated UTI
What is urosepsis?
A complicated UTI where temperature >38 Celsius, heart rate >90, respiratory rate >20, WBC >15 or <4
In what patients does bacteria usually occur?
Preschool age Affects girls more than boys Hospitalised Catheterised Diabetic Anatomical abnormalities Pregnancy
When should asymptomatic bacteriuria be treated?
Preschool children
Pregnancy
Renal transplant
Immunocompromised
What are the clinical features of a UTI?
Suprapubic discomfort Dysuria Urgency Frequency Cloudy, blood stained, smelly urine Low grade fever Sepsis
What are the signs/symptoms of UTI in neonates?
Failure to thrive and jaundice
What are the signs/symptoms of UTI in children?
Abdominal pain
Vomiting
What are the signs/symptoms of UTI in the elderly?
Nocturia
Incontinence
Confusion
What bacteria commonly cause UTI?
E.coli Klebsiella Proteus Pseudomonas Streptococci Staphylococci Anaerobes
In non-pregnant women with suspected UTI should a urine culture be taken?
No
Should children and men with suspected UTI have a urine culture taken?
Yes
For how long should non-pregnant women with UTI be treated?
3-7 days
In pregnant women with suspected UTI should a urine culture be taken?
Yes
For how long should pregnant women with UTI be treated?
7-10 days
UTI in pregnancy can cause pyelonephritis. T/F?
True
How is recurrent UTI be defined?
> 2 episodes in 6 months
>3 episodes a year
How can recurrent UTI be avoided?
Encourage urge initiate and post-coital boiding
Intravaginal/oral oestrogen
Single post coital antibiotics
Prophylactic antibiotics if simple measures fail. (trimethoprim, nitrofurantoin)
How should suspected complicated UTIs be investigated?
FBC U&Es CRP Urine sample Blood sample Renal ultrasound CT
What complications can result from a catheter?
UTI Obstruction hydronephrosis Chronic renal inflammation Urinary tract stones Long term risk of bladder cancer
How can catheter infections be prevented?
Catheterise only when necessary
Remove catheters when no longer needed
Removing/replacing catheters if they were causing infection, catheter care and hand hygiene
How should catheter associated UTI be treated?
Empirical antibiotics
Catheter removed if not needed or replaced under antibiotic cover
What causes acute pyelonephritis?
Upper UTI
How can community acquired infections causing acute pyelonephritis be treated?
Co-ampxiclav, ciprofloxacin and trimethoprim
How can hospital acquired infections causing acute pyelonephritis be treated?
Broad spectrum antibiotics for 7-14 days +/- radiological/surgical intervention
There is positive urine and blood cultures in renal abscess. T/F?
True
How can renal abscess become life threatening?
Emphysematous
Pyelonephritis
What are the risk factors for perinephritic abscess?
Lower tract UTI Anatomical abnormalities Renal calculi Bacteraemia Haematogenous spread
What are the common causative organisms which can cause perinephritic abscess?
e.coli proteus s.aureus streptococci candida
There are usually positive blood cultures in perinephritic abscess. T/F?
True
Perinephritic abscess may require surgical management. T/F?
True
Acute bacterial prostatitis is usually spontaneously. T/F?
True
What are the symptoms of acute bacterial prostatitis?
Fever Perineal/back pain UTI Urinary retention Diffuse oedema Micro abscesses
What are the likely causative organisms or acute bacterial prostatitis?
E.coli
proteus
s.aureus
N.gonorrhoea
What are the possible complications of acute bacterial prostatitis?
Prostatic abscess Spontaneous rupture Epidiymitis Pyelonephritis Systemic sepsis
What investigations should be conducted in acute bacterial prostatitis?
Urine culture Blood culture Transcranial ultrasound CT MRI
What antibiotics should be given for acute bacterial prostatitis?
Ciprofloxacin
Olfoxacin
What are the symptoms of chronic prostatitis?
Perineal discomfort
Back pain
Low grade fever
UTI symptoms
What are the common causative organisms of chronic prostatitis?
E.coli
Proteus
Enterococcus
S.aureus
Chronic prostatitis may follow chlamydia urethritis. T/F?
True
Chronic prostatitis is usually asymptomatic. T/F?
True
What is epididymitis?
Inflammatory reaction of the epididymis
What can cause epididymitis?
Ascending infection from the urethra
Urethral instrumentation
What are the symptoms of epididymitis?
Pain Fever Swelling Penile discharge Symptoms of UTI/urethritis
What are the common causative organisms of epididymitis?
GBN Enterococci Staphylococci TB Chalmydia N.gonorrhoea
What is orchitis?
Inflammation of one or both testicles
What are the symptoms of orchitis?
Testicular pain and swelling
Dysuria
Fever
Penile discharge
What is the common cause of orchitis?
Mumps
What are the complications of orchitis?
Testicular infarction
Abscess formation
Sexual transmitted bacteria should be ruled out in orchitis. T/F?
True
What is Fournier’s gangrene?
A form of necrotising fasciitis
What are the risk factors for Fournier’s gangrene?
UTI
Complications of IBD
Trauma
Recent surgery
Fournier’s gangrene is usually a mixed infection. T/F?
True
How is Fournier’s gangrene investigated?
Blood cultures
Urine
Tissue/pus
How is Fournier’s gangrene treated?
1st line management alongside broad spectrum antibiotics (pip-tazobactam, gentamicin, metronidazole, clindamycin)
What can pyuria with no bacteria indicate?
Previous/recent antibiotics Tumour Calculi Urethritis Tuberculosis
For uncomplicated UTI what antibiotics can be given?
Amoxicillin Trimethoprim Nitrofuratoin Pivmecillinam Fosfomycin
