Urinary tract infection Flashcards
Define a urinary tract infection
An infection of the urinary tract system
What are the two subtypes of UTI’s?
- Upper UTI - kidney (pyelonephritis)
2. Lower UTI - (urethritis, cystitis, prostatitis)
What is the most common type of UTI?
Infectious cystitis
What are the common pathogens responsible for UTI’s and which one is the most common cause?
- E.coli (most common)
- Staphylococcus
- Enterococcus
- Klebsiella
What are the risk factors for UTI’s?
- Sexual activity
- Female
- Menopause
- Spermicide
- Catheterisation
What is the epidemiology of UTI’s?
Very common
UTIs are among the most common conditions encountered in primary care, hospitals, and extended care facilities
What are the presenting symptoms of a lower UTI?
- Cystitis:
- Increased frequency
- Urgency
- Dysuria
- haematuria
- Suprapubic pain - Prostatitis:
- flu-like
- Fever
- lower back ache
- few urinary symptoms
What are the presenting symptoms of a upper UTI?
pyelonephritis:
- Lower back pain
- fever
- Vomiting
- rigors
What are the signs of a UTI on physical examination?
- Fever
- Tender abdomen or loin
- Distended bladder
- Enlarged prostate if prostatitis
What are the appropriate investigations for a UTI?
- MSU and dipstick - +ve leukocyte esterase and nitrites
- MCS
- Bloods - FBC, CRP, U&E’s, blood cultures
- USS
What is sterile pyuria and what does it indicate? And what is it most commonly caused by?
Leukocytes present in the urine but urine culture is -ve.
It indicates urethritis and is most commonly caused by STI’s
What is the management for UTI’s?
- Antibiotics - nitrofurantoin or trimethoprim
2. Alternative antibiotic = co-amoxiclav
What are the complications of UTI’s?
- Sepsis
- AKI
- renal or peri-renal abscess
What is the prognosis for UTI?
Very good with treatment
