Urinary tract infection Flashcards
How is UTI’s classifies
uncomplicated “lower” UTI e.g. cystitis
uncomplicated “upper” UTI e.g. acute pyelonephritis
uncomplicated= no anatomical or neurological abnormalities of the urinary tract.
What are host factors of lower UTI’s
obstruction e.g. prostatic hypertrophy poor bladder emptying catheterisation/instrumentation vesicoureteric fistula sex (female= vaginal or anal, male= insertive anal) diabetes
What are host factors of upper UTI’s
may follow on from lower UTI’s e.g. vesicoureteric reflux, obstruction e.g. calculus
What is the pathogenesis of UTI’s
Contamination of the periurethral area with a uropathogen from the gut,
the colonisation of the urethra and migration to the bladder
colonisation and invasion of the bladder, mediated by pili and adhesins.
neutrophil infiltration
bacterial multiplication and immune system subversion
biofilm formation
epithelial damage by bacterial toxins and proteases
the colonisation of the kidney
host tissue damage by bacterial toxins
bacteremia
What does bacterial virulence depend on
The ability to Adhere, invade and evade
What is needed for clinical diagnosis for UTI
Clinical symptoms + Urine dipstick testing and Urine culture.
What is the symptom of cystitis (a lower UTI)
all lower UTI’s symptoms are localised,
bladder + urethral symptoms
dysuria, frequency, urgency, suprapubic pain, nocturia
smelly, cloudy urine/ visible blood
children, elderly and catheterized can be non-specific
What are the symptoms of pyelonephritis
fever, rigors, loin pain, renal angle tenderness
often lower UTI symptoms in addition
if the pain is radiating to the groin- stone?
risk of bacteraemia
What is catheter-associated UTI
bacteria colonise the catheter and bladder at a rate of 3-5% people, usually asymptomatic but some will develop UTI, and bacteremia which may lead to sepsis and death.
