Urinary Tract Infection COPY Flashcards
Which sex are UTI’s most common in?
Females
What is the definition 0of bacteriuria?
Bacteria in the urine - may be symptomatic/asymptomatic
What is a UTI?
A diagnosis based on symptoms and signs. Tests which prove bacteria in the urine may provide additional information
What parts of the urinary tract fall under the classification of lower urinary tract infection?
- Bladder (cystitis)
- Prostate (prostatitis)
- Urethra (Urethritis)
What parts of the urinary tract are involved in upper UTI?
Kidney/renal pelvis (pyelonephritis)
What is the definition of an uncomplicated UTI?
Normal renal tract structure and function
What is the definition of a complicated UTI?
Structural/functional abnormality of the GU tract e.g. obstruction, catheter, stones, neurogenic bladder, renal transplant
What are groups of risk factors for the development of a UTI?
- Increased bacterial inoculation
- Increased binding of uropathogenic bacteria
- Decreased urine flow
- Increased bacterial growth
What are causes of increased bacterial inoculation?
- Sexual activity
- Urinary incontinence
- Faecal incontinence
- Constipation
What are causes of decreased urinary flow which can lead to the development of UTI?
- Dehydration
- Obstructed urinary tract
What conditions can increase bacterial growth in the urinary tract?
- DM
- Immunosuppression
- Obstruction
- Stones
- Catheter
- Renal tract malformation
- Pregnancy
What are symptoms of cystitis?
Complex of:
- Frequency
- Dysuria
- Urgency
- Suprapubic pain
Plus:
- Polyuria
- Haematuria
What are symptoms of acute pyelonephritis?
- Fever
- Rigors
- Vomiting
- Loin pain/tenderness
- Costovertebral pain
- Associated cystitic symptoms
- Septic shock
What are the most commonly implicated organisms which cause UTIs?
- E.Coli
- Proteus spp
- Klebsiella aerogenes
- Enterococcus faecalis
- Staph epidermidis
What organism is most commonly implicated in UTI?
E. Coli
What are symptoms of prostatis?
- Pain - perineum, rectum, scrotum, penis, bladder, lower back
- Fever
- Malaise
- Nausea
- Urinary symptoms
- Swollen tender prostate on examination
What are signs of a UTI?
- Fever
- Abdo/loin pain
- Distended bladder
- Enlarged prostate
If you suspected someone had a UTI, what investigtions might you do?
- Urine dipstick
- MSU culture/microscopy
- Bloods - FBC, U+E’s, CRP, Blood culture
Consider
- Fasting glucose
- Imaging - consider US, urodynamics, cystoscopy, CT urogram/Abdo/pelvis
When would you consider treating a UTI without investigation?
Non-Pregnant women with >/= 3 symptoms of cystitis, and no vaginal discharge
What does a negative diptick reduce the probability of a UTI to?
<20%