Urinary Tract Infections Flashcards
what can bacterial UTI’s involve
urethra
prostate
bladder
or kidneys
what can be the symptoms of UTI
urinary frequency
urgency
dysuria
lower abd pain
flank pain
or may be asymptomatic
how are UTI’s diagnosed
urinalysis and urine culture
what is the treatment of UTI
antibiotic and removal of any urinary tract catheters and obstructions
what is the typical population affected by UTIs
Adults 20-50yo; 50x more common in females
what are female risk factors for the development of UTIs
sexual intercourse
diaphragm and spermicide use
new sex partner within past year
history of recurrent UTI’s
first UTI at early age
menopause
what increases the risk of UTI’s in both sexes
immunocompromised states
kidney stones or other blockages of urinary tract such as enlarged prostate, pelvic prolapse, or neurogenic bladder
congenital abnormalities of urinary tract
catheter use or recent urinary instrumentation/procedure
what is the most common pathogen for UTI
E.coli
gram neg: Klebsiella or P. mirabilis
Gram pos: S. saprophyticus
what is a complicated UTI
infection with factors that increase colonization and decrease efficacy of therapy (pregnant, post-menopause, male GU tract, DM)
what is cystitis or pyelonephritis
uncomplicated UTI: pre-menopause adult females with no structural or functional abnormality of urinary tract and who are not pregnant and have no significant comorbidity that could lead to more serious outcome
what is urethritis
urethral infectio with bacteria, protozoa, virus or funi
what is cystitis
infection of bladder
what is acute urethral syndrome
females
dysuria, frequency, and pyuria which resembles cystitis; urine cxs negative or low colony counts
what is acute pyelonephritis
bacterial infection of kidney parenchyma
what is the clinical presentation of urethritis
main symptom dysuria; in males, urethral discharge
-discharge: purulent, whitish or mucoid
what is the clinical presentation of cystitis
sudden onset frequency, urgency, burning/painful voiding, small volumes
-suprapubic pain common
-urine is turbid; microscopic hematuria may occur
-low-grade fever may develop
what is the clinical presentation of acute pyelonephritis
same as cystitis (frequency, dysuria)
-fever, chills, flank pain, colicky abdominal pain, N/V
-tender, enlarged kidney may be palpable
-CVA tenderness usually present on infected side
what is the most common UTI causative agent in a normal genitourinary tract
E. coli
what is highly speicifc for UTI on dipstick
Nitrites
if a female has repeated dysuria and pyuria but no bacteriuria what should be considered
urethral syndrome
what do WBC casts on urine testing indicate
inflammatory reaction; pyelonephritis, glomerulonephritis, tubuloinerstitial nephritis
when is urinary culture recommended
if complicated UTI or pathogen identification needed
when is pathogen identification needed
pregnant patients
postmenopausal females
males
prepubertal children
urinary tract abnormalities or recent instrumentation
immunosuppression or significant comorbidities
symptoms suggest pyelonephritis or sepsis
recurrent UTIs (> 3/year)
what is the typical antibiotics used for all symptomatic bacterial UTI
Fluoroquinolones
nitrofuratoin
TMP/SMX
