Urinary tract Infections Flashcards
Define :
bacteruria
UTI
Cystitis
Pyelonephritis
Funguria
Bacteriuria presence of bacteria in urine
UTIS -presence of microbes in urine that can Invade structures and tissues of urinary tract and surrounding areas
Cystitis-inflammation of bladder d/t infection
Pyelonephritis-affect kidneys and upper urinary tract
Funguria-presence of fungi/yeast in urine
Define uncomplicated , complicated UTIs, relapse , reinfection,recurrent
Uncomplicated- occur in healthy men and women with completely normal genitourinary systems
Complicated- infections interfere with normal urine flow can be due to stones, catheter
Recurrent UTI->3 episodes /year with asymptomatic periods in between
Relapse -same pathogen
Reinfection-different pathogens
Examples of lower urinary tract infections
Cystitis , urethritis, prostatitis
Etiology of uncomplicated UTIs (pathogens)
E.Coli (80-90%)
K. Pneumonia
Proteus mirabili
Pseudomonas aeruginosa
Enterococcus
Staph saprophytic
Etiology of complicated UTI
E.coli
K.pneumonia
Proteus
Enterobacter
P. Aeruginosa
Enterococcus
What pathogens are patients with vancomycin resistant enterococci( VRE)
E.faecalis
E.faecium
Pathophysiology uti
Results from normal flora from bowel can gain entry into urinary tract by ascending up urinary tract , hematogenous route , lymphatic system
Diagnostic and treatment plan depends on (uti)
Location of UTI
Comorbidities such as diabetes
Complications such as nephrolithiasis
Resistance of organisms
Clinical presentation of Lower and upper UTIs
Lower-dysuria, nocturia, supra pubic tenderness, haematuria, urinary urgency
Upper -flank pain, fever , chills , N/V , malaise
What are some treatment concerns utis
Resistance to fluoroquinolones
Cotrimoxazole increased
Resistance of E.coli, E. Faecalis, proteus mirabilis
Diagnosis uti
Dipstick diagnosis- cost effective, use midstream urine culture asses elevated nitrites and wbc
Urine culture - for elderly women, cystitis in Immunocompromised, exposure to antibiotics
Bacteremia associated with pylenephritis
Urinalysis-proteinuria
Dipstick testing
Glucose, protein ,blood,nitrite , leukocyte esterases help screen UTIS
Speak on urine culture
Not needed in uncomplicated UTI(cystitis)
Criterion standard for diagnosis of UTIs
Especially for complicated UTIs, and failing initial /empiric therapy
What does it mean when patient has had UTI within month of treatment
Relapse probably due to treatment failure, obtain urine culture and perform gram stain for sensitivity
Characteristics sign of pyelonephritis
Fever
Severe flank pain
In elderly women cases of cystitis involve upper tracts