Urinary Tract Infections Flashcards
Acute cystitis is?
infection of bladder
pyelonephritis
ascending infection of kidney
what is sterile pyuria?
pus in urine without bacterial growth
asymptomatic bacteriuria?
bacteria in urine without symptoms
where in the urinary tract should it be sterile?
bladder, ureter, kidneys
which bacterial species accounts for 80% of community vs. hospital acquired UTIs?
80% v. 40%
Proteus species are gram what?
-ve rods
What is a common gram +ve UTI agent?
staph saprophyticus
polyomaviruses for UTIs are only applicable to what population?
immunocompromised
adenovirus may cause what in UTIs?
haemorrhagic cystitis
hantavirus may cause what?
renal disease
most common mode of contamination for UTIs?
from perineum and of gut origin
Salmonella typhi causing UTIs how?
in septicaemic phase, can shed and fix into different organs and into urine
where is the reservoir for S. Typhi in humans?
gall bladder
3 organisms that cause UTI and spread through blood
staph aureus
salmonella Typhi
TB
Innate immunity of the UT include what 4 things?
Transitional epithelium
Resistant architecture
urine
constant flushing
4 normal host factors that promote UTIs
short urethra in females
coitus
colonisation of distal urethra
no circumcision in infant boys only
2 abnormal host factors promoting UTIs
- incomplete bladder emptying (neuro or structural)
2. catheterisation
what is vesico-ureteric reflux?
ureter entering bladder spincter doesn’t contract when bladder contracts during voiding and can cause pyelonephritis
What is siderophores?
iron acquisition: can suck iron from transferrin and bacteria uses it
adhesins used in UTIs by bacteria? 2 most common:
type 1 fimbriae
PAP pili both E.coli
E.coli Hly secretes what associated with kidney damage?
Haemolysin
Urease in which bacteria? what does it do?
Proteus uses it to make struvite stones (ammonia)
E.coli and Klebsiella have what kind of capsule? polysaccharide or protein?
polysaccharide
E.coli uses PAP pili where? uses type 1 fimbriae where?
kidneys
Bladder
can one distinguish between upper and lower UTI?
no not easily
clinical symptoms of UTI?
burning with urination
fever, chills
tenderness with kidney/bladder
when use radiology for UTI?
detect structural/functional abnormality
What is suprapubic aspirate? significance of culture?
urine sample directly through abdomen into bladder, ANY bug is significant
when use bag sample for UTI? useful?
in babies
not really useful, only if it’s negative
how to collect urine per urethra?
MSU
midstream urine
where to collect urine from catheter?
junction b/n catheter and collection tube
Why get urine to lab ASAP?
bacteria will replicate and double every 30 minutes and get skewed result
What is a normal squamous epithelial cell count in urine?
ZERO. if there is = poorly collected sample
WBC in urine: normal vs. abnormal?
N= 10^5
RBC in urine: normal vs. abnormal?
N= 10^5
quantitative bacteria in urine: normal vs. abnormal especially??
N=10^5 especially if only one species
abnormal bacterial from catheter urine is more than?
> 10^2
How long can you keep urine refrigerated?
18 hours
What is sterile pyuria?
no growth but WBCs >10^5
3 causes of sterile pyuria
non-infectious eg. tumour
partial treatment
hard to grow bacteria eg. TB
3 drugs choices for cystitis treatment? how long?
cephalexin
co-amoxyclav
trimethoprim
5 days
what should you do if <2yr. old UTI?
Urinary tract abnormality check
3 drugs choices for pyelonephritis treatment? how long?
cephalexin
co-amoxyclav
trimethoprim
10 days
severe pyelonephritis use what antibiotics?
amoxycilllin + gentamicin
when is asymptomatic bacteriuria significant?
pregnancy: causes premature labour
what is considered time wise: recurrent UTI in women?
> 2UTIs in 6 months
management of recurrent UTI in women? 2 main ones.
postcoital voiding
antimicrobial prophylaxis
