Urinary Tract infections

Question 1

What are the two routes by which UTIs can occur, and which groups of organisms typify each?

Answer 1

Ascending: coliform bacteria (E. coli, Klebs, Proteus, Strep, Serratia, Pseudomonas)

Hematogenous: Staph and Group A Strep

**Hematogenous is much less common

Question 2

Certain strains of E. coli have ____ which allow for attachment to glycosphingolipid receptors on urothelial cells. These so called “uropathogenic” strains more commonly cause UTI, particularly pyelonephritis.

Answer 2

“P” pili

** E. coli with P-pili agglutinate human RBCs (basis for test).

Question 3

Name 7 predisposing factors for UTI

Answer 3

Diabetes (sugar in urine)
Female (short urethra)
Pregnancy (obstruction decreases flow)
Vesical-ureteral reflux
Decreased flow
Catheterization
Calculi
Underlying kidney/urogenital disease of any type

Question 4

What are the two main causes of chronic pyelonephritis?

Answer 4

Vesical-ureteral reflux (VUR) and obstruction.

Recurrent infections without obstruction, reflux or some other underlying urinary tract disease (e.g., stones, diabetes) rarely if ever cause chronic pyelonephritis.