Urinary Tract Infections Flashcards
Which bacteria cause UTIs?
E coli (85%)
Enterbacter - Klebsiella, proteus, pseudomonas
Staph saprophyticus, epidermidis, aureus
What is lobar nephronia?
Pyelonephritis in a section of the kidney only
What is azotemia?
Renal impairment causing failure of Abx filtering by the kidney
What might predispose a 30-60 year old to a UTI?
Prostatic obstruction
Pregnancy
Vaginal prolapse
Catheters
What are the route of infection for UTIs?
Ascending
Haematogenous
Lymphatic
What predisposes people to bacterial persistance?
Bacterial sanctuaries:
Stones
Prostatitis
Foreign bodies
Congenital abnormalities
Obstructive pathology
Fistulae - secondary to diverticulitis or cancer
Tumour
Papillary necrosis
MSK
How might you Mx recurrent UTIs?
Increase fluids
Cranberry supps
Hygiene issues
Post coital voiding (or Abx)
Prophylatic Abx / home supply
Topical peri urethral oestrogen (post menopausal)
What is a complicated UTI?
An infection in a patient with a structural or functional impairment that reduces efficacy of the abx
What is the common symptoms of pyelonephritis?
Temperature
Fever
Loin Pain
Which abx are given for UTIs?
Bactrim
Fluoroquinolones: Ciprofloxacin/Norfloxacin
Nitrofurantoin - commonly used for prophylaxis
Aminoglycosides: gentamicin
Cephalosporins: cephazolin or ceftriaxone
Penicillin: Augmentin DuoFort
What are some side effects of nitrofurantoin?
Peripheral polyneuropathy
Pulmonary fibrosis
What is the normal leucocyte number in MSU?
10-12
What abx are used for pyelonephritis?
Ceftriaxone
Tazacin and merapenem if that fails
Then more prolonged fluoroquinone
What is pyuria?
WBCs in urine
What is pyonephrosis?
Infection of the upper urinary tract with WBCs commonly secondary to calculi
(Not pyelonephritis)
