Urinary tract infections Flashcards
what are the main sites of GU infection?
- blood borne - renal parenchyma
- ureter
- uretero-vesicular junction
- bladder
- urethra
definition: upper urinary tract
above vesicoureteral valves
definition: lower urinary tract
below vesicoureteral valves
definition: complicated urinary tract infection
involvement of tissue structures, with instruments or co-morbidities
definition: uncomplicated urinary tract infection
local effects only OR upper tract without co-morbidities
pyelonephritis
kidney, calyces, pelvis
definition: recurrence
3 or more UTIs per year
definition: relapse
recurrence in a month with same organism
definition: reinfection
relapse over a month, usually a different organism
what are the main causative organisms of symptomatic UTIs?
e. coli (80%)
s. saprophyticus (15%)
other gram negative (5%)
why is it important to know the epithelial cell : WBC ratio?
epithelium of urethra will contaminate early parts of the specimen
if specimen is reported as ratio of epi : WBCs roughly equal to WBCs then there is a possible contamination (especially if it is a dirty collection)
what are the important things to look at in a urinalysis report?
WBC
RBC
epithelial cells
bacteria
what does lactate measure?
tissue hypoperfusion
is pyelonephritis a tissue infection or space infection?
tissue
what should you avoid doing in a patient with pyelonephritis?
catheter
pyelonephritis + stone should be checked for what major complication?
intraabdominal abscess
chlamydia UTI: treatment
ceftriaxone, azithromycin
what are the common infectious causes of urethritis?
e. coli chlamydia gonorrhea herpes trichomatis yeast
signs / symptoms of cystitis
- over 10^5 CFUs with symptoms: pain, frequency
- usually afebrile
- UA shows many WBCs with few epis
- UA may show nitrites, leukocyte esterase
