Urinary Tract Infections Flashcards

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1
Q

What risks increase your chance of getting a UTI?

A
  • women over men have an increased risk
  • pregnancy increases the risk
  • sexual activity
  • the elderly have an increased risk
  • patients with comorbid conditions (diabetes, spinal cord injuries, catheters, GU tract abnormalities)
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2
Q

How is the urinary tract infection usually spread in the body?

A
  • the bacteria is usually acquired from the urethra to the bladder, where the infection could then have the potential to spread to the kidney (occasionally can also penetrate into the bloodstream and cause septicaemia)
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3
Q

What is hematogenous spread of a UTI referring to?

A
  • the kidney is the first organ that is affected by the infection
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4
Q

In which population of people is treatment recommend for certain individuals?

A
  • during pregnancy and prostate resection
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5
Q

_______ are readily treated with antibiotics

A

Uncomplicated UTIs

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6
Q

_________ are more difficult to treat and the key risk factors include: underlying diseases, kidney stones, urinary tract abnormalities, indwelling urinary catheters

A

Complicated UTIs

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7
Q

What are the contributing factors that leads to an increased pathogenesis of the UTI infections?

A
  • shorter length of urethra
  • sexual activity in females
  • uncircumcised male infants
  • blockage of the urethra
  • catheterization (3-10% increased risk/day of catheterization)
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8
Q

What is urethritis?

A
  • infection of the urethra

- symptoms of dysuria (pain when urinating) and frequency

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9
Q

What is cystitis?

A
  • bladder infection
  • dysuria, frequency, urgency, pain over the bladder area
  • signs: bloody urine, cloudy urine and a bad odour
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10
Q

What is acute urethral syndrome?

A
  • same symptoms as cystitis but lower CFU/mL than cystitis

- pyuria: 8 leukocytes/mm of uncentrifuged urine

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11
Q

What is pyelonephritis?

A
  • infection of the kidney and the renal pelvis
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12
Q

What is prostatitis?

A
  • an infection involving the prostate
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13
Q

What is cervicitis?

A
  • inflammation of the cervix
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14
Q

What is the epidemiology of UTIs in paediatrics?

A
  • high morbidity
  • impaired renal function
  • hypertension
  • end stage renal disease
  • complications during pregnancy as an adult
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15
Q

What is the epidemiology of UTIs in geriatrics?

A
  • incidence in both men and women increases but the ratio changes
  • prostate enlargement, leads to poorer bladder emptying and an increased UTI incidence
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16
Q

What are the microbial virulence factors that allow the bacteria to attach to the urinary tract?

A
  • adherence (via bacterial adhesins)
  • calculi formation
  • toxin and enzyme production (hemolysins and LPS)
  • capsular polysaccharide
  • biofilms
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17
Q

What are the host defences in protecting the body from bacterial infection?

A
  • flushing action of urine
  • growth inhibitory properties of urine (low pH, osmolarity, high urea, organic acid concentrations)
  • mucopolysaccharides
  • preventing reflux
18
Q

When a baby is newborn, it will have a ______ urethra

A

sterile

19
Q

Within 1-3 years of life, what bacteria start colonizing the urinary tract?

A
  • Staphylococcus, enterococci, and diptheroids
20
Q

From the time of 3 days to a few weeks old, what bacteria starts to colonize the urinary tract?

A
  • lactobacillus acidophilus
21
Q

In the prepubertal stages, what bacteria start to colonize the urinary tract?

A
  • micrococci
  • streptococci
  • coliforms
  • diptheroids
22
Q

In the adult stages of life, what bacteria start to colonize the urinary tract?

A
  • L acidophilus, Staph epidermidis, Streptococci (alpha and non-hemolytic) as well as E coli, diphtheroids and yeasts
23
Q

In pregnancy, what bacteria begin to colonize the urinary tract?

A
  • L acidophilus, yeasts and S epidermidis
24
Q

In the postmenopausal stages of life, the urinary tract in similar to having the ____ flora

A

prepubertal

25
Q

What are the two main agents of UTIs?

A
  • gram negative bacilli, as well as gram positive cocci
26
Q

What are the most common gram negative bacilli to infect the urinary tract?

A
  • enterobacteriaceae
  • – fecal E. coli, uncomplicated UTIs
  • – MDR enterbacteriaceae, hospital acquired
27
Q

What are the bacteria that are LEAST likely to have a hospital stay?

A

E coli

28
Q

What bacteria causing a urinary tract infection are more likely to cause a stay in the hospital?

A
  • pseudomonas, prteus, klebsiella, acinetobacter and enterobacter
29
Q

What bacteria is a gram positive cocci and is most likely to cause a symptomatic UTI in sexually active women under the age of 40?

A
  • staphylococcus saprophyticus
30
Q

What gram positive bacilli are agents of causing UTIs?

A
  • diphtheroids, mycobacteria, and Listeria monocytogenes
31
Q

What fungi that can colonize the urinary tract can also lead to hospitalizations

A
  • candiduria
32
Q

What constitutes a lower urinary tract infection?

A
  • bladder and urethra
  • cystitis (infection of the bladder)
  • can cause dysuria (pain during urination) and is more common than upper UTIs
  • increased urgency to urinate as well as increased frequency of urination
33
Q

What bacteria is likely to cause a lower UTI?

A

E coli, Klebsiella spp, other enterobacteriaceae and enterococci, CoNS

34
Q

What are two upper UTI infections?

A
  • acute pyelonephritis

- subclinical pyelonephritis

35
Q

What are the symptoms of acute pyelonephritis?

A
  • fever, lower UTI symptoms (typically caused by enterobacteriaceae and staph aureus)
36
Q

What are the most common bacteria that cause subclinical pyelonephritis

A

candida spp, mycobacterium spp, mycoplasma hominis

37
Q

What are the most vulnerable groups of people experiencing an upper UTI?

A
  • pregnancy women and young children
  • patients undergoing instrumentation in UT
  • elderly and diabetics
38
Q

When doing a laboratory diagnosis of a UTI, how is there a differentiation between a UTI and contamination of the urine by microflora at the distal end of the urethra

A
  • there should be a collection of midstream urine - this should not have over 10^5 organisms within
  • typically will see only one bacterial species
  • collection and transportation methods are critical in ensuring a good sample
39
Q

A urine sample should be cultured within ___ of collection and stored at 4 degrees for not over 18h

A

1 h

40
Q

Uncomplicated UTIs usually resolve _____ within 4 weeks in up to 40% of patients

A

spontaneously
(tx with an Ab though ensures eradication)
- follow up recommended at the end of the treatment

41
Q

With a UTI, the patient should also be advised to _______ to flush the bacteria?

A
  • to drink large amounts of water
42
Q

What is the treatment typically of a completed UTI - pyelonephritis?

A
  • systemic IV treatment until the symptoms subside
  • oral therapy can occur afterwards
  • over 10 days to sterilize the kidney