Urinary Tract Infections Flashcards
Organs of the urinary system consist of
Two kidneys, two ureters, a single bladder and a single urethra
The bladder should be sterile
Urethra in males and females
Females: only carries urine to to the exterior
Males: carries both urine and seminal fluid
What is cystitis?
Infection of the urinary tract
What is pyelonephritis?
Infection of the kidneys with a risk of bacteraemia. commonly caused when a UTI ascend to affect the kidney are termed pyelonephritis.
Community-acquired UTIs are caused by what 80% of the time
E.coli gut flora
Female reproductive organs:
Two ovaries, two fallopian tubes, the uterus (including the cervix, the vagina and external genitals.
What do the ovaries do?
Produce female sex hormones and ova
What happens during the process of ovulation?
Ovum is released, it enters a uterine/fallopian tube, where fertilisation may occur if viable sperm are present. the zygote then descends the tube and enters the uterus. it implants in the inner wall of the uterus.
Why do women get UTIs more commonly than men?
Close proximity of the urethra to the vagina and short length of the urethra.
Men have a much longer urethra making UTIs more complex.
What are the predominant bacteria in the vagina and what do they do?
Lactobacilii, produce lactic acid which maintains the acidic pH (3.8-4.5) of the vagina, inhibiting growth of other bacteria.
What happens in a derangement of the careful balance of bacteria in the vagina?
Leads to bacterial vaginosis
Male reproductive organs:
Two testes, a system of ducts accessory glands and the penis.
What do the testes produce?
Sex hormones and sperm
How do sperm cells exit the body?
Through a series of ducts: the epididymis, ductus deferens, ejaculatory duct and urethra.
The male urethra is usually
Sterile, expect for a few contaminating microbes near the external opening
What is a good urine specimen?
Midstream urine, should be bladder urine only (no menstrual blood, epithelial cells, bowel flora)
What are you looking for when observing the urine?
Blood content, debris, unusual material
What does a dipstick analysis look at?
Glucose, ketone, specific gravity, blood, pH, nitrate (due to nitrate reduction by e. coli), and leucocytes (an indication of infection)
What do you look for in a microscopy?
WBC, RBC, Casts, crystals, bacteria
What is currently the drug of choices for the empirical treatment of uncomplicated UTIs
Trimethoprim 300mg nocte 3 days. It is vital to detect resistance
UTIs acquired in hospital tend to be caused by
More antibiotic-resistant organisms
What should you always do to test for pyelonephritis?
Urine culture and perform dipstick analysis. Must rely on evidence of UTI as well as symptoms suggesting upper UTI, lower UTI symptoms may be absent
When should you start antibiotics?
Before results are available
Screening in Long-term care facilities
Not recommended for UTIs, although symptomatic UTIs need investigating
UTIs are a result of what?
faecal flora spreading from the anus to the urethra leading to inflammation of the urinary tract.
Investigation into UTIs can be classed into
Complicated and Uncomplicated.
What is an uncomplicated UTI?
usually occur to women with classical presentation of symptoms and no complicating factors
What are complicated UTIs?
are those that occur in men, children, pregnancy, people with suspected pyelonephritis, recurrence or persistence of symptoms, hospital acquired infection, catheterised patients, people with genitourinary tract abnormalities and those that are immunocompromised
What is the difference between first pass urine and midstream urine?
First pass urine is from the urethra and midstream urine is from the bladder so technically.
Why would the lab consider the specimen contaminated?
Epithelial cells wouldn’t be there if it was midstream. Enterococcus faecalis indicates it was already there.
Most UTIs are mono-microbial
