Urinary Tract infections Flashcards
UTI Most common agents
E. Coli (75-95%)
Proteus
Staph Sapro.
Cystitis diagnostic criteria
Dysuria + frequency without vaginal discharge or irritation
Components of Urine Dipstick (9)
- pH
- Specific Gravity
- Protein (albumin)
- Blood/heme/myo
- Glucose
- Leuk esterase
- Nitrite
- Bile
- Ketones
Cystitis Treatment in Women
- Low Risk Resistance: Nitrofurantoin, TMP/SMX, + Fosfomycin
- High Risk Resistance: Nitrofurantoin, Fosfomycin
- Symptomatic: Phenazopyridine
Cystitis + Prostatitis Tx Men
Cipro or Levofloxacin
When should patients be screened for Asymptomatic bacteriuria
- pregnancy
- Urological procedures
- Renal transplants
Complication of pyelonephritis
- Renal corticomedullary abscess
- Perinephric abscess
- Emphysematous pyelonephritis
- papillary necrosis
Acute uncomplicated Urinary Tract Infection define
Cystitis or pyelonephritis in a nonpregnant premenopausal woman without underlying urologic abnormalities
Complicated Urinary Tract Infection Definitions
- cystitis or pyelonephritis in a patient with underlying urologic abnormalities.
- Individuals who do not fit into either category have often been treated as having a complicated UTI by default
Types of Prostatitis
I. Acute Prostatitis
II. Chronic Bacterial Prostatitis
IIIa. Chronic Prostatitis/Pelvic Pain Syndrome, Inflammatory
IIIb. Chronic Prostatitis/Pelvic Pain Syndrome, Noninflammatory
IV. Asymptomatic Inflammatory Prostatitis
Acute Bacterial Prostatitis tx
rimethoprim/sulfamethoxazole or a fluoroquinolone for 4-6 weeks
Meares-Stamey four-glass test
- prostatitis
- Positive test when the samples expressed prostatic secretions (EPS) and voided #3 (VB3) have pathogens 10 times higher than samples VB1 and VB2
- VB3 collected after prostatic massage
Chronic Prostatitis Tx
Fluoroquinolone is the first choice for at least 4-6 weeks
Trimethoprim/sulfamethoxazole is second choice for at least 4-6 weeks
Doxycycline or azithromycin if associated with Chlamydia trachomatis
Emphysematous Pyelonephritis
- organisms
- A/S
- LabDx
- Tx
- Org: E. Coli + Klebsiella
- A/S: Diabetes mellitus and urinary tract obstruction
- LabDx: CT/Plain films of the abdomen
- Tx: Systemic parenteral antibiotics with appropriate bacterial coverage AND Percutaneous catheter drainage of gas and purulent material along with relief of urinary obstruction, if present
Pregnancy UTI or Asymptomatic Bacteriuria Tx
amoxicillin, cephalosporin, or nitrofurantoin (not in first trimester) for 5-7 days
