Urinary tract infections Flashcards
Definition of UTI
Significant bacteriuria + dysuria frequency urgency suprapubic tenderness
What constitutes significant bacteriuria for it be diagnostic of a UTI?
> 10 5(superscript) organisms/ ml of voided urine
What is asymptomatic bacteriuria?
A positive urine culture without urinary tract symptoms
When should one treat asymptomatic bacteriuria?
Only if:
- Pregnant
- Prior to an invasive urological procedure
What is an uncomplicated UTI?
Either or lower or upper UTI in non-pregnant women with structurally + neurologically normal genitourinary tracts
What are the most common pathogens causing UTIs?
E.coli (+++) Klebsiella pneumoniae (++)
What are the most common culture contaminants?
Candida Enteorcoccus (+++) Gardnerella Mycoplasma Ureaplasma
How is a UTI diagnosed?
Symptoms
+ bacteriuria
OR indirect evidence of infection (leucocyte esterase + or nitrate + on urine dipstick; >1 + leucocyte on urine microscopy)
Are urine cultures done routinely?
NO
When are urine cultures performed for uncomplicated UTIs?
Only if there is persistent or recurrent cystitis and/or there are symptoms but a negative urine dipstick
Treatment of uncomplicated cystitis
Nitrofurantoin
2nd generation cephalosporin
What constitutes a complicated UTI?
A UTI in:
- Individuals with structural and functional abN of the genitourinary tract
- Men
- Pregnant women
- Patients with an indwelling catheter
- Blood culture positive
Which pathogens cause complicated UTIs?
E.coli
K. pneumoniae
In patients with indwelling catheter: drug-resistant organisms
What investigations are done for complicated UTIs?
- Urine culture
- Blood culture and imaging (if symptoms persist for >48 hours)
- If catheterised–> urine sample
Which AB is safe in all trimesters of pregnancy in the treatment of symptomatic UTIs?
Cefuroxime
