Urinary Tract Infections Flashcards
How does cystitis present?
Dysuria, frequency, urgency, suprapubic pain, haematuria, polyuria, incontinence, confusion in elderly
How does pyelonephritis present?
Loin pain, fever, pyuria, back pain, severe headache, associated cystitis symptoms
Where are UTI causative organisms usually from?
Perineal flora
What are common UTI causative organisms?
KEEPS Klebsiella E.coli Enterococci Proteus/psuedomonas Staph aureus/saprophylitus
What are the two reasons for UTIs?
Introduction of pathogen into urinary tract, obstruction of renal tract
What are some common causes for UTIs?
Sexual intercourse, catheterisation, enlarged prostate, renal tract tumours, renal stones
What might urinalysis show in cystitis?
Leukocytes, blood, nitrates
What is the causative bacteria if it’s gram positive cocci in clusters, on CLED it’s small yellow colonies, on blood agar it’s small white colonies with no haemolysis and coagulase test is negative?
S.saprophyticus
What might urinalysis show in pyelonephritis?
Blood, leucocytes, protein
What is the causative bacteria if it’s gram negative bacilli that is pink on MacConkey, yellow on CLED and lactose fermenting?
E.coli
Why can’t urinalysis be done with a catheter?
WBC and bacteria will be present irrespective of active infection
What is the causative bacteria if patient has cloudy urine, blood agar can’t be distinguished due to so much growing, CLED has mainly yellow colonies but some blue?
Proteus
What does it usually mean if urinalysis shows protein and leucocytes, microscopy shows epithelial cells and CLED shows at least 2-3 organisms?
A mixed culture due to perineal flora and a repeat MSU is needed
How should you instruct a patient to do a MSU?
Wash hands, start to urinate and do not collect, then collect some
What is the gold standard investigation in cystitis?
MSU MC+S
