Urosepsis

Question 1

Name some common causative agents for UTI

Answer 1

E Coli, Proteus mirabilis
Men, young children: Klebsiella species
Females: staphylococcus saprophyticus
Catheterisations / Hospital acquired: pseudomonas aeuroginosa

Question 2

Septic screen investigations?

Answer 2

1. Urine dipstick
2. Blood cultures - 2 different sites, at least 2 sets, prior antibiotic therapy
3. Sputum sample - MCS
4. CXR
5. Stool specimen

Question 3

Important imaging modality for long term scarring and/or fibrotic damage to kidneys

Answer 3

DMSA scintigraphy (Tc99)

Question 4

Empirical treatment

Answer 4

IV Gentamycin + Amoxicillin

*check baseline kidney function beforehand

Question 5

Mechanism and side effect profile of Gentamycin

Answer 5

Class: Aminoglycoside
MOA: protein synthesis inhibitor by binding to 30S ribosomal subunit
Side effects: vestibular toxicity, ototoxicity, nephrotoxicity

Monitor with baseline EUCs, measure plasma concentration 5 minutes after commencement of IV and then 5-6 hours later + ask about side effects