UTI Flashcards
definition of a UTI
the presence of microorganisms in the urinary tract that are causing clinical infection
what is a lower UTI
infection confined to the bladder (cystitis)
what is an upper UTI
infection involving the ureters +/- the kidneys (pyelonephritis)
what is a complicated UTI
a UTI complicates by
- systemic sepsis or
- urinary structural abnormality/stones
does bacteriuria always mean infection
no
what is cystitis
inflammation of the bladder
routes of ascending infection
- bacteria from bowel
- perineal skin
- lower end of urethra
- bladder > ureters > kidneys
what are some UTI causing bacteria
- escherichia coli
- kelbsiella spp
- enterobacter spp
- serratia spp
- citrobacter spp
is e.coli gram negative or positive
negative
is proteus gram negative or positive
negative
what is pseudomonas aeruginosa associated with
catheters and instrumentation
-resistant to most oral antibiotics except ciprofloxacin
symptoms of UTI
- dysuria
- frequency or urination
- nocturia
- haematuria
- fever
- loin pain
- rigors
risk factors for cystitis
- females
- history of UTI
- sexual activity
- vaginal infection
- diabetes, obesity, genetics
risk factors for pyelonephritis
- diabetes
- HIV/AIDs
- iatrogenic immunosuppression
- congenital or acquired urodynamic abnormalities
how do you collect a mid-stream specimen of urine
- first pass urine into the toilet
- next part collected in foil bowl
- last urine passed in toilet
indicators of infection in urine diptick
- leukocyte esterase
- nitrites
- protein
- blood
what is KASS’s criteria
causes of abacterial cystitis (no growth on culture)
- early phase of UTI
- urethral trauma
- chlamydia, gonorrhoea
treatment for a female lower UTI
-trimethoprim
-nitrofurantoin
3 days
treatment for an uncatheterised male UTI
-trimethoprim
-nitrofuantoin
7 days
complicated UTI or pyelonephritis (GP)
co-amoxiclav or co-trimoxazole (14 days)
complicated UTI or pyelonephritis (hospital)
amoxicillin and gentamicin IV for 3 days
co-trimoxazole if penicillin allergic
complicated UTI or pyelonephritis (hospital)
amoxicillin and gentamicin IV for 3 days
co-trimoxazole if penicillin allergic
can gentamicin be given in pregnancy
no
how long should gentamicin be prescribed for
3 days only unless advice otherwise
