UTI Flashcards
why are women more prone
Shorter + Wider Urethra closer proximity to the anus
threshold for bacteria
> X105 C
examples of aysymptomatic bacteriuria
Asymptomtamic bacteriuria: Significant bacteriuria in 2 consecutive mid-stream samples
in women or 1 in men WITHOUT any symptoms of UTI - Common in pregnancy
lower uTI
Predominantly bladder infection, can also involve urethra and prostate
Posthitis, balanitis, balanoposthitis, cavernitis, orchitis, epididymitis,
epididimorchitis, urethritis, prostatitis, cystitis
balantititis
Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis that happens most often in uncircumcised males.
balanoposthitis
an inflammation that affects both the glans penis and prepuce
complicated uTI
males pregnancy congenital anomalies resistant to AB'S obstruciton immunodeficiency
recurrent UTI
> 2 infections within 6 months or 3 infections within 1yr
isolated UTI
Interval of at least 6 months between infections
RF
women
sexual activity - multiple sexual partners
SPERMICIDES
not drinking enough water
menopause - alterations in vaginal flora, including replacement of lactobacilli by potential uropathogens.
diabetes catheters - non social infection bad Hygiene POLYCTSTIC KIDNEY DISEASE colovesical fistula spinal cord injury causing a neurogenic bladder VUR
organisms
gy
Gram (-Ve): E.coli (80%), Klebsiella
S.epidermidis: Common in women?
s. saprophyticus, a coagulase-negative staphylococcal species, is an organism virtually unique to acute cystitis.(lecture)
P.miribilis: Suspect if staghorn calculi present also
Fungal & Staph spp: Associated with hematogenous spread
Viral infections: Adenovirus (rare)
pathogenies
- Ascending mode of entry of infection into upper urinary tract (95%)- usually GRAM NEGATIVE
2.hematogenous - gram + staphylococcal - Direct extension of infection from adjacent organs - surgical point of view
Fistulas - vesicointestinal/recta
4 .lymph- but little evidence
why are elderly more at risk
prolapsed organs which impaired bladder emptying , more states of urine in general
Bph
Drinking. Less fluids
Caterers
charactersisc of pyelonpehriits
FEVER !!!!!
postive succucio renalis
general intoxicated state, nausea, vomiitn
complications
May develop peritonitis Peri-renal Abscess formation
Rupture Peritonitis
urine findings
k: Elevated Leukocyte esterase (detect a substance that suggests there are white blood cells in the urine) + Nitrite (bacteria reduce nitrate to nitrite) +
RBC’s and Proteinuria (1g10 WBC/mL
pyuria
Pyuria >10 WBC/mL
false negative
Antibiotics, soap, fastidious organism (don’t grow on
agar), TB
indications for urine culture
pregnancy
sepsis
children
what should you always do when you suspect UTI in patient
always give ab’s!
always do imaging to look for a stone!
dx of pyelonephritis
Acute cholecystitis, Appendicitis, Renal colic, Pelvic inflammatory disease, lower lobe pneumonia
most common uti in men without any anomalies
proasttits
REINFECTION VS RELAPSE
reinfection : usually a diff organism
relapse: sme organismi persist despite microbial therapy
host protective factors
The normal flora of the distal urethra plays an important role in host defense by preventing colonization at this site by potential uropathogens.
Urine is a good nutrient source for most bacterial species, and common uropathogens grow well in urine.
The most important host defense that maintains sterility of the urine is normal, unobstructed voiding.
Tamm-Horsfall protein prevents attachment of Escherichia coli to uroepithelial cell receptors and also removes other uropathogens such as Klebsiella pneumoniae and Staphylococcus saprophyticus
secretory ig a too, urine iG G
rf in men
Acute uncomplicated urinary tract infection in men is uncommon, but reported risk factors have included intercourse with a female partner with recurrent urinary tract infection, not being circumcised, and anal intercourse.
where are you most likely to see gross hematuria
acute cystitis
