UTI Flashcards
What is a UTI?
presence of a pure growth of > 10^5 organisms per mL of fresh MSU
How are UTIs classified?
Lower: urethra, bladder (cystitis), prostate
Upper: pyelitis + pyelonephritis.
What is an uncomplicated UTI?
infection of UT by a usual pathogen in a person with a normal UT + normal kidney function.
What is a complicated UTI?
where anatomical, functional, or pharmacological factors predispose the person to persistent infection, recurrent infection or tx failure - eg, abnormal urinary tract.
What are most UTIs caused by?
Escherichia coli
List 3 other causes of UTIs
Staphylococcus saprophyticus
Proteus mirabilis
Enterococci
List 10 risk factors of UTI
Abnormality of the renal tract Incomplete bladder emptying (e.g. prostatic obstruction) Sexual activity. New sexual partner. Use of spermicide. Diabetes. Institutionalisation. Pregnancy. Immunocompromise. Genetics
List 3 iatrogenic risk factors for UTI
Recent instrumentation of the renal tract.
Abx use changes vaginal flora + promotes colonisation of the genital tract with E. coli
Presence of catheter.
Give 2 epidemiological facts about UTIs
VERY COMMON
F > M
List 10 symptoms of UTI
Frequency. Dysuria. Haematuria. Foul-smelling ± cloudy urine. Urgency. Urinary incontinence. Suprapubic or loin pain. Rigors. N+V Acute confusional state
List 5 signs of UTI
Fever Abdominal or loin tenderness Foul-smelling urine Distended bladder (occasionally) Enlarged prostate (if prostatitis)
What is a positive result for UTI using Urine Dipstick ?
Positive leucocyte
Positive nitrites
What bloods should be checked in suspected UTI?
FBC
U+Es: check renal function
CRP
Blood cultures: if systemically unwell + risk of urosepsis
What is seen on urine microscopy and culture in UTI?
M: leucocytes indicates infection
C: exclude dx or if the pt failed to respond to empirical abx
Why may ultrasound be performed in suspected UTI?
Exclude obstruction
Which drugs would you use to treat an uncomplicated UTI pharmacologically?
TRIMETHOPRIM
NITROFURANTOIN
Treat for 3-6 days
Men may need a longer course
Which 3 conservative strategies would you discuss with a patient who has a UTI?
Risk factors e.g. Spermicide, Sex
Increase fluid intake
Cranberry juice
Which 2 antibiotics are used in mild uncomplicated pyelonephritis?
Co-amoxiclav
Cefalexin
When may prophylactic low dose antibiotics be prescribed?
In women, for recurrent cystitis associated or not associated with sexual intercourse
What 5 complications may be caused by ascending infection in UTI?
Pyelonephritis Perinephric + intrarenal abscess Hydronephrosis or pyonephrosis AKI Sepsis
What complications may result in men with a UTI?
Prostatic abscess
Prostatitis
What is the prognosis for UTI?
Good with appropriate treatment
