UTI Flashcards
What criteria make an UTI a complicated UTI?
- men
- pregnant women
- children
- patients who are hospitalised or in health care–associated settings
- Catheters
What is the most common species causing UTIs?
E.coli
What is a lower UTI vs an upper UTI?
Lower= only bladder
Upper/Pyelo= kidney infection, systemically unwell
Name 2 organisms that commonly cause UTIs in structurally abnormal Urinary tracts
Proteus
Klebsiella
What is the most common pathogen causing an upper UTI via haematogenous spread?
S.aureus
Other than E.coli, what other pathogen commonly causes UTIs, especially in young women?
Staphylococcus saphrophyticus
What are common findings for a UTI on a urine dipstick?
+ve nitrites and leukocytes, RBC
* Nitrites are quite specific for UTI – if nitrites -ve, unlikely to be UTI
* Leukocytes are not specific (seen in any inflammation of urinary tract)
* RBC +ve indicating Upper UTI
What would make you think that the MSU sample the lab recieved is not a mid-stream sample?
Contamination (i.e. not MSU sample): mixed growth, squamous cells
In what instences would you expect a patient to have sterile pyuria?
Pyuria: white cells in urine, sterile:without infective orgnaism seen/grown
- Prior treatment with antibiotics
- Calculi
- Catheterisation
- Bladder neoplasm
- TB
- Sexually Transmitted Disease
Becuase of contamination most MSUs have some sort of bacterial growth - how can you differentiate between an infection and contamination on culture?
Due to amounts of bacteria
culture of >10^4 colony forming units / ml is diagnostic (10^3 for E.
coli / S. saprophyticus)
What is the usual treamtment for a lower UTI?
Depending on local guidelines:
nitrofurantoin/trimethoprim/cephalexinPO,
3d if uncomplicated/
7d if complicated or male
What is the usual treatment plan for a upper UTI?
Pyelonephritis:
admit
IV co-amox+gent
What would be the most likely treatment of a catheter-associated UTI?
Stat dose of aminoglyclosides like
gentamicin or
amikacin
