UTI Flashcards
Asymptomatic bacteriuria usually represents…
bacterial colonization
**It has not clinical features of UTI
Urethritis in isolation is suggestive of…
STI
Infection of kidneys and ureter
Pyelonephritis
Risk factors for Complicated UTIs
Male sex
Pregnancy
Postmenopausal
Immunosuppresion
Renal failure
Metabolic Disorders (Diabetes)
Anatomical or Functional abnormalities
Health care associated UTIs are classified as
Complicated UTI
T or F: UTIs are the most common infections leading to septic shock
T
Reccurent UTI
≥ 3 episodes of symptomatic, culture proven UTI @1 year OR
≥ 2 episodes @6 months
Route of Transmission of UTI
Ascendente
Hematogena *Stapg aureus
Inoculacion directa al riñon
Bacteria commonly associated with UTIs
SEEK PP
Staph. saprophyticus
E.coli (UPEC)
Enterococcus
Klebsiella
Proteus
Pseudomonas
Bacteria associated with UTIs that produces ureasa y alacaliniza orina (7-8 pH)
Proteus mirabillis
Bacteria associated with UTI that produces ammonia and causes a pungent/irritating smell
Proteus mirabillis
Nosocomial UTI infection by bacteria (enterococci, pseudomonas) is associated with
Drug resistance
T or F: Adenovirus can also cause UTI @Immunocompromised Px and children
T
Virulence factor if UPEC
Type 1 Fimbrae
Virulence factor of Staph. saprophyticus
Adehisins
Why is diabetes a risk factor for UTIs?
They inhibit phagocytosis and diapedesis of neutrophils
Sex as Risk Factor in UTIs
W: shorter urethra + close anal-genital regions
M: uncirmcised
Postmenopause as risk factor of UTI
↓ Estrogen levels –> ↓ vaginal lactobacilli —> ↑ vaginal pH –> E.coli colonization
Structural or functional abnormalities of the UT
Prevent bladder emptying and/or result in urinary stasis
-Bening prostatic hyperplasia
-Congenital malformations
-Neurological bladder
-Urinary tract calculi
T or F: Complicated UTI can happen equally at all people
F
They usually happen at predisposing factors
How does the urine look in a UTI?
Cloudy (Turbia)
Hypogastric pain
Cystitis
Lower UTI
Immune response at Upper UTI
↑IL-6
T or F: Pyelonephritis can cause bacteremia
T
Sintoma distintivo de Upper UTI
Fever
Flank pain @_____ UTI
Upper
Clinical Features @Lower UTI
↑ Urinary frequency
Urinary urgency
Dysuria
Hematuria
Tenesmus
ACUTE Pyelophreitis can cause
Necoris
Abscess
CHRONIC Pyelonephritis can lead to
Scarring
Male with UTI usually refer ___ as symptom @UTIs
Pain @prostatic/perineal area
Atypical symptoms @Older Adults
Urinary incontinence
Constipation
Altered mental status
UTI complications @Pregnant women
↑ risk of Preterm labor
Hypertension and Preeclampsia
Chorioamnionitis
What makes a pregnant women a risk px for UTIs?
↑ Progesterone levels –> urinary stasis + ureteral smooth muscle relaxation + dilation –> Vesicouretral reflux
Gravid Uterus –> ↑ pressure @bladder –> Vesicouretral reflux
Relative immunosuppression
When is it recommended to do a screening test for UTIs @Preganant women?
1st Trimester
What part of the urethra is colonized by E.coli?
1/3 parte distal
When is an Urinalysis indicated?
To ALL Px with suspected UTI
4 cosas que indican UTI @Urinalysis
Pyuria (>10,000)
Nitrates (producto de metabolismo de bacteria)
Esterasa Leucocitaria (producida por leucocitos activos)
Bacteria
When is an Uriculture indicated?
Suspicion of:
- complicated UTI
- uncomplicated cystitis with:
· history of recurrent UTI
· ≥ 65 yo
* concern of multi resistant pathogens
* atypical symptoms
Methods of collection for Uriculture
Clean catch (mid stream) = ≥10^5
Catheter = ≥ 5 x 10^4
Suprapubic = any
T or F: Px with complicated or recurrent UTI, uriculture should be obtained AFTER initiating antibiotic tx
F
= BEFORE, because of false negatives
When is imaging indicated? @UTI
Urinary tract obstruction
Severe Illness (complicated pyelonephritis or urosepsis)
Early recurrence of UTI
Descartar litiasis como dx diferencial
Tx for uncomplicated UTI infecctions
Beta lactams (@examen)
Nitrofuranation
Trimethoprim/Sulfamethazole
Tx for complicated UTI
Fluorquinolones
TMP/SMX
T or F: UTI in men is classified at uncomplicated UTI
F
What antibiotic cannot be used in men with UTI?
Nitrofuranation anf Fosfomycin
because they are not able to penetrate the prostate tissue
General recommendations to Tx UTI
Ir al baño = Flujo urinario = tomar mucha agua
Citricos = ↓pH @orina
T or F: Antibiotic Tx only for complicated UTI
F
= for ALL symptomatic UTI
Dysuria + Abnormal vaginal/urethral discharge
Diferential Dx = Vaginitis or STI
