UTI Flashcards
how many people are affected by UTI yearly?
Epidemiology: affect 150 million people a year
who is most at risk of UTI? is
- Peak is young, sexually active women aged 18 to 24
- Sexual activity, pregnancy, incontinence
- Post-menopause (absence of oestrogen – vaginla atrophy)
- Presence of cystocele
what is pyelonephritis?
upper or complicated UTI bacterial ascent
kidney infection
what defines a recurrent bacterial cystitis?
two or more UTIs in 6mths or three in 12months
what are the most common pathogens causing UTI?
most common e.coli, klebsiella, pneumonia and enterococcus faecalis
why are females more at risk of UTI?
females are 30x more likely to get UTI than males due to shorter urethra. Greater chance of bacteria reaching bladder before being expelled in urine
what is cystocele?
where supportive tissues around bladder and vaginal wall weaken and stretch – bladder and vaginal wall fall into vaginal canal
in males what can increase risk of UTI?
BPH, urethral strictures
what can increase risk of UTI in both sexes?
histories of UTI, diabetes
what symptoms are seen within incomplicated UTIs?
- Dysuria, urgency, frequency, hesitancy, suprapubic pain
- New onset nocturia, new onset incontinence, haematuria (can be non visible)
what systemic features may be seen in neonates with a UTI?
- Neonates/ infants: irritability, poor feeding, fever
what symptoms may be seen within complicated UTIs?
- Flank pain, suprapubic pain, cloudy urine, pelvic pain
what is important within history taking of UTI?
hydration, diet, prior UTIs, sexual history, medication history
what can be seen within clinical exam indicating UTIs?
suprapubic tenderness, costovertebral tenderness (if kidneys)
what should be included to diagnose a UTI?
clinical features
history
MC&S
urine dip
when is MC&S needed?
always need in complicated or recurrent UTI
why would nitrities be positive within urine dip?
nitrates are broke n down into nitrites only in presence of bacteria
why would leucocytes be present on urine dip
enzyme leukocytes produce in response to bacteria to urine
what is pyuria?
WBC in urine
what is sterile pyruia?
WBC in urine without infection - renal malignancy, GU TB
who should be medically management if diagnostic tests of UTI are positive but they are asymptomatic
pregnant women only
what conservative management is there within UTI?
increased hydration
- Personal hygiene
- vitC as urinary acidifier
- consumption of D-mannose and cranberry products
how can you manage cystitis - uncomplicated UTI?
- simple analgesia
- 3 day nitrofurantoin or trimethoprim are 1st line on lower/ uncomplicated women
- 7-14 days in men or pregnant – complicated
what medication may be used in complicated UTIs?
- Fluoroquinolone may need IV if urosepsis
- Urosepsis/ severe pyelonephritis co-amox or ceftriaxone
