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PEBC > UTI > Flashcards

UTI Flashcards

1
Q

What is a UTI ?

A

Microorganisms infecting any part of the urinary tract WITH the presence of symptoms NOT JUST COLONIZATION

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2
Q

What are the different types of UTI?
1
2
3
4

A
  1. LOWER UTI (most common)
  2. Upper UTI
  3. Urosepsis
  4. Prostatitis
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3
Q

A lower UTI (cystitis) presents with ______, _______, ________, ________, __________

A

burning, frequency, urgency, pain, hematuria

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4
Q

Upper UTI (pyelonephritis aka kidney infection) presents with +/- lower UTI symptoms PLUS ________, ______, _____ etc

A

flank pain, fever, chills, N/V, CVA tenderness

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5
Q

Prostatitis is a type of UTI common in

A

MEN

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6
Q

An uncomplicated UTI is defined as a UTI in ____________ female patients __________ structural/ functional abnormalities or _____________

A

non-pregnant female patients WITHOUT // immunocompromised

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7
Q

Most common pathogens for a uncomplicated UTI
1.
2.
3.
4.
5.

A
  1. E.Coli (70-90%)
  2. P. mirabilis
  3. K. pneumoniae
    “PEK”
  4. S. SAPROPHYTICUS
  5. Enterococcus spp
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8
Q

A complicated UTI is defined as a patient having structural or functional abnormalities that interfere with normal flow of urine and the following:

A
  • Male
  • Children
  • Pregnant
  • Diabetes
  • Catheters
  • Immunocompromised
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9
Q

Most common pathogens for complicated UTI
1.
2.
3.
4.
5.

A
  1. Ecoli (~50%)
  2. P. mirabilis
  3. Enterococcus faecalis
  4. Staphylococcus
  5. Pseudomonas
    Acinetobacter
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10
Q

Asymptomatic bacteria is defined as

A

Bacteriuria in the absence of symptoms
common pathogens E. coli etc

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11
Q

Recurrent UTI is defined as

Recurrent UTI causative pathogens are:

A

2 episodes of uncomplicated UTI in past 6 months
3 episodes of uncomplicated UTI in past 12 months

Same as initial pathogens

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12
Q

Urinary tract infection most common route is _________ colonization of urethra by fecal flora, can ascend to bladder and kidneys

A

Ascending

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13
Q

List some risk factors of UTI
1.
2.
3.
4. Diabetes
5. Catheter, renal dysfx
6. neurologic dysfunction
7. previous antibiotic use
8. sexual intercourse

A
  1. Age young very old
  2. Females
  3. Pregnancy
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14
Q

Diagnosis of UTI is based on _______ +/- urine culture and urinalysis

A

symptoms

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15
Q

Indication for urine culture:
1.
2.
3.
4.

A
  1. ALWAYS for pyelonephritis and or complicated UTI
  2. ALWAYS for pregnancy or diagnostic uncertainty
  3. bacterial prostatitis
  4. uncomplicated cystitis only if failure to respond or early recurrence or relapse
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16
Q

Examples of non pharm therapy for UTI
1.
2.
3.

A
  1. Surgical for deformities
  2. fluid hydration
  3. cranberry juice extract

probiotics low evidence

17
Q

Treatment of UNCOMPLICATED UTI
1st line therapy
1.
2.
3.

A
  1. Nitrofurantoin po x 5 days
  2. tmp-smx (or tmp alone) po x 3 days
  3. fosfomycin 3 g PO x 1 dose (only available as powder) good for ESBL / pseudomonas

2nd Line
1. FQ (Cipro/Levo/Norflox) Po x 3D
2. Beta-lactams 3-7 d (lower efficacy)

18
Q

Ampicillin or Amoxicillin alone should be avoided in UTI treatment because ?

A

HIGH E.Coli resistance

19
Q

Asymptomatic bacteriuria treatment?

A

Bacteriuria without symptoms does not need to be treated

E.Coli most common

20
Q

The only time patients with asymptomatic bacteriuria should be treated are if
1.
2.

A
  1. Pregnant
  2. Undergoing endourological procedures
21
Q

Treatment of COMPLICATED UTI
1st line therapy
1.
2
3.
4.

A

1.Tmp-smx
2. FQ x 7-14d
3. amox-clav
4. cefixime

22
Q

Pyelonephritis Empiric Treatment
Outpatient uncomplicated (Mild-Mod)
1.

A

FQ (cipro/levo) x 5-7d

2nd line
Amox clav
tmp-smx
tmp

23
Q

Pyelonephritis Empiric Treatment
Inpatient
1.
2.
3.
4.

A
  1. AMG IV (+ ampicillin if enterococcus suspected) x 10-14 d
  2. Carbapenem IV +/- ampicillin (if not using imipenem) x 7-14 d
  3. FQ IV
  4. 3rd gen cephalosporin (cefepime) +/- ampicillin or piptaz IV x10-14d
24
Q

The following two classes of antibiotics should be used when considering additional coverage for ESBL hospital-acquired UTI
1.
2.

A
  1. Carbapenem (pref Ertapenem IV)
  2. AGs
25
Q

The following antibiotics should be used when considering additional coverage for Pseudomonas spp hospital-acquired UTI
1.
2.
3.
4.
5.

A
  1. pip-taz
  2. meropenem
  3. imipenem
  4. cipro/levo
  5. cefepime
26
Q

The following antibiotics should be used when considering additional coverage for resistant enterococcus hospital-acquired UTI
1
2
3

A
  1. vancomycin IV
  2. linezolid
  3. daptomycin
27
Q

The treatment of acute or chronic prostatitis involves either of these two medications:
1.
2.

A
  1. FQ
  2. TMP-SMX

Ceftriaxone then doxycycline if STI related

28
Q

The following are common pathogens for prostatitis:
Ecoli, P. aeruginosa,

Others can be STI related, and these two are:
1
2

A
  1. N. Gonorrhea
  2. C. trachomatis
29
Q

Recurrent UTI infections, defined as >2 infections in 6 months or >3 in 12 months can be treated via these 3 methods
1.
2.
3.

A
  1. short course self therapy
  2. post-intercourse
  3. long term prophylaxis
30
Q

First line options for post intercourse prophylaxis include the following:
1.
2.
3.

A
  1. TMP SMX
  2. Macrobid
  3. FQ (norflox/cipro)

TMP, Cephalexin

31
Q

First line options for long-term low dose prophylaxis for recurrent UTI include the following:
1
2
3

A

1 TMP SMX (1st)
2 macrobid
3 FQ (norflox/cipro)

TMP, cephalexin, FOSFOMYCIN, vaginal estrogens

32
Q

Which of the following medications is safe for use in UTI pregnant patient?
a. Nitrofurantoin
b. TMP-SMX
c. FQ
d. AG
e. Amox/Clav

A

E

33
Q

Candida spp and other fungi may cause UTIs in patients with _____________

A

indwelling urinary catheters

34
Q

In patients with diabetes and candiduria, ________ is the preferred treatment

A

Fluconazole

35
Q

A patient with asymptomatic catheter UTI should be treated? T or F

A

FALSE, do not treat if patient is asymptomatic

CULTURE and remove catheter

Mild/Mod symptoms: FQ or ceftriaxone

PEBC (35 decks)

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