UTI

Question 1

What is the most common organism causing UTIs?

Answer 1

E. coli

Question 2

What other organisms can cause UTI?

Answer 2

Staphylococcus saprophyticus
Proteus mirabilis
Klebsiella
Candida
Pseudomonas aeruginosa

Question 3

What are the risk factors for UTI?

Answer 3

Female
Post-menopause
Sex
History of UTI in childhood
Urinary incontinence
Atrophic vaginitis
Cystocele

Question 4

What are the clinical features of UTI?

Answer 4

Dysuria
Frequency
Urgency
Incontinence
Haematuria
Cloudy or foul smelling urine
Confusion
Suprapubic tenderness

Question 5

What are the initial investigations for UTI?

Answer 5

Urine dipstick
- Positive for nitrites, leukocytes and RBCs
Urine microscopy, culture and sensitivity

Question 6

When should MC&S be requested for UTI?

Answer 6

Request in all women with positive dipstick findings
Request in all women >65 years, cathetrised, pregnanct or with visible/non-visible haematuria regardless of dipstick findings

Question 7

What are the first choice antibiotics for UTI?

Answer 7

Nitrofurantoin (avoid in patients with GFR<45)
Trimethoprim

Question 8

What are the alternative antibiotics used in UTI?

Answer 8

Pivmecillinam
Amoxicillin
Cefalexin

Question 9

How long are antibiotics given for UTI?

Answer 9

3 days - simple UTI in women
5-10 days - immunosuppressed women, abnormal anatomy or impaired kidney function
7 days - men, pregnant women, or catheter related UTIs

Question 10

Which antibiotics are suitable for UTI in pregnancy?

Answer 10

Nitrofurantoin (avoid in third trimester)
Cefalexin
Amoxicillin (only after sensitivities are known)