UTI Flashcards
What is the definition of a UTI?
An infection of the urethra, prostate, bladder, ureter, pylorus, or kidney. Urethritis is typically considered under STIs.
What distinguishes uncomplicated from complicated UTI?
Uncomplicated UTI occurs in a normal urinary tract; complicated UTI involves predisposing anatomic or physiologic factors.
What is the difference between relapse and reinfection in UTI?
Relapse is a recurrence of UTI with the same organism after therapy; reinfection is with a different organism.
What is urosepsis?
A clinical syndrome of UTI with ≥2 of the following: temperature >38°C or <36°C, tachycardia, tachypnea, WBC >12,000/mm³ or <4,000/mm³, or >10% band forms.
What are the classifications of UTI?
Lower UTI (cystitis, ureteritis, prostatitis), Upper UTI (pyelonephritis), Hospital-acquired UTI, and Community-acquired UTI.
What is the most common bacterial cause of UTI?
Escherichia coli (E. coli).
Which factors predispose individuals to UTI?
Infancy, female gender, pregnancy, urinary obstruction, prostatic hypertrophy, catheterization.
What are normal host defenses against UTI?
One-way urine flow, micturition shearing force, urine acidity, lactoferrin, IgA, Tamm-Horsfall protein, and zinc in prostatic fluid.
What are virulence factors of uropathogens?
Adhesins, capsules, aerobactin, hemolysins, and siderophore receptors.
What are the routes of UTI pathogenesis?
Ascending (bladder), hematologic (bloodstream), and lymphatic routes.
What are common symptoms of cystitis?
Dysuria, frequency, urgency, cloudy or foul-smelling urine, suprapubic pain, nocturia.
Which organisms are common in complicated UTI?
Proteus, Klebsiella, Enterobacter, Pseudomonas, Enterococci, Staphylococci, and resistant strains like ESBL-producing bacteria.
What is the significance of sterile pyuria?
The presence of pus cells in urine without bacterial growth on culture, suggesting contamination or atypical pathogens.
What is the first-line treatment for lower UTI?
Nitrofurantoin or fosfomycin.
What are non-antimicrobial therapies for UTI?
Hydration, cranberry juice, and dietary acidification (though no longer widely advocated).
What are the four patterns of UTI response to therapy?
Cure, persistence, relapse, reinfection.
How is significant bacteriuria defined?
A urine culture with >105 CFU/mL from two mid-stream samples in symptomatic patients.
What are recommended methods of specimen collection for UTI diagnosis?
Mid-stream urine for adults; suprapubic bladder tap or new urine bag for children.
What are appropriate transport and storage conditions for urine samples?
Transport within 2 hours and process within 4 hours; refrigeration at 4–8°C or boric acid preservation if delayed.
What is the drug of choice for Corynebacterium urealyticum?
Vancomycin.
What is the role of probiotics in UTI prevention?
Lactobacillus crispatus for premenopausal/postmenopausal women with recurrent UTI.
What imaging modalities are used for UTI diagnosis?
Plain abdominal X-rays, renal ultrasound, and CT scans.
What is the importance of antimicrobial therapy urinary concentration?
Urinary concentration determines efficacy, especially for agents excreted by the kidney.
Which antibiotics are preferred for upper UTI?
Fluoroquinolones, aminoglycosides, beta-lactams, or trimethoprim-sulfamethoxazole.
