UTI

Question 1

What is the definition of a UTI?

Answer 1

An infection of the urethra, prostate, bladder, ureter, pylorus, or kidney. Urethritis is typically considered under STIs.

Question 2

What distinguishes uncomplicated from complicated UTI?

Answer 2

Uncomplicated UTI occurs in a normal urinary tract; complicated UTI involves predisposing anatomic or physiologic factors.

Question 3

What is the difference between relapse and reinfection in UTI?

Answer 3

Relapse is a recurrence of UTI with the same organism after therapy; reinfection is with a different organism.

Question 4

What is urosepsis?

Answer 4

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.

Question 5

What are the classifications of UTI?

Answer 5

Lower UTI (cystitis, ureteritis, prostatitis), Upper UTI (pyelonephritis), Hospital-acquired UTI, and Community-acquired UTI.

Question 6

What is the most common bacterial cause of UTI?

Answer 6

Escherichia coli (E. coli).

Question 7

Which factors predispose individuals to UTI?

Answer 7

Infancy, female gender, pregnancy, urinary obstruction, prostatic hypertrophy, catheterization.

Question 8

What are normal host defenses against UTI?

Answer 8

One-way urine flow, micturition shearing force, urine acidity, lactoferrin, IgA, Tamm-Horsfall protein, and zinc in prostatic fluid.

Question 9

What are virulence factors of uropathogens?

Answer 9

Adhesins, capsules, aerobactin, hemolysins, and siderophore receptors.

Question 10

What are the routes of UTI pathogenesis?

Answer 10

Ascending (bladder), hematologic (bloodstream), and lymphatic routes.

Question 11

What are common symptoms of cystitis?

Answer 11

Dysuria, frequency, urgency, cloudy or foul-smelling urine, suprapubic pain, nocturia.

Question 12

Which organisms are common in complicated UTI?

Answer 12

Proteus, Klebsiella, Enterobacter, Pseudomonas, Enterococci, Staphylococci, and resistant strains like ESBL-producing bacteria.

Question 13

What is the significance of sterile pyuria?

Answer 13

The presence of pus cells in urine without bacterial growth on culture, suggesting contamination or atypical pathogens.

Question 14

What is the first-line treatment for lower UTI?

Answer 14

Nitrofurantoin or fosfomycin.

Question 15

What are non-antimicrobial therapies for UTI?

Answer 15

Hydration, cranberry juice, and dietary acidification (though no longer widely advocated).

Question 16

What are the four patterns of UTI response to therapy?

Answer 16

Cure, persistence, relapse, reinfection.

Question 17

How is significant bacteriuria defined?

Answer 17

A urine culture with >105 CFU/mL from two mid-stream samples in symptomatic patients.

Question 18

What are recommended methods of specimen collection for UTI diagnosis?

Answer 18

Mid-stream urine for adults; suprapubic bladder tap or new urine bag for children.

Question 19

What are appropriate transport and storage conditions for urine samples?

Answer 19

Transport within 2 hours and process within 4 hours; refrigeration at 4–8°C or boric acid preservation if delayed.

Question 20

What is the drug of choice for Corynebacterium urealyticum?

Answer 20

Vancomycin.

Question 21

What is the role of probiotics in UTI prevention?

Answer 21

Lactobacillus crispatus for premenopausal/postmenopausal women with recurrent UTI.

Question 22

What imaging modalities are used for UTI diagnosis?

Answer 22

Plain abdominal X-rays, renal ultrasound, and CT scans.

Question 23

What is the importance of antimicrobial therapy urinary concentration?

Answer 23

Urinary concentration determines efficacy, especially for agents excreted by the kidney.

Question 24

Which antibiotics are preferred for upper UTI?

Answer 24

Fluoroquinolones, aminoglycosides, beta-lactams, or trimethoprim-sulfamethoxazole.