UTI Flashcards
what is cystitis
lower UTI, uncomplicated
what is pyelonephritis
upper UTI, in the kidney
risk factors for UTI
women
urologic instrumentation and catheterization
urinary tract obstruction
neurogenic bladder
renal transplantation
factors that make a UTI complicated
male sex
anatomical abnormality of urinary tract
recurrent infections despite appropriate treatment
recent urologic procedure
immunocompromised
UTI in pregnancy
examples of anatomical abnormality of urinary tract that would increase risk for complicated UTI
obstruction
hydronephrosis
renal tract calculi
colovesical fistula
examples of recent urologic procedure that would increase risk for complicated UTI
nephrostomy tube placement
stent
suprapubic catheter
foley catheter
risks for uncomplicated UTI
premenopausal women
not meeting complicated criteria
most common pathogen for UTI
e. coli
- Klebsiella
- Proteus
- Enterococcus
- Pseudomonas
- GNRs
signs and symptoms of uncomplicated UTI
dysuria
increased urinary urgency
increased urinary frequency
suprapubic heaviness
signs and symptoms of pyelonephritis
uncomplicated symptoms plus
- systemic signs of infection: fever, chills, rigors, N/V, diarrhea
- flank pain (CVA tenderness)
signs and symptoms of complicated UTI
classic UTI symptoms (usually)
fever
malaise
altered mental status
urinary incontinence
change in appetite
signs and symptoms of catheter associated UTI
often no classic symptoms
pain over kidney and bladder
fever
lethargy and malaise
what does altered mental status mean?
could be complicated UTI but not always, could be polypharmacy
what do we need for diagnosis of UTI or pyelonephritis
symptoms + microbiologic criteria
- >10^5 of clean void
- >10^3 of catheter
key components of a UTI from urinalysis and culture
bacteria present
WBC present
leukocyte esterase present
nitrite +/-
what is asymptomatic bacteriuria and when should it be treated
shouldn’t be treated - only pregnant women
most common misdiagnosed infections
causes lots of antimicrobial resistance
commonly used oral antibiotics for UTI
nitrofurantoin
fosamycin
cephalexin
cefadroxil
cefpodoxime
amoxicillin/clav
amoxicillin (only after suseptibility is confirmed)
which agents should only be used in uncomplicated UTI?
nitrofurantoin
fosamycin
at what resistance rate should we not use an agent for e. coli
over 20%
what is bacteremia
can develop in pts with complicated UTI and pyelonephritis
can we use oral antibiotics with bacteremia
yes
should we lengthen therapy with bacteremia?
no, we can use the same duration
prostatitis treatment options
fluroquinolones
TMP/SMX
cephalexin
amox/clav
treatment duration for prostatitis
2-4 weeks
recurrent UTI classified as what
3+ in 1 year
2+ in 6 months
what can we do for recurrent UTI
can identify cause: sex, post menopausal women, urologic abnormality
- could do prophylaxis but resistance risk
- increase water intake!
