UTI Flashcards
What are the 2 categories of UTI’s?
Uncomplicated and Complicated
: If a patient has a UTI and they are pregnant, diabetic, sxs x7 days, renal failure, have a catheter, have an anatomic abnormality of urinary tract, Hx of UTI’s in childhood, or are immunosuppressed – what type of UTI do they have?
Complicated
If a patient has bacteria in the urine, but lacks sxs of a UTI – what do they have?
Asymptomatic Bacteriuria
What are some common sxs we see with healthy outpatient UTI’s?
Dysuria, increased superpubic pain, increased frequency, urgency, and hematuria
What are the sxs we see in a hospital/elderly patient with a UTI?
Fatigue/Malaise, “mom’s not herself,” forgetfulness/confusion/disorientation (delirium), unsteady on feet, foul smelling urine, cloudy urine, elevated Cr or Acute renal failure
How do we obtain a clean urine for diagnosis?
Clean catch or straight cath. Sample
What do we look for on the UA for a UTI?
Leukocyte esterace
Nitrates (MOST PREDICTIVE OF AN ACTUAL UTI)
What would you find on labs that would indicate the UA is contaminated?
Squamous cell and/or mucous
When we order a UA what should always be ordered with it?
Culture and sensitivity (tells you what drugs can kill your bugs)
**Follow them until they are finalized
If a patient has diabetes with worsening abdominal pain, fatigue, and malaise with a Temp of 101 – what should be on our DDx list?
UTI
If the UA comes back with leuk’s but no nitrates and squamous cell are present – what diagnosis do you think?
Asymptomatic Bacteriuria → AKA NOT a clean catch with squamous cells and mucous
What Abx are POOR choices for a complicated UTI?
Bactrim and Macrobid
*Lots of drug resistance AND renal toxic properties
What are recommended Abx for a complicated UTI?
Floroquinolone or Ceftriaxone
What should we always remember with regards to UTI’s?
Expect the unexpected = VRE, ESBL, MRSA
