UTI Flashcards
Define UTI
The presence of a pure growth of >10^5 organisms per mL of fresh MSU (not necessarily symptomatic)
In what cases is a UTI defined as uncomplicated?
Normal renal tract
Normal function
In what cases is a UTI defined as complicated?
Abnormal anatomy (strictures, fistulas, kidney stones) Abnormal renal function (CKD, AKI) Impaired host defences Pregnancy
Name some risk factors for getting a UTI
Female Sexual intercourse Pregnancy Decreased defences Renal tract abnormality Stones Catheter Decreased bladder emptying Older adults
Should you treat asymptomatic bacteria?
NO, unless pregnant or undergoing urology procedures
Name some signs of a UTI?
Fever, abdo tenderness, loin tenderness, foul-smelling urine, cloudy urine
Name some symptoms of urethritis/cystitis
Increased frequency Dysuria Urgency Haematuria Suprapubic pain Lower back ache
Name some symptoms of prostatitis
Flu-like symptoms
Lower back ache
FEW URINARY SYMPTOMS
Perineal pain
What route of admin for abx for prostatitis?
IV
Name some symptoms of pyelonephritis
Upper UT symptoms Fever (& other systemic symptoms) Rigours Vomiting Loin pain and tenderness
+ oliguria if AKI
What is the most common organism causing UTI?
E. coli
What other organisms cause UTI?
Proteus mirabilis Staph. sapro Klebsiella Enterobacter Enterococcus faecalis
What can proteus mirabilis predispose you to?
Stone formation
When doing a urine dipstick, what results would make you think it could be a UTI?
High nitrites and leucocytes
How is a UTI managed?
- Drink fluids
- Urinate often
- Trimethoprim/nitrofurantoin (uncomplicated - 3 days) (complicated - 7 days)
What are some complications of UTI?
- AKI
- Sepsis
- Renal scarring
- End-stage renal dysfunction
Why should you never give nitrofurantoin to a patient with renal complications?
It is excreted in the urine so if renal function is impaired, the dosage needs to be adjusted accordingly
What should you give a patient with comorbid UTI and chest infection?
Co-amoxiclav
What are some risk factors for catheter associated UTI?
Duration Female Older age Diabetic Bacteria in drainage bag Poor catheter care
Which organisms cause catheter associated UTI?
Largely the same as a normal UTI - additionally candida spp.
How many days should a person with a catheter associated UTI be treated with abx for?
- 7 days if symptoms resolve quickly
- 10-14 days if severe
- 3 days in women over 65 with no upper urinary tract symptoms
