UTI Flashcards
What result of what test would strongly (99/100) suggest a UTI
MSSU (mid stream specimen urine) of 10^5 CFU’s/ml
And symptoms present
What result of what test would suggest a POSSIBLE UTI (50/50)
MSSU 10^3-10^4 CFU’s/ml
No symptoms
What result of what test would suggest a PROBABLE UTI
MSSU 10^3-10^4 CFU’s/ml
Symptoms present
What result of what test would suggest no UTI
MSSU <10^3 CFU’s/ml
Problems with interpretation of MSSU
Some bacterial species are not normally present in terminal urethra/rectal flora and may be pathogenic at low colony numbers
Micro-organisms that cause UTI’s
Bacteria mainly gut flora especially E. Coli
Rarely viral cause
Route of UTI
Almost always Ascending
What kind of UTI is more serious
Upper UTI’s
Inflamation of; Urethra Bladder Ureters Kidneys
Urethritis
Cystitis
Ureteritis
Acute pyelonephritis
Result of recurrent/prolonged Acute pyelonephritis
Chronic pyelonephritis
Predisposing factors to UTI’s
Stasis of urine
Pushing bacteria up urethra (catheters/sex)
Generalised predisposition to infections
What can cause stasis of urine
Obstruction (congenital or acquired)
Loss of feeling of full bladder (spinal cord/brain injury)
What can push bacteria up urethra
Sexual activity
Catheters and other urological procedures
What would obstruction at the level of the urethra cause
Upper urethra and bladder dilation => bilateral hydroureter => bilateral hydronephrois => chronic renal failure
What would obstruction at the level of the renal pelvis cause
Unilateral hydroureter => unilateral hydronephrosis
Basic consequences of obstruction
Proximal dilatation
Slowed urine flow => Cannot flush out bacteria => infection
Slowed urine flow => sediments form =>calculous (stone) formation => obstruction (worsens problem)
What problem can bacterial infections cause unique to the kidneys
Some bacteria predispose one to calculous formation
Cycle of obstruction
Infection => calculi => obstruction => infection
What is seen in vesicouteric reflux in regards to bladder and ureters
Decreased angulation (enters bladder more horizontally)
Common causes of obstruction in men, women and both sexes
Benign prostatic hyperplasia
Uterine prolapse
Calculi and tumours
UTI’s more common in men or women and why
Women
Short urethra
Lack of prostatic bacteriostatic secretion
Closeness of urethral orifice to rectum
Sexual activity – (helps if void after intercourse)
Pregnancy – pressure on ureters and bladder
Why do UTI’s become more common ~>60
Prostate problems in males; uterine prolapse in females; tumours in both sexes
Why do UTI’s become more in females in late teens early twenties
Sexual activity
Acute complication of UTI
Severe sepsis and septic shock
Chronic complications of UTI
Chronic damage to kidneys if repeated infections (chronic pyelonephritis) => hypertension, chronic renal failure
Calculi => obstruction => Hydronephrosis => hypertension, chronic renal failure
