UTI Flashcards
What is the definition of a UTI?
Pure growth of >10^5 organism per ml of fresh MSU
In who does asx bacteruria occur?
> 65
Catheter
Preg
What is a complicated UTI?
Pregnancy Men Catheter Child Recurrent Persistent Immunocompromised
Give 5 RF
Female Intercourse Pregnancy UT obstruction Catheter Menopause DM
What is the most common bacterial cause of UTI?
E. coli
What are the causative bacterias?
KEEPPSS
Klebsiella - catheter Enterococci E. coli Proteus P. aueruginosa - recurrent Saprophyticus S. aureus
How does it present?
Dysuria Urinary frequency Urinary urgency Cloudy/offensive smelling urine Lower abdo pain/ supra-pubic tenderness Malaise Fever: low-grade in lower UTI
How may elderly people commonly present?
Acute confusion
Delirium
What is a UTI in the bladder called?
Cystitis
What is a UTI in the renal pelvis called?
Pyelonephritis
What is a UTI in the prostate called?
Prostatitis
What IX do you want to do?
Urine dip - nitrites + leucocytes
Bloods: WCC, CRP - infection
MCS of MSU**
Glucose - DM
Which group of pts with a particular medical condition are more likely to suffer from recurrent UTIs?
Diabetics
Do you RX asx bacteruria?
No
When should you send for a urine culture?
> 65y
Visible or non-visible haematuria
How do you MX UTI in pregnancy?
SX:
- urine culture
- abx for 7 days
ASX:
- urine culture performed routinely at first antenatal visit
- abx for 7 days
- sig risk of progression into pyelonephritis
- send further urine culture after completion of course
Which abx do you give in pregnancy?
Which should be avoided near term?
Nitrofurantoin, amoxicillin pr cefalexin
Nitrofurantoin should be avoided near term
How do you MX UTI in non-preg women?
Trimethoprim or nitrofurantoin for 3d
How do you MX UTI in men?
What abx do you give?
Immediate 7d course abx prescription
Trimethoprim or nitrofurantoin
How do you MX UTI in catheterised pts?
Do you RX ASX bacteruria here?
If SX 7d course
No don’t RX asx bacteruria