UTI Flashcards
what is a complicated uni?
Complicated urinary tract infection refers to infection in a urinary tract
with functional or structural abnormalities (including indwelling catheters and calculi).
what % of the female population will experience a symptomatic urinary tract infection at some time during their life?
40% to 50%
most common cause of UTI?
E. coli
Name other organisms with potential to cause UTI?
mmemonic?
KESS P:
Klebsiella aerogenes
Enterococcus faecalis
Staphylococcus saprophyticus
Staphylococcus epidermis
Proteus mirabilis
Name 3 Antibacterial Host Defences in the Urinary Tract
Urine (osmolality, pH, organic acids)
Urine flow and micturition
Urinary tract mucosa (bactericidal activity, cytokines)
why are ascending UTIs more common in women?
The female urethra is short and is in proximity to the warm moist vulvar and perianal areas, making contamination likely
risk factors for cystitis.
in healthy women?
hx UTIs
recent sex
For Ascending UTIs, which symptoms does one get first?
LUTs rather than UUTs
name some extra renal causes of obstruction?
Extrarenal:
valves,
stenosis, or bands;
calculi;
extrinsic ureteral compression from a variety of causes; and benign prostatic hypertrophy
name some intra renal causes of obstruction?
nephrocalcinosis,
uric acid nephropathy, analgesic nephropathy,
polycystic kidney disease, hypokalemic nephropathy,
and the renal lesions of sickle cell trait or disease
name some Neurogenic causing obstruction in the urinary tract
poliomyelitis,
- tabes dorsalis - syphilis - diabetic neuropathy, - spinal cord injuries
which bacteria affect the kidneys via the Haematogenous Route?
Staphylococcus aureus bacteremia or
endocarditis - strep and staph
which bacteria DO NOT infect the kidneys via the Haematogenous Route?
gram negatives
In LUTz what symptom is absent?
Fever
name the LUTs symptoms
Frequency
Urgency
Dysuria ; small amount of turbid urine
suprapubic heaviness
don’t forget: nocturia and grossly cloudy urine
List the UUTs symptoms
Fever (sometimes with rigors)
Flank pain
and frequently LUTs (e.g., frequency, urgency, and dysuria)
at times, the lower tract symptoms antedate the appearance of fever and upper tract symptoms by 1 or 2 days
how would an older patient present with uti?
ATYPICAL PRESENTATION
Majority - asymptomatic
Symptoms, not diagnostic as many experience:
frequency, dysuria, hesitancy, and incontinence
Symptoms of UUTs often atypical e.g., abdominal pain, change in mental status
ivx for incomp uti?
Urine dipstick
MSU for urine MCS
Bloods
How to investigate complicated UTI?
Renal USS
Intravenous urography
which substances present on urine dipstick are suggestive of UTI?
Positive Nitrites or leucocytes
RBC positive
what ivx NOT to do for uni in adults over 65?
why?
Dont do DIPSTICK - unreliable:
asymptomatic bacteriuria because half have bacteria in urine anyways, especially with catheter
Name 3 protocols for management of sepsis?
NICE
NEWS2
RCGP
perform dipstick, get negative nitrites and positive leucocyte. meaning?
UTI equally likely to other diagnoses.
if init was pos nitrites, neg leucocytes, uti is still likely
what organisms are responsible for sterile pyuria?
Chlamydia
other vaginal infections
non-culturale organisms: TB
