UTI Flashcards
why are UTIs more common in women?
shorter urethra allows bacteria entry into bladder
Main source of bacteria
faeces - E.coli
risk factors for UTI
women
sexually active
incontinence/hygiene problem
catheter
Lower UTI symptoms
dysuria suprapubic pain frequency urgency confusion - elderly
dysuria
pain, stinging or burning when passing urine
pyelonephritis presenting features
fever
loin, suprapubic or back pain
vomiting
haematuria
examination finding of pyelonephritis
renal angle tenderness
explain nitrites on urine dipstick
gram negative bacterial eg Ecoli break down nitrates to nitrites
what do urine dipsticks look for in leucocytes?
leucocyte esterase
Are nitrites or leukocytes a better indication of infection?
nitrites
What to do if leucocytes/nitrites present
send an MSSU to microbiology for culture and sensitivities
Describe E.coli
gram-negative anaerobic rod shaped lower intestinal microbiome found in faeces
Other causative agents of UTIs
klebsiella pneumoniae
enterococcus
pseudomonas aeruginosa
candida albicans
duration of antibiotics - 3 different possibilities
3 days - women LUTI
5-10 days = immunosuppressed women/impaired renal function
7 days = men, pregnancy or catheter
appropriate initial anitibiotic in community? (2)
trimethoprim
nitrofurantoin
Alternative antibiotics
amoxicillin
cefalexin
What 3 things does UTI in pregnancy increase the risk of?
pyelonephritis
PROM
pre-term labour
Managing UTI in pregnancy
7 days antibiotics
nitrofurantoin
or amoxicillin
do you treat aymptomatic bacteruria in pregnancy?
yes
Is trimethoprim safe in pregnancy?
avoided in first trimester or if on meds which affect folic acid eg anti-epileptics due to anti-folate effects
When is nitrofurantoin avoided in pregnancy?
3rd trimester
haemolytic anaemia in the newborn
When should pyelonephritis be referred to the hospital?
sepsis
Antibiotics for pyelonephritis in the community
co-amoxiclav
cefalexin
trimethoprim
ciprofloxacin
