UTI Lecture 14

Question 1

Epidemiology

Answer 1

-20% of women will get UTI’s duringa year. Majority is cystitis. Majority is E coli with Staph saprphyticus second.

Question 2

Transmission

Answer 2

-Colonic bacteria move to urethra. Can be increased by sexual intercourse.

Question 3

Disease

Answer 3

• Three primary symptoms Urgency, Dysuria, Frequency.

- If there is flank pain and fever be weary of pyleonephritis.

Question 4

Diagnosis

Answer 4

-Many are clnical diagnosis. Can see 5-10 WBC per hpf, lymphocyte esterase in dipstick is very common. Also 10^5 CFU/ml of urine.

Question 5

Bacteriology

Answer 5

• E coli is most common cause and most common in complicated cases.
• Complicated cases see more gram negative other than E coli and also a number of staph sp.

Question 6

Treatment

Answer 6

• Can begin treatment and normally don’t get cultures unless complicated case.
• 3 days for uncomplicated, 7 days for complicated and 14 days for complicated.
• TMP/SMX (sulfa) and fluoroquinilones are best options.

Question 7

Pyelonephritis

Answer 7

• Most common serious complication of UTI
• Flank pain and fever, although 1/3 can be “silent”
• More likely if the patient has had UTI for more than 5 days.
• Can lead to septicemia
• Treat 14 days with same drugs.

Question 8

Assymptomatic Bacteremia

Answer 8

• Somewhat common in elderly patients, and is not a good thing, but treatment with antibiotics does not improve condition.
• Do not be alarmed if cultures of urine come back positive, could be this in elderly.

Question 9

Male UTI

Answer 9

• Rare and considered a complicated case
• Gram negative species are most common although E Coli is only 25% of this.
• Diagnosis at 10^3 CFU/ml in males.