UTI Lecture Flashcards
what makes a UTI “complicated”?
literally everything
highlights: pregnancy, presence of indwelling catheter, SX for more than 7 days before seeking care, HX of UTI in childhood
isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen in a patient without sx/s of UTI
asymptomatic bacteriuria
what are common UTI symptoms?
dysuria, increased frequency, urgency, suprapubic pain, hematuria
atypical UTI symptoms?
fatigue, malaise, forgetfulness, confusion, disorientation, unsteady on feet
foul smelly, cloudy urine should make you think what?
complicated UTI
what is the most predictive lab finding of an actual UTI? what other lab finding is pretty specific?
nitrites most predictive
also leukocyte esterase
squamous cells and mucus on urinalysis should make you think what?
contamination
do we treat complicated UTIs empirically?
NO – always make sure a culture is cookin
what are the three worrisome pathogens that are beginning to emerge in the hospital setting in terms of complicated UTI?
vancomycin resistant enterococcus (VRE)
extended spectrum beta lactamase E coli and klebsiella (ESBL)
MRSA
should our urine culture be a clean catch or a dirty sample?
clean catch
when should urine culture results be available?
12-24 hours
when should the sensitivity reports be available?
48-72 hours
true or false, macrobid (nitrofurantoin) and bactrim are excellent choices for complicated UTI?
false
high prevalence of drug resistance and renal toxicity
what are your two options for treating complicated UTI?
1) fluoroquinolone (cipro or levaquin) PO or IV depending on how sick
2) ceftriaxone (IV/IM only)
how do we treat asymptomatic bacteriuria?
we don’t
bye
