UTI things to try and memorize Flashcards
48 hour rule
hospital aquired/nosomcomial
Recurrent UTI
3 or more symptomatic episodes w/in one year
Significant bacteruria
Greater than or equal to 10 to the fifth
E. coli
UPEC
Gram negative
Proteus mirabilis
urease producer
gram neg
Klebsiella pneumoniae
gram neg
Staph saprophyticus
urease producer
gram positive
Only time women don’t have more UTIs than men
0-1 year
>50 yo (evens out)
REFLUX: Blocks flow of urine and promotes pyelo Muscle tone reduction on ureter valves STASIS: Hormonal effects on persitalsis
Pregnancy!
Messes you up.
Fimbrial lesions of E. coli:
Mannose sensitive
LOWER UTI - acute cystitis
Bind mannose residues on proteins of bladder mucosa, free mannose blocks binding
Fimbrial lesions of E. coli:
P fimbria
A/w acute pyelonephritis
Bind to P blood group antigen on RBC and uroepithelial cells
*do not bind mannose
2 toxins
Hemolysin Endotoxin (LPS - gram neg)
Siderophore
Aerobactin - scavenges iron
Raises pH of urine by hydrolyzing urea to ammonia
Can cause struvite crystals
Urease enz
mirabilis and saprophyticus
Capsular K antigen
Protects from phagocytosis
ONLY gram negative enterobacteriacea
Descending bacteria (rare) indicates
Hematogenous and lymphatic source of infection (maybe sepsis)
Urethritis
Bacteriuria
Pyuria
Cystitis, lower UTI
Localized infection wtih systemic effects May precipitate premature labor *HALLMARK of flank pain** CVA tenderness Fever
Pyelonephritis, upper UTI
Criteria to dx UTI
+culture 10 to the 5 AND 10 to the 5 WBC
10 to the 2 w/ acute sx and pyuria
ANY CFU/ml from suprapubic aspiration or that has staph aureus
