UTIs Flashcards
what are the consequences of UTIs?
- societal and individual health costs
- time missed from work
- frequent recurrences
- uncontrolled infection/sepsis
- renal damage in young children
- preterm birth
- recurrent courses of antibiotics contribute to antimicrobial resistance and risk of CDI
what are the 2 main classifications of UTIs?
1) uncomplicated lower UTI
2) uncomplicated upper UTI
what are the key uncomplicated lower UTIs?
- cystitis
- urethritis
- prostatitis
- epididymo-orchitis
what is the key uncomplicated upper UTI?
acute pyelonephritis
what does uncomplicated mean in terms of UTI?
no anatomical or neurological abnormalities of the urinary tract
what are the risk factors for lower UTIs?
- obstruction
- poor bladder emptying
- catheterisation
- vescio-enteric fistula
- sex
- diabetes
- genetics
what are the 10 steps of getting a UTI?
1) contamination of the periurethral area with a uropathogen from the gut
2) colonisation of the urethra and migration to the bladder
3) colonisation and invasion of the bladder, mediated by pili and adhesins
4) neutrophil infiltration
5) bacterial multiplication and immune system subversion
6) biofilm formation
7) epithelial damage by bacterial toxins and proteases
8) colonisation of the kidneys
9) host tissue damage by bacterial toxins
10) bacteremia
what are the 3 factors bacterial virulence depends on?
1) adherence
2) invasion
3) evasion
what are the key characteristics of cystitis?
- bladder and urethral symptoms
- overlap with urethritis
- dysuria, frequency, urgency, suprapubic pain, nocturne
- cloudy urine/visible blood
what are the key characteristics of pyelonephritis?
- fever, rigors, loin pain
- renal angle tenderness
- often lower UTI symptoms in addition
- if pain radiates to groin = possible stone
- risk of bacteraemia
what are the main types of urine specimens?
- midstream urine
- suprapubic aspirate
- catheter urine: acute, intermittent self catheterisation, indwelling
why is boric acid used in midstream urine samples?
- helps to maintain the microbiological quality of the specimen
- it prevents cell degradation and overgrowth of organism that can occur if the sample is not analysed within 4 hours of collection
what is the problem with boric acid use in midstream urine samples?
can cause false negative culture if urine not filled to correct mark on specimens bottle and can affect urine dipstick tests
what are the 2 key laboratory diagnostic tools?
- microscopy
- culture and antibiotic sensitivity
what are they key characteristics of using microscopy in the lab?
- white cells represent inflammation in the urinary tract
- automated urine analysers in lab scan for red blood cells, white cells and organisms
- discard without culturing if scan negative
