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PHM 603- ID Part 1 > UTIs > Flashcards

UTIs Flashcards

1
Q

UTI risk factors

A

Healthy, premenopausal women
Sexual behavior and contraceptive devices
Pregnancy
Male
Badly controlled DM
Transient short-term urinary tract catheter
Asymptomatic bacteriuria
Long-term urinary tract catheter treatment

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2
Q

Uncomplicated UTI

A

Normal urinary tract with normal voiding

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3
Q

Microbiology of uncomplicated UTI

A

Mostly E. coli

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4
Q

Complicated UTI

A

Congenital or acquired abnormality that prevents normal dispensing of bacteria from the urinary tract

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5
Q

Conditions for complicated UTI (disease states)

A 
Pregnancy
Uncontrolled DM
Kidney transplant
Urinary anatomical abnormalities
Acute renal failure/chronic renal failure
Immunocompromised
Noscomial bacterial infections
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6
Q

Risk factors for complicated UTI

A

Lack of response to treatment, severity of illness, comorbidities like DM and immunosuppression

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7
Q

Clinical implication of complicated UTI (what are the risk factors?)

A

Recurrence, SIRS/sepsis, extensive antimicrobial resistance, immunosuppression, instrumentation/catheters

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8
Q

Microbiology of complicated UTI

A

Mostly E. coli and other GNR

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9
Q

Diagnosis of lower tract infection: cystitis

A

Urinalysis, urine gram stain and culture

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10
Q

Urinaylsis results that would suggest a UTI

A 
Leukocyte esterase
Nitrile
Hematuria
WBC casts
Proteinuria
Bacteria
Pyuria
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11
Q

Diagnosis of upper tract infection: pyelonephritis

A

Also UA and urine gram stain and culture

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12
Q

Non-pharmacologic treatment for UTI

A

Don’t really work

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13
Q

Treatment for women with acute, uncomplicated cystitis

A

Nitrofurantoin for 5 days

Bactrim for 3 days

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14
Q

Treatment for subclinical pyelonephritis in women

A

PO therapy for 7-14 days

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15
Q

Subclinical pyelonephritis

A

No symptoms of an upper tract infection and they appear to have uncomplicated cystitis

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16
Q

Outpatient treatment of acute pyelonephritis in women

A

Ciprofloxacin PO for 7 days
Levofloxacin PO for 5 days
Bactrim PO for 14 days

17
Q

Inpatient treatment of acute pyelonephritis in women

A

Extended-spectrum cephalosporin or penicillin +/- aminoglycoside for 10-14 days

18
Q

Relapse in UTI

A

Infected with same organism

19
Q

Treatment for UTI relapse

A

Extend treatment duration (up to 6 weeks)

20
Q

Reinfection in UTI

A

Infected with different organism

21
Q

Treatment for UTI reinfection

A

3-5 days with whatever ABX is recommended in the guidelines

22
Q

Prostatitis in men: etiology

A

E. coli is the major pathogen

23
Q

Presentation of cystitis in men

A

Younger: dysuria, frequency

More typical: elderly male with dysuria, frequency, fever, lower abdominal pain, possible bacteremia in severe cases

24
Q

Presentation of pyelonephritis in men

A

Similar to presentation in women

25
Q

Physical exam in men

A

Prostate is tender and swollen

26
Q

Lab findings for prostatitis

A

UA: pyuria, bacteria, urine culture is positive

Possible bacteremia

27
Q

Acute treatment for prostatitis

A

Bactrim 160/800mg PO BID

28
Q

Chronic treatment for prostatitis

A

Also Bactrim 160/800mg PO BID

29
Q

Catheter-related UTIs treatment

A

NO ABX because asymptomatic bacteriuria is common with indwelling and condom catheters! Prevention is key by avoiding unnecessary and prolonged use of ABX, and intermittent catheterization

30
Q

Candiduria pathogens

A

Albicans and glabrata

31
Q

Presentation of candiduria

A

Asymptomatic
Lower tract: dysuria, frequency, urgency
Upper tract infection is rare

32
Q

Management of symptomatic candiduria

A

NO TREATMENT unless patient is high risk or undergoing a urologic procedure

33
Q

Pharmacological treatment for symptomatic candiduria

A

Albicans: fluconazole for 2 weeks
Glabrata: Ampho B for 1-7 days or flucytosine for 7-10 days
Krusei: Ampho B for 1-7 days

34
Q

Treatment for asymptomatic bacteriuria

A

NO ABX TREATMENT unless you’re pregnant, undergoing an invasive urinary tract procedure, or getting a renal transplant

35
Q

UTIs and asymptomatic bacteriuria in pregnancy: treatment

A

Amoxicillin/clav for 7 days
Amoxicillin for 7 days
Cephalexin for 3-7 days

36
Q

Which ABX should you avoid in pregnant women close to delivery?

A

Nitrofurantoin and Bactrim

37
Q

Antimicrobial therapy of pyelonephritis in pregnancy

A

IV beta-lactams like ceftriaxone and cefazolin

38
Q

Which ABX are CI’ed in pregnancy?

A

TTCs, quinolones

PHM 603- ID Part 1 (22 decks)

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