UTIs Flashcards
what is an urinary tract infection?
condition where microrganisms are established and are multiplying in the urinary tract (bladder,prostate, ureters or kidney)
what is bacteriuria?
demonstration of bacteria in voided urine
what is categorized as a significant bacteriuria?
100,000 bacteria per ml in clean catch MSU
what is MSU?
MSU - mid stream urine. Void. Stop. collect void. Stop. Void.
why must MSU be collected?
To avoid skin and organisms that aren’t causing infection and isn’t in bladder. Avoiding the lining bacteria
what is the significance of a Low count bacteriuria?
urethral syndrome
how to UTIs happen?
Ascending faecal organisms
can be facilitated by instrumentation - catheter
what natural defenses does the body have against UTIs
Hydrodynamic factors
Phagocytosis
Humoral immunity
Non-specific antibacterial substances in secretions –prostate, mucosal glands
how is age a Predisposing factor?
more likely in the elderly
how is sex a Predisposing factor?
more likely in females, roughly 80% of UTIs in women
how is diabetes a Predisposing factor?
high blood sugar in urine. A good breading ground for bacteria
how is Structural/functional Urinary tract abnormalities a predisposing factor?
caused urine to fall back into bladder and breed bacteria
what are the complications of UTIs?
Pyelonephritis
Renal scarring
Septicaemia
Recurrence – risk increased
what are all the bacteria that can cause UTIs?
E.coli
Enterococcus sp.
Staph. saprophyticus
Proteus sp.
Klebsiella sp.
Pseudomonas aeruginosa
Candida sp.
whats the importance of Staph. Saprophyticus?
species of the epidermis type. Important in pregnancy, if low number of wbc, early on set labour.
what is the importance of
Proteus sp.?
gut bacteria, very alkaline, increase risk of developing bladder storms
what is the importance of
Klebsiella sp. ?
.highly resistance organisms, ESPLs
best ways the collect a good urine sample?
Mid stream
Catheter
Clean catch
Bag
Suprapubic aspirate
how can urine samples be stored for transport?
Refrigeration at 4oC
Dip-slide technique
Boric acid 1.8%
what is positive diagnosis?
Usually pure growth of single species
80% positive predictive value
Increased confidence if symptoms and pyuria present
95% if 2 specimens positive for same organism
key advice to elderly patients?
Encourage fluids
what treatment prescribed?
antibiotics
for how long?
Normal treatment for 5 days
Can be up to 10 days for resistance strains
why must complete course?
risk resistant or/and reoccurring infection
what if UTI reoccurs anyway with the same bacteria cause?
prophylaxis may be prescribed for up to 2 months
