UTIs Flashcards
What are the types of lower UTI infections and what are the symptoms of each
Bacterial cystitis - frequency, dysuria, urgency, low grade fever
Abacterial cystitis - frequency, dysuria, urgency, low grade fever
Prostatitis - fever, dysuria, frequency, perineal and low back pain
Name some upper UTIs and their symptoms
Acute pyelonephritis - frequency, dysuria, fever, malaise, loin pain
Chronic intersitial nephritis
What mechanisms help prevent against UTIs
Voiding
Antibacterial secretion
What are the host factors that increase risk of UTIs
Shorter urethra -> increased risk in females
Obstruction - enlarged prostate, pregnancy, stones, tumours
Neurological - incomplete empting, residual urine
Ureteric reflux
Defective or missing urethral valves -> retrograde flow
What bacterial factors increase risk of UTIs
Faecal flora - bacteria colonise periurethral area
Adhesion
K antigens
Haemolysis
Urease
What is the difference between complicated and uncomplicated UTI
Uncomplicated - infection by usual organism in patient with a normal urinary tract
Complicated - UTI when one or more factors are present that predispose the patient to persistant infection, recurrent infection or treatment failure
How is contamination of urine specimens minimised
First portion of voided urine is discarded and a midstream sample is collected
Specimens are refrigerated or collected in containers with boric acid to prevent multiplication
What is sterile pyuria and what is it caused by
Sterile pyuria - white cells in urine without bacterial growth
- Prior antibiotic
- Urethritis
- Vaginal infection or inflammation
- Fastidious organisms
- Non-infectious inflammation
- Urinary tuberculosis
What is urethral syndrome, what else it is known as and what can cause it
Urethral syndrome - when a woman presents with clinical features of cystitis but does not have a positive urine culture
Also known as Abacterial cystitis
Caused by:
- Infection with low counts of bacteria
- Infection with fastidious organism
- STIs
- Vaginal infection/inflammation
- Non-infective inflammation
What is the treatment for UTIs
Increase fluid intake
Address underlying disorders
Antibiotic course - type and length depends on type of UTI
What is an uncomplicated lower UTI treated with
3 day course is used to treat simple cystitis
Give trimethoprim or nitrofurantoin
What antibiotics course is used to treat a complicated lower UTI
5-7 day course of trimethoprim, nitrofurantoin or cephalexin
Amoxicillin not appropriate as 50% of isolates are resistant
Give post-treatment follow up for paeditrics and pregnant women
What is the antibiotic course for pyelonephritis
14 day course, usually given IV unless good PO absorption and patient well enough
Give co-amoxiclav or ciprofloxacin
When would prophylaxis be given and what antibiotics are used
Can be given at night to reduce risk of recurrent cystitis if 3 or more episodes in a year
Give trimethoprim or nitrofurantoin
Why do patients with kidney disease need to be careful and look out for UTIs
Because patients with kidney disease have increased risk of developing a UTI
Infections can also cause or contribute to development of kidney disease
Risk of infection increases as kidney function declines
