UTIs Flashcards

1
Q

Infection of lower urinary tract?

A

Urethritis or cystitis

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2
Q

Infection of kidneys?

A

Pyelonephritis

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3
Q

What is vesicouretal reflux?

A

Backflow of urine into kidneys, may be due to malfunction of cysto-uretic valve

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4
Q

When is a UTI complicated?

A

Abnormality in urinary tract:
Pregnancy, stent, indwelling device, scarring
Neurological

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5
Q

Bacterial causes of UTIs?

A

E. coli
S. saprophyticus
Klebsiella, Enterobacter, Proteus and Citrobacter

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6
Q

What is urosepsis?

A

Infection spread to kidneys, bacteria may be found in blood

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7
Q

Common source of bacteria causing UTIs?

A

Gut contamination

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8
Q

Host resistance mechanisms? (6)

A

1) Bulk urine flow
2) Low pH and osmolarity
3) Lactoferrin
4) Colonisation resistance
5) Neutrophil influx
6) Bladder cell exfoliation

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9
Q

Host risk factors? (6)

A

1) Sex and spermicide use (nonoxynol)
2) Dehydration
3) Uropathogenic colonisation of GI tract
4) Pregnancy - high progesterone and uterus enlargement
5) Colonisation/blockage of indwelling devices
6) Poorly managed diabetes

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10
Q

UTI pathogenesis?

A

Adhere to epithelium using pili (type 1 for bladder, P. fimbriae for kidneys)
Forms pods or biofilms in bladder
Inflammatory response damages epithelium, causes symptoms

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11
Q

UTI symptoms? How long for? (5)

A

1) Need to urinate
2) Feeling of bladder fullness
3) Pain when urinating
4) Suprapubic tenderness
5) Sometimes blood in urine

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12
Q

Symptoms of pyelonephritis? (5)

A

1) Lower back pain
2) Fever
3) Chills
4) N&V
5) Pain around ribs

PLUS UTI symptoms

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13
Q

What is seen under microscope in pyelonephritis?

A

Red and white blood cells in urine surrounded by bacterial cells

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14
Q

Define recurrent UTI

A

2 proven episodes in 6 months, 3 suspected in 12 months

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15
Q

Causes of UTI recurrence? (4)

A

1) Genetics
2) Congenital abnormalities
3) Behaviours
4) Presence of pods or biofilms

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16
Q

Describe E. coli biofilms?

A

Invades superficial cells, surrounded by polysaccharide matrix and coated in uroplakin

17
Q

Treatment of UTIs?

A

First line - Trimethoprim or nitrofurantoin

Second line - Nitrofurantoin, pivmecillinam, fosfomycin (if no improvement in 48 hours)

18
Q

Novel treatment of UTIs?

A

Around 15 new drugs, mainly for complicated UTIs
Pilicides - Interfere with pilus assembly
Mannosides - Interfere with anti-adhesives

19
Q

UTI vaccinations?

A

Urovac - 90 day tablet, 18 types of E. coli
Uro-vaxom - Pessary
ExPEC4V - Injection, 4 types of E. coli
Uromune - Sublingual spray, in phase 3 trials