UTIs Flashcards
What defines a recurrent UTI?
3 symptomatic UTIs within a year (following therapy)
What defines a relapse UTI?
Same bacterial organism within 7 days
*after completing the antibacterial treatment
What defines a reinfection?
Bacterium absent for 14 days post treatment, infection comes back same or diff organism
What are 4 risk factors for developing a UTI?
Female, age, comorbidities change pH, institutional care
What’s the difference between a complicated and uncomplicated UTI?
Uncomplicated: Infection via usual pathogen, person has normal UT/kidney function
Complicated: everything else
Name 5 things that can present as inflamed in a patient with a UTI
- Pyelonephritis
- cystitis; bladder
- urethritis
- epididymitis
- prostatitis
List 6 typical symptoms of a UTI
Frequency, dysuria, bad smell, lower abdo pain, urge incontinence, unspecific discomfort; aching, nausea
How would you diagnose a severe UTI?
3 or more of following symptoms:
- polyuria: >3L a day of urine 2. frequency
- hematuria
- suprapubic tenderness
- urgency
- dysuria
How would you treat women under 65 presenting with 3 severe UTI symptoms without discharge
Immediate treatment
*high chance culture is +ve
How would you treat a women over 65 with symptoms and discharge
Culture
*less chance of UTI
Two UTI differentials
Sexually transmitted diseases, sepsis
How does a mild UTI present and what investigations would you do?
2 or less symptoms:
dipstick test: check nitrates IF cloudy
Which urine dipstick results indicate a definite UTI, probably UTI and the likelihood of a different disease?
Definite: positive nitrites (with/without leukocytes and blood)
Possible: negative nitrites but positive leukocytes
Sm else: -ve all 3 OR just +ve blood and protein
Why are nitrites indicative of infection? What time of day is best to test for them?
Bacteria in urine releases nitrate reductase enzyme: reduces nitrates-> nitrites
Morning (built up over night)
How should you treat an asymptomatic woman over 65?
Only send for urine culture if 2+ signs of infection (especially temperature),
*those with no symptoms usually don’t need treatment
List 6-7 scenarios where you would perform an automatic urine culture
- Pregnancy
- suspected pyelonephritis
- suspected UTI in men:
- Failed antibiotic treatment or recurrent symptoms
- Recurrent UTI
- Abnormalities in the GU system
- Renal impairment: (undiagnosed UTI would make the renal impairment worse)
What could happen to the fetus if the mother has a UTI?
death, developmental delay, cerebral palsy
How do UTIs often present in children?
Unexplainable fever.
What is the difference between a white top and a red top container?
Red top has boric acid (culture can be left room temp for longer)
What is the main organism causing uncomplicated UTIs?
E-coli
Name 3 organisms that can cause an uncomplicated and complicated UTI
Klebsiella, Staphlococci, Proteus
List 3 ways that bacteria can spread through the urinary tract
Catheters, infection from urethra (esp females), blood/lymphatics
Name 3 things our UT does to protect itself
Transitional cells secrete glucosamine: forms mucin layer - prevents bacterial spread
Low pH and urea
Bladder sheds inflamed layers (eradicates bacteria attached to epithelia)
List 2 antibiotics you could prescribe for a UTI and how long antibiotic treatment is in males and females
Nitrofurantoin: good for genital infection if renal function is working
Trimethoprim 3 days women, 7 days men
At what age do men most commonly acquire UTI?
> 65
