1 UTIs Flashcards
(56 cards)
Urinary tract infections refer to infections residing in the…
Kidneys, ureters, bladder, or urethra
Examples:
Pyelonephritis (kidneys and ureters)
Urethritis (urethra)
Cystitis (bladder)
UTIs are usually initiated as the infecting bacteria contaminates…
The opening of the urethra and moves UPWARD into the urinary tract
UTIs are more common in…
Adults vs children
Female vs men
Risk factors for UTIs
Obstructions (stones) Conditions —> incomplete bladder voiding Immunosuppression Sexual activity Use of diaphragms as BC Enlarged prostate Catheterization Pregnancy
Risk factors for UTI specific to children
Poor hygiene
Partial blockage
Typical SSx of a Lower UTI
Bladder inflammation Dysuria Frequent urination Urinary urgency Cloudy, malodorous or bloody urine Lower abdominal pain or pressure MILD FEVER**** Burning with urination (urethritis)
Do you get a fever with a lower UTI?
You can but it would be mild
Usually due to inflammation rather than the bacteria themselves
SSx of an upper UTI (Pyelonephritis)
HIGH FEVER (>101˚F) Shaking Chills Nausea Vomiting Flank pain
SSx of UTIs in newborns
Fever or hypothermia
Poor feeding
Jaundice
SSx of UTIs in infants
Vomiting
Diarrhea
Poor feeding
(Mimics GI infection)
SSx of UTIs in Children
Irritability Eating poorly UNEXPLAINED FEVER Loss of bowel control (loose stools) Change in urination patterns
What is the URI-cult CLED/EMB?
Paddles used to make a presumptive ID of pathogen and CFU/ml in UTIs
ID and NUMBER***
What is the EMB side of the CLED/EMB selective for?
Gram negative bacteria
Contains BILE salts, which kill off G(+) organisms
(emB = BILE)
What does the CLED side of the CLED/EMB select for?
Growth of G+ and G- organisms
Determines ability to ferment LACTOSE
(cLed = LACTOSE)
Why is it important that the CLED/EMB paddles provide a somewhat quantitative measure of the number of organisms?
B/c a lot of these pathogens are also a part of our normal flora, so you need at least a certain amount for it to be considered an active infection
How should your urine specimen be collected in order to diagnose a UTI?
Midstream clean catch
Catch or aspiration in infants and young children
What U/A microscopy findings indicate an active infection requiring treatment?
2-5 or more WBCs or 15 bacteria per high powered microscopic field in a centrifuged urine sample
What additional diagnostic testing should be done in men presenting with UTI symptoms?
Prostate exam
Assume that there is an anatomical abnormality present that is causing it
What populations should have an U/S or CT done when diagnosing a UTI?
Children - 50% of infants with UTI have an anatomical abnormality
Adults with recurrent infections
Blood in urine
Most common bacteria causing UTI
E.coli (75-90% of all UTIs)
Specifically, Uropathogenic E.coli (UPEC)
Other less common bacterial causes of UTIs
Klebsiella spp Proteus spp Enterococcus spp Staphylococcus saprophyticus Streptococcus Group B Pseudomonas aeruginosa
Super rare:
Candida
Adenovirus
Klebsiella UTIs are rare but more common in …
Immunocompromised patients
Bacteria to be suspected in sexually active females
Staphylococcus saprophyticus
Bacteria to be suspected in neonatal UTIs
Group B Strep
