Flashcards in Infectious Diseases Deck (30)
classic sxs of UTI
- dysuria- frequency- urgency
sx and sign seen in about 1/2 of pts w/ pyelonephritis
- flank pain- fever
risk factors for UTIs in WOMEN
- DM- sexual activity- diaphragm use- vaginal atrophy- genetic predisposition
when is sexual activity a risk factor in MEN?
risk factors for UTIs in HETEROSEXUAL MEN
- obstruction- ureterovesical reflux- prostatic hypertrophy
what are the MOST COMMON nosocomial infections?
risk factors for UTIs in EITHER gender
- DM- SCD- renal stones
what bug is specifically associated w/ urinary stones?
when Proteus is identified in the urine (UTI), what should be done next?
imaging test to look for stones
group B strep (S. agalactiae) UTI is seen in
diagnosis for UTI
- urine culture growing 100,000 or more of gram-negative organisms- gram-positive organisms or yeast can cause infection with lower colony counts
what is a positive urine culture in the absence of sxs called?
NOT a UTI; asymptomatic bacteriuria
MC gram-negative organism causing UTI
MC gram-positive organism causing UTI
uncommon cause for UTI if NO urinary catheter, and should raise concern for what?
- Staphylococcus aureus- bacteremia from another source seeding to the kidney
what is the FIRST step in evaluating whether to treat a positive urine culture?
determine if the pt has SIGNS or SYMPTOMS of infection
treat ASYMPTOMATIC bacteriuria under ONLY 3 circumstances
1. pregnant women2. pts about to undergo a urologic procedure3. renal transplant recipients w/i the first 3 mos
why do you treat asymptomatic bacteriuria in pregnant women?
- prevent progression to pyelonephritis- decrease maternal and fetal morbidity and mortality
treatment for asymptomatic bacteriuria in pregnant women
- TMP/SMX during weeks 12-36 ONLY x 3 days- nitrofurantoin x 3 days- cephalexin x 3 days
why do you treat asymptomatic bacteriuria in renal transplant recipients?
- decrease r/o a SYMPTOMATIC UTI, which increases risk of rejection
w/ SYMPTOMATIC UTIs, what is the next step?
determine if LOWER tract (cystitis), or UPPER tract (pyelonephritis)
w/ SYMPTOMATIC UTIs, what is the next step after determining if lower vs upper tract?
complicated or not
definition of complicated UTI
- DM- structural anomalies- foreign bodies- prior resistant organisms- immunocompromised- male
when do you NOT need a urine culture?
when should imaging be performed in pyelonephritis?
ONLY if sxs PERSIST after 72 hours of culture-guided therapy
treatment for uncomplicated cystitis
- 3-day course of:- TMP/SMX- fluoroquinolone- cephalexin
treatment for complicated cystitis or UNcomplicated pyelonephritis
- fluoroquinolone- TMP/SMX- beta-lactam- depending on C+S data
treatment for complicated pyelonephritis and/or hospitalized pts
- 7-10 days unless bacteremic- fluoroquinolone- ceftriaxone- beta-lactam + beta-lactamase inhibitor- ampicillin + aminoglycoside
when should a urinary catheter be changed in UTI?
ONLY if symptomatic