Microbio - UTI

Question 1

What population is generally classed as uncomplicated UTI?

Answer 1

Non-pregnant women

Question 2

What population is generally classed as complicated UTI?

Answer 2

Pregnant women, men, and structural abnormality to urinary tract

Question 3

*Most common overall organism

Answer 3

E. Coli

Question 4

*Most common organism in young women

Answer 4

Staph. saprophyticus

Question 5

Most common organism for hospital acquired

Answer 5

Proteus, Klebsiella

Question 6

Most common organism for haematogenous

Answer 6

Staph aureus

Question 7

UTI general presentation

Answer 7

Frequency, urgency, dysuria, abdo pain

Question 8

UTI presentation elderly

Answer 8

non-specific, delirium

Question 9

Pyelonephritis presentation

Answer 9

systemically unwell, fever + rigors, loin pain

Question 10

What is urosepsis

Answer 10

Sepsis due to UTI

Question 11

UTI investigations

Answer 11

1. Dipstick
2. MC&S

Question 12

What may you find on urine dipstick for UTI?

Answer 12

Nitrites and leukocytes +
± haematuria

Question 13

Whether to treat UTI based off urine dip results:

1. Nitrite +ve
2. Nitrite -ve, leukocyte +ve
3. Nitrite -ve, leukocyte-ve

Answer 13

1. UTI -> Treat
2. ?UTI -> ?treat, culture
3. Not UTI

Question 14

Diagnostic MC&S results for UTI (2)

Answer 14

1. >10³ CFU/ml E.coli or S. saprophyticus
2. >10⁴ CFU/ml other organisms

Question 15

*What MC&S results mean contamination?

Answer 15

Mixed growth, squamous epithelium/ mixture of staphs and streps

Question 16

Management for UTI

Answer 16

nitrofurantoin / trimethoprim / phenytoin/ cephalexin / amoxicillin

3d if uncomplicated; 7d if complicated

Question 17

Management for clinically unwell pyleonephritis

Answer 17

admit, IV co-amox + gentamycin

Question 18

*Which organism is associated with renal calculi formation?

Answer 18

Proteus mirabilis

Question 19

*Between nitrites and leukocyte on urine dip, which is more sensitive for UTI and which is more specific?

Answer 19

Leukocyte more sensitive

Nitrite more specific

(Nitrite miight be better overall then?)