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Micro 3010 > Unit 13 - UTI's > Flashcards

Unit 13 - UTI's Flashcards

(54 cards)

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1
Q

UTI’s are a very common type of ______ infection

A

bacterial

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2
Q

What gender is at greater risk?

A

women > men

  • pregnancy increases risk
  • sexual activity
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3
Q

Does age pose a risk?

A

yes - elderly more likely to get UTI’s

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4
Q

Who else is at risk of getting a UTI?

A

Patients with:

  • co-morbid conditions (diabetes)
  • spinal cord injuries (can’t empty bladder as frequently and smoothly)
  • catheters (substrate for bacteria to grow on, and a passage for bacteria)
  • GU tract abnormalities
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5
Q

There are 2 types that a UTI can occur: Describe them

A

1) Ascending route (up urinary tract)

2) Hematogenous spread (gets into blood then into kidneys and urinary tract)

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6
Q

_____ is a common cause because antibiotics suppress normal microflora

A

candida

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7
Q

More gram _____ in hospitals because they are intrinsically resistant to antibiotics which allows them to grow in hospital.

A

negative

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8
Q

Bacteriuria

A

bacteria in urine

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9
Q

Bacteriuria can be _______ or _________

A

symptomatic or asymptomatic

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10
Q

asymptomatic bacteriuria (ASB) is if person is healthy and resolves it by itself but treatment is recommended for certain individuals: which individuals?

A

during pregnancy, prostate resection, immunosuppression

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11
Q

Relapse

A

an infection when the same agent causes infection after 2 weeks without symptoms

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12
Q

Reinfection

A
  • brand new infection
  • needs to be 1 month between 2 infections
  • could be same organism or new organisms
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13
Q

Describe uncomplicated UTI’s

A
  • usually happen in healthy females (50% of all females will have UTI at least once)
  • readily treated with antibiotics
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14
Q

Describe complicated UTI’s

A
  • either gender
  • more difficult to treat
  • Key risk factors:
    • underlying diseases
    • kidney stones
    • urinary tract abnormalities
    • indwelling urinary catheters
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15
Q

Contributing factors?

A
  • length of urethra
  • sexual activity (females)
  • uncircumcised male infants
  • blockage
  • catheterization (3-10% increased risk/day of catheterization)
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16
Q

Bacterial attributes to UTI’s

A
  • capsular antigens
  • haemolysins
  • urease
  • adhesion to uroepithelium
  • introital colonization
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17
Q

Host factors to UTI’s

A
  • renal calculi
  • ureteric reflux
  • tumours in and adjacent to urinary tract
  • pregnancy, bladder stones
  • neurologic problems (incomplete bladder emptying, large volume of residual urine, loss of sphincter control)
  • prostatic hypertrophy
  • short urethra in women
  • catheterization
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18
Q

List types of UTI’s

A
  • Asymptomatic bacteriuria
  • Urethritis
  • Cystitis
  • Acute urethral syndrome
  • Pyelonephritis
  • Prostatitis
  • Cervicitis
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19
Q

Describe the type:

Asymptomatic bacteriuria

A

is if person is healthy and resolves it by itself but treatment is recommended for certain individuals (during pregnancy, prostate resection, immunosuppression)

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20
Q

Describe the type:

Urethritis

A
  • infection of the urethra

- symptoms include dysuria (pain or discomfort when urinating) & frequency

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21
Q

Describe the type:

Cystitis

A
  • bladder infection
  • symptoms include dysuria (pain or discomfort when urinating), frequency, urgency, pain over bladder area
  • signs include bloody urine, cloudy urine, bad odour
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22
Q

Describe the type:

Acute urethral syndrome

Study These Flashcards
A
  • same symptoms as cystitis but lower CFU/mL than cystitis

- pyuria (pus in the urine from a bacterial infection)

23
Q

Describe the type:

Pyelonephritis

Study These Flashcards
A

infection of kidney & renal pelvis

24
Q

Describe the type:

Prostatitis

Study These Flashcards
A

infection involving prostate

25
Describe the type: | Cervicitis
inflammation of cervix
26
Epidemiology of UTIs in pediatrics
- high morbidity - impaired renal function - hypertension - end-stage renal disease - complications during pregnancy as adult
27
Epidemiology of UTIs in adults < 65 years old
incidence in women > incidence in men
28
Epidemiology of UTIs in geriatrics
- incidence in both men and women increases but ratio changes - prostate enlargement leads to poorer bladder emptying which leads to increased UTI incidence
29
Microbial Virulence Factors
- Adherence (bacterial adhesions) - Calculi formation - Toxin & enzyme production (hemolysins, lipopolysaccharides) - Capsular polysaccharide - Biofilms
30
Host defences
- Flushing action of urinary flow - Growth inhibitory properties of urine (low pH, osmolarity, high urea, organic acid concentrations) - Mucopolysaccharides - Preventing reflux
31
Resident normal microflora of the urethra varies with age & health status: Describe newborns
sterile
32
Resident normal microflora of the urethra varies with age & health status: Describe 1-3 days
Staph, enterococci, diptheroids
33
Resident normal microflora of the urethra varies with age & health status: Describe 3 days - weeks
lactobacillus acidophilus
34
Resident normal microflora of the urethra varies with age & health status: Describe prepubertal
micrococci, streptococci, coliform, diptheroids
35
Resident normal microflora of the urethra varies with age & health status: Describe adult
L. acidophilus, staphylococcus epidermis, streptococci (alpha & non-hemolytic), E. coli, diphtheroids, yeasts
36
Resident normal microflora of the urethra varies with age & health status: Describe pregnancy
increase L. acidophilus, yeasts, S. epidermidis
37
Resident normal microflora of the urethra varies with age & health status: Describe postmenopausal
similar to prepubertal flora: | micrococci, streptococci, coliform, diptheroids
38
Gram-negative bacilli
Enterobacteriaceae - fecal E. coli, uncomplicated UTIs - MDR (multi-drug resistant) enterobacteriaceae, hospital-acquired - duration of hospitalization and catheterization - Increased pseudomonas, proteus, klebsiella, acinetobacter, and enterobacter - decreased E. coli
39
Gram-positive cocci
Enterococci -older men, urinary tract manipulation, instrumentation Staphylococcus saprophyticus -symptomatic sexually active women <40 yrs
40
Gram positive bacilli
Diphtheroids, mycobacteria and Listeria monocytogenes | -Bacillus
41
Fungi
Candiduria, hospitalized patients
42
Lower UTI affects ??
bladder and urethra
43
Lower UTI includes ____
cystitis
44
Describe cystitis
- dysuria (burning pain during urination) - urgency - increased frequency - E. coli, Klebsiella spp, other enterobacteriaceae, enterococci, CoNS
45
Upper UTIs include ??
- Acute pyelonephritis | - Subclinical pyelonephritis
46
Describe acute pyelonephritis
- fever - lower UTI symptoms (dysuria, urgency, increased frequency) - enterobacteriaceae, staphylococcus aureus
47
Describe subclinical pyelonephritis
-CoNS, candida spp, mycobacterium spp, mycoplasma hominis Important: -pregnant women and young children -patients undergoing instrumentation in UT -elderly and diabetics
48
Laboratory diagnosis determine ______ vs ______
infection vs colonization
49
Laboratory diagnosis collects _________ urine
midstream MSU = midstream urine
50
Describe the microscopic examination
rapid | preliminary report
51
Describe suprapubic aspiration of bladder urine and when it would be useful
Urine samples are collected directly from the bladder by insertion of a needle. This method is useful in young children from whom it is difficult to obtain an uncontaminated midstream urine specimens
52
Describe the interpretation of results
- Collection - Storage (cultured within 1 hour of collection, stored at 4 degrees celsius for not > 18 hours) - Antibiotic treatment (take into thought resistance, and if the number is significant ??) - Fluid intake (influence on quantitation) - Kind of specimen (MSU vs catheter/suprapubic aspiration) *MSU = midstream urine
53
What is the treatment for an uncomplicated UTI - cystitis?
- may resolve spontaneously within 4 weeks (up to 40% patients) - antibiotics administered to reduce symptoms & ensure complete eradication - followup recommended at the end of the treatment - drink lots of fluids to facilitate flushing action
54
What is the treatment for a complicated UTI - pyelonephritis?
- systemic IV treatment until symptoms subside - oral therapy afterwards - >10 days to sterilize kidney

Micro 3010 (20 decks)

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