Flashcards in Urinary Tract Infection (UTI) Deck (16):
What is infection of the epididymis/ testes called?
What are the most common causes of HAI?
Urinary tract 38%
Surgical wound 22%
Lower Respiratory tract 15%
What general predisposing factors make an individual more susceptible to infection?
What specific predisposing factors make an individual more susceptible to UTI?
Female sex (short urethra)
Sexual intercourse and poor voiding habits
Congenital abnormalities (e.g. duplex kidney)
Stasis of urine (e.g. due to poor bladder emptying)
Foreign bodies e.g. catheters, stones
Oestrogen deficiency in postmenopausal women
Fistula between bladder and bowel
What are the most common bacterial aetiologies of UTI?
-Group B strep
What is strangury?
Characterized by painful, frequent urination of small volumes that are expelled slowly only by straining and despite a severe sense of urgency, usually with the residual feeling of incomplete emptying
What are the clinical features of UTI in children?
-Nausea and vomiting
What are the clinical features of UTI in adults?
-Cloudy offensive urine
-Confusion (very old people)
What are the clinical features of acute pyelonephritis?
Loin tenderness (renal angle)
Signs of dehydration
Give a differential diagnosis for acute pyelonephritis
Renal/ ureteric calculi
What are the investigations in UTI?
Urinalysis in ward
-Microscopy and gram staining
-Bacteruria >10^5 CFU/ml
-Culture and sensitivity
What further investigations will you want to consider in children, men or when UTIs are frequent?
Ultrasound or IVU
Isotope studies to rule out reflux and scarring
What are the principles of UTI management?
Identify the infecting organism and institute appropriate treatment
Identify predisposing factors and treat if possible
How do you treat UTI?
-Amoxicillin (3-5 day course or 3g x 2)
Severe infections -> IV antibiotics
How do you diagnose reflux nephropathy?
Micturating cystogram (radionuclide 99Tc techniques)
Assess progression by ultrasound scan and biochemistry