Which bacteria cause UTIs?
E coli (85%)
Enterbacter - Klebsiella, proteus, pseudomonas
Staph saprophyticus, epidermidis, aureus
What is lobar nephronia?
Pyelonephritis in a section of the kidney only
What is azotemia?
Renal impairment causing failure of Abx filtering by the kidney
What might predispose a 30-60 year old to a UTI?
What are the route of infection for UTIs?
What predisposes people to bacterial persistance?
Fistulae - secondary to diverticulitis or cancer
How might you Mx recurrent UTIs?
Post coital voiding (or Abx)
Prophylatic Abx / home supply
Topical peri urethral oestrogen (post menopausal)
What is a complicated UTI?
An infection in a patient with a structural or functional impairment that reduces efficacy of the abx
What is the common symptoms of pyelonephritis?
Which abx are given for UTIs?
Nitrofurantoin - commonly used for prophylaxis
Cephalosporins: cephazolin or ceftriaxone
Penicillin: Augmentin DuoFort
What are some side effects of nitrofurantoin?
What is the normal leucocyte number in MSU?
What abx are used for pyelonephritis?
Tazacin and merapenem if that fails
Then more prolonged fluoroquinone
What is pyuria?
WBCs in urine
What is pyonephrosis?
Infection of the upper urinary tract with WBCs commonly secondary to calculi
How do you investigate recurrent UTI’s?
Blood glucose (exclude DM)
Urinary tract imaging (US) for stones, retention
Cystoscopy for pathology in bladder (automatically for men)
What might predispose a newborn or infant to a UTI?
Anatomical / congenital problem eg reflux
What some non-bacterial sources of pyuria?
Virus’, fungi, parasites
How do you diagnose UTIs?
Urinalysis - leucocyte esterase and nitrites
MSU - M + C&S
How does pyelonephritis appear on CT?
(focal or general)
What is strangury?
Urgency without satisfying voiding