Urinary Tract Infections Flashcards
(26 cards)
Commensal flora in the kidneys/ureter
Considered sterile
Commensal flora in the bladder
Almost always sterile
Commensal flora in the urethra
Perineal flora (skin/lower GI tract flora)
What organisms make up the perineal flora?
Skin flora-coagulase -ve staphylococci
Lower GI flora-anaerobic bacteria,aerobic bacteria (enterobacteriaeceae), gram +ve cocci-enterococcus
Lower UTI
Cystitis
Symptoms of cystitis
Dysuria Urinary frequency Urgency Supra-pubic pain/tenderness Polyuria,nocturia, haematuria
Upper UTI- infection of kidney and/or pelvis
Pyelonephritis
What additional symptoms do you get in pyelonephritis?
Fever or other evidence of systemic infection
Abacterial cystitis- symptoms of UTI without infection
Urethral syndrome
Who typically gets urethral syndrome?
30-50yrs women.
What are the possible causes of urethral syndrome?
Hypersensitivity reactions, hormone imbalances etc.
Who defined ‘significant bacteriuria’ and what level is classes as significant?
Kass criteria
10(5)cfu/ml
what does cfu stand for?
colony forming units
Significant bacteriuria with a single organism but no symptoms of UTI
Asymptomatic bacteriuria
Pus cells in urine, no organisms grown
Sterile pyruria
Predisposing factors for UTI
Female
Urinary stasis-pregnancy, prostatic hypertrophy, stones, strictures, neoplasia, residual urine
Instrumentation
Sexual intercourse
Fistulae-recto-vesical, vesico-vaginal
Congenital abnormalities e.g. vesico-ureteric reflux
Sources of UTI infection
Perineum
Fistulae-genital/GI tract to urinary tract
Haematogenous
3 causes of sterile pyruia
Inhibition of bacterial growth e.g. unprescribed antibiotics
Fastidious (hard to grow) organisms
Urinary tract inflammation
4 types of investigations for someone with a UTI
Urinanalysis
Blood tests
Microbiological
Imaging
Name 5 types of urine samples
Mid stream Catheter urine 'clean catch' supra-pubic aspirate early morning urine (whole contents of bladder_
When would you carry out an early morning urine test?
Suspected urinary TB
When would you carry out a blood test?
suspected pyelonephritis
Name 4 UTI antibiotics
Nitrofurantoin
Pivmecillinam
Trimethoprim
Fosfomycin
When woudl you treat asymptomatic bacteriuria
Pregnant women, infants or prior to urological procedures
