Flashcards in Urinary tract infections Deck (23):
1
What marks the boundary between the upper and lower urinary tracts?
Above the bladder = upper
2
What areas of urinary tract are considered sterile?
Kidney/ureters
Bladder (not might not be the case!)
3
What type of flora lines the urethra?
Perineal flora (skin/lower GI flora)
4
What constitutes the perineal bacterial flora?
Skin - staph
GI
- anaerobic
-gram negative, aerobic enterobacteriaceae
- Gram positive - E.coccus spp
5
What is the definition and clinical characteristics of cystitis?
Lower UTI
- Dysuria, polyuria, nocturia, haemturia
- freq/urgency
- supra-pubic pain
6
What is the definition and clinical characteristics of pyelonephritis?
Upper UTI (kidney and/or renal pelvis)
- same symptoms as lower UTI (i.e. - 'urias'/ab pain/freq/urgency) BUT with LOIN PAIN
Also systemic infection features - fever, rigour, nausea, D&V, elevated CRP and WBC
7
What is the definition of urethral syndrome?
Symptoms of lower urinary tract infection but without evidence of infection
8
What is meant by CFU?
Colony forming units (used as a means to identify bacteriuria)
9
According to the Kass criteria, what is considered a significant bacteriuria in cfu/mL
10^5 cfg/mL
10^4-10^5 = probable
10
What is the definition of asymptomatic bacteriuria?
Significant bacteriuria (i.e 10^5 cfg/mL) but WITHOUT symptoms of UTI
11
What is the definition of pyuria? What are the potential causes for this?
Pus in urine but without organisms
Differential diagnosis - inflammation of urinary tract - trauma, kidney stones, polycystic kidney disease etc
12
What are the predisposing factors for a UTI infection?
- Female
-Stasis e.g. pregnancy, stones, prostatic hypertrophy, neoplasm, strictures
- Instrumentation e.g. catheter, cystoscopy
- fistulae
- congenital conditions e.g. vesico-ureteric reflux
- sex
13
What are the sources of UTI infection?
Perineum (movement of bacteria along lumen)
Fistulae
Haematogenous - seeding (rare)
14
What are the 3 main causative organisms for UTI?
-E coli**
-Staph saprophyticus
-Proteus mirabilis
15
What are the causes of sterile pyuria?
-inhibition of bacterial growth e.g. unprescribed antibiotics/antiseptic
- Fastidious organisms - hard to grow in culture e.g. gonorrhoea
- Urinary tract inflammation - renal/bladder stones, other renal disease
16
What investigations should be carried out for a UTI?
-Dipstick testing (urinalysis)
-Blood test
-Microbiological
-Imaging
17
What are the 4 ways by which urine is investigated?
-Mid stream urine
-Clean catch urine
-Cateter urine
-Supra pubic aspirate (directly from bladder)
18
What condition is an early morning urine test used for?
Renal TB
19
What further investigations should be performed followingurine test?
Ultrasound
20
What antibiotic should be used for UTI?
Trimethoprim
21
What are the requirements for antibiotics in the treatment of a UTI?
Cheap
Oral form
Present in urine
Effective against UTI bacteria
Minimally toxic
22
Who long should antibiotics should be administered for in a) males and b) females with CYSTITIS?
a) 7 days (longer course)
b) 3 days (shorter course)
23