Flashcards in Urinary tract infections Deck (23)
What marks the boundary between the upper and lower urinary tracts?
Above the bladder = upper
What areas of urinary tract are considered sterile?
Bladder (not might not be the case!)
What type of flora lines the urethra?
Perineal flora (skin/lower GI flora)
What constitutes the perineal bacterial flora?
Skin - staph
-gram negative, aerobic enterobacteriaceae
- Gram positive - E.coccus spp
What is the definition and clinical characteristics of cystitis?
- Dysuria, polyuria, nocturia, haemturia
- supra-pubic pain
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
What is the definition of urethral syndrome?
Symptoms of lower urinary tract infection but without evidence of infection
What is meant by CFU?
Colony forming units (used as a means to identify bacteriuria)
According to the Kass criteria, what is considered a significant bacteriuria in cfu/mL
10^4-10^5 = probable
What is the definition of asymptomatic bacteriuria?
Significant bacteriuria (i.e 10^5 cfg/mL) but WITHOUT symptoms of UTI
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
What are the predisposing factors for a UTI infection?
-Stasis e.g. pregnancy, stones, prostatic hypertrophy, neoplasm, strictures
- Instrumentation e.g. catheter, cystoscopy
- congenital conditions e.g. vesico-ureteric reflux
What are the sources of UTI infection?
Perineum (movement of bacteria along lumen)
Haematogenous - seeding (rare)
What are the 3 main causative organisms for UTI?
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
What investigations should be carried out for a UTI?
-Dipstick testing (urinalysis)
What are the 4 ways by which urine is investigated?
-Mid stream urine
-Clean catch urine
-Supra pubic aspirate (directly from bladder)
What condition is an early morning urine test used for?
What further investigations should be performed followingurine test?
What antibiotic should be used for UTI?
What are the requirements for antibiotics in the treatment of a UTI?
Present in urine
Effective against UTI bacteria
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)