Flashcards in UTI Deck (30):
What are common causative organisms of UTIs?
E. coli – most common
**95% from GI tract
In infants, (M, F) more commonly have UTI's.
In 3-50 y/o, (M, F) more commonly have UTI's.
What age group has the highest rate of bacteriuria?
What are contributing factors that increase # UTI's in younger ages?
What contraceptives have increased incidence of UTI?
diaphragm/spermicide > spermicidal foam/condoms > oral contraceptives
What is the most common route of infection?
95%: Ascending route (Urethral trauma, Intercourse, Instrumentation, Diaphragm use)
<5%: Hematogenous route
Mechanisms for pathogenesis of UTIs?
What bacterial factors contribute to UTI's?
1. Uropathogenic E. coli = Virulence factors
2. Structural = adhesions on fimbriae (type 1 and p-)
**ADD INFO ON PATHOGEN!
Host Defense Mechanisms?
Bacterial growth inhibition
Epithelial cell turnover
Predisposing host factors?
Urine flow obstruction
Abnormal urine flow
Clinical Manifestations of UTI of lower tract?
Frequency of urination
Dysuria - painful urination
Clinical Manifestations of UTI of upper tract?
Flank pain and “CVAT”
Dx of UTI?
Gram stain of urine
Blood cultures (PRN)
Complications of UTI:
Gram negative sepsis
Intrarenal or extrarenal abscess
Chronic renal insufficiency
Struvite renal calculi
Prevention of UTI:
Proper use of urinary catheterization
Correction of anatomic abnormalities
Prophylactic antibiotics - RARELY
Abx treatment for asymptomatic bacteriuria in elderly?
Abx treatment of upper tract UTI?
1-6 weeks (IV vs oral therapy)
Abx treatment of upper tract UTIs for M vs F?
Males: 1 week
Females: 1-3 days (but longer if complicated UTI)
pus in urine (inflammation or infxn)
inflamm. of renal pelvis (upper UTI)
symptoms of UTI (frequency, urgency, dysuria), but no apparent source of infxn
Acute urethral syndrome
How do birth control methods increase UTI risk?
spermicide changes flora of vagina
diaphragm changes angle of urethra, may ↑ reflux
Abx which are best at concentrating more in inflamed kidney than uninflamed
Aminoglycosides (tobramycin, gentamicin)
Abx which concentrate about the same in inflamed vs uninflamed
Sulfonamides and trimethoprim
Abx which concentrate LESS in inflamed kidney than uninflamed
Abx which can treat prostatitis
Capsular polysaccharide [K antigen]
Proteins at the end of type 1 fimbrae can bind:
Why is this important?
mannose in host tissues (=attachment)
Mannose present in lower UT → lower UTI