Flashcards in UTI Deck (45)
Cystitis is often referred to as...
a lower UTI
a upper UTI
The kidneys, ureters, bladder and urethra are normally sterile - TRUE/FALSE
FALSE - the lower urethra is normally colonised by coliforms and enterococci
What is meant by a complicated UTI?
a UTI complicated by systemic symptoms or urinary tract structural abnormalities
Bacturia does not always mean a UTI - TRUE/FALSE
TRUE - bacteria in the urine may not mean infection in the elderly or catheterised patients; ask about symptoms
All cystitis is infection - TRUE/FALSE
FALSE - cystitis simply refers to inflammation in the bladder
Risk factors for a UTI (7)
Female sex, sexual contact, pregnancy, immunosuppression/compromise, obstruction, malformation, familial
You should treat a positive urine dipstick without symptoms in pregnancy - TRUE/FALSE
TRUE - many women who are positive may be asymptomatic until they develop pyelonephritis or fetal death occurs
You should treat a positive urine dipstick without symptoms in the elderly - TRUE/FALSE
FALSE - only treat if symptomatic
You should treat a positive urine dipstick without symptoms in patients with a catheter - TRUE/FALSE
FALSE - the longer a catheter is in place, the more likely it is to be colonised
Symptoms of a UTI
Dysuria, frequency of urination, nocturia, haematuria, fever, loin pain, rigors
Which symptoms of a UTI suggest pyelonephritis?
fever, loin pain, rigors
What are some risk factors for developing pyelonephritis?
diabetes, HIV/AIDs, immunosuppression, UT abnormalities
Whhat form of specimen should be collected for urinary culture and why?
Mid-stream urine - the initial urine passed will be contaminated with colonisers of the urethra
What features of a urine dipstick suggest infection?
Leukocytes (WBCs), Nitrites - coliforms convert nitrates to nitrites
Why are protein and blood not necessarily suggestive of infection?
protein should not be positive, blood may suggest infection or may be a sign of other things
What are the ideal features of an antibiotic used to treat an uncomplicated lower UTI?
excreted in the urine, oral, inexpensive and few side effects
What is abacterial cystitis/urethral syndrome?
when a patient has symptoms of a UTI but no growth in culture
What may cause abacterial cystitis/urethral syndrome?
early phase UTI, urethral trauma (honeymoon cystitis), urethritis (chlamydia/gonorrhoea)
Do you treat asymptomtomatic bacturia?
Only in pregnant women, not in the elderly
When should a catheterised patient with significant bacteruria be given antibiotics?
Only when there is supporting evidence of UTI - unneccessary antibiotics may only result in resistance
Treatment for lower UTI - women
trimethoprim or nitrofurantoin - 3 days/PO
What organisms does trimethoprim treat?
Treatment for lower UTI - men
trimethoprim or nitrofurantoin - 7 days/PO + get cultures
Treatment for complicated UTI/pyelonephritis - GP
Co-amoxiclav or co-trimoxazole - 14 days
What organism does co-trimoxazole treat?
Treatment for complicated UTI/Pyelonephritis - Hosp
Amoxicillin and gentamicin - 3 days/IV; co-trimoxazole if penicillin allergic
What organisms does amoxicillin treat?
What organisms does gentamicin treat?