UTI - Learning Package Flashcards
What is cystitis?
Cystitis = inflammation of the bladder which can by due to infection (bacterial cystitis) or other cause
What is bacteruria?
Bacteruria = presence of bacteria in urine, note anterior urethra is not sterile and presence of urethral organisms washed out during micturition is not bacteriuria
What is pyuria?
Pyuria = presence of pus cells (neutrophil polymorphs) in significant quantities in urine
What is sterile pyuria?
Sterile pyuria = urine is negative on culture but significant numbers of pus cells present
What is acute pyelonephritis?
Acute pyelonephritis = infection of the upper urinary tract involving the kidneys
What is chronic pyelonephritis?
Chronic pyelonephritis = pathological condition with renal scarring and potentially loss of renal function
Describe the aetiology of UTI?
Aetiology in men:
- Prostatitis
- Infection of the prostate
- STIs
Aetiology in woman:
- Sex
What are some predisposing factors for UTI?
- In females, short urethra and its proximity to rectum
- Trauma to female urethra during coitus and childbirth
- In pregnancy due to stasis of urine allowing bacteria to flourish
- Anatomical abnormalities
- Congenital pelvi-ureteric junction obstruction, vesico-ureteric reflux, duplex kidneys, horseshoe kidney, urethral valves, prostatic enlargement etc
- Renal cysts
- Pre-existing renal parenchymal damage
- Such as from recurrent pyelonephritis
- Stones in urinary tract
- Immunosuppression including diabetes, prolonged steroid therapy, transplant rejection medication
- Instrumentation of urinary tract
- Presence of foreign body in urinary tract including catheter
How can UTI be classified?
- Complication
- Those which occur in situations other than young, sexually active woman
- Uncomplicated
- Occur in healthy, sexually active young woman
- Organisms usually E-coli or skin commensals such as staph saprophyticus
- Further investigations not required
What organisms are usually responsible for uncomplicated UTI?
- Organisms usually E-coli or skin commensals such as staph saprophyticus
In what situations should cultures be done to diagnose UTI?
There are many cases when clinical diagnosis of simple, uncomplicated UTI does not require lab confirmation and empirical antibiotics can be used
But, situations where cultures should be done:
- Woman with mild or limited symptoms for whom dipstick testing is inconclusive
- Suspected UTI in men
- Suspected acute pyelonephritis
- Pregnant woman with symptoms and for screening
- After failed antibiotic treatment or persistent symptoms
- Recurrent UTI
- Defined as >2 UTIs within 6 months or >3 in a year
- Children with suspected UTI
What is recurrent UTI defined as?
Defined as >2 UTIs within 6 months or >3 in a year
How is urine collected for culturing?
Urine collected with mid-stream urine (MSU), should be done early morning
Catheter specimens should be obtained from the catheter sampling port and not from the collection bag
What are some common organisms that cause UTI?
- E-coli most common cause
- Staph. Saprophyticus is a common cause in young sexually active woman
- Protease, Klebsiella and Pseudomonas are more often found in hospital patients
- Often associated with catheters
Other than culturing, what other investigation can help diagnosis?
Microscopy of unstained urine can also be carried out:
- To determine whether or not there are cells, casts or organism present
