what is the definition of an adult UTI? who is it common in?
dysuria, frequency and urgency with >100 organisms/mL
common in women
what are the symptoms and signs of pediatric UTI?
tenderness in the lower abdomen, inadequate urine flow and >50,000 IU/mL
what organisms cause UTIs?
75-90% are E coli. others are opportunistic: enterobacteriaceae, enterococcus (less pathogenic) sti etc
what is one of the major difficulties of treating UTIs?
drug resistance in E coli, enterobacteriaceae and enterococci
what organisms fall under the group enterobacteriaceae?
E coli, shigella, salmonella and two groups of opportunistic pathogens that are normal GI flora
how do enterobacteriaceae acquire drug resistance?
they are promiscuous to incorporating foreign DNA (also acquiring virulence factors)
what is the morphology and metabolism of enterobacteriaceae?
gram negative rods that are facultative anaerobes
what are the dangers of untreated E coli UTI?
obstruction and sepsis
what is the major virulence factor of uropathogenic E coli?
factor P fimbrae that attach to uroepithelial cells and allow ascent into the bladder
what leads to susceptibility to atypical UTIs?
urinary tract procedures/catheters, diabetes or sepsis
what are the two groups of opportunistic UTI infectious bugs?
klebsiella/enterobacter/serratia (ICU bugs)
proteus/providencia/morganella
what is a special consideration when approaching enterobacter UTI?
it can become “panresistant”
what are two virulence factors of the proteus/ providencia/ morganella group of UTI bugs? what may they cause?
urease and fimbrae for attaching
may cause struvite stones
describe enterococci morphology. what is a concern with these bugs?
they are gram positive cocci in chains (like strep) and are very drug resistant. may cause endocarditis or abdominal infections as well
what is the difference between cystitis and pylonephritis?
cystitis is normal UTI where nephritis is a kidney infection that requires antibiotic susceptibility testing and/or combined drugs
what is the cranberry juice window?
when a patient can recognize very early symptoms before antibiotics are indicated. may be cleared with home remedies at this point.
