Urinary Tract Infection

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What four things do antibacterials have to be?

-Ability to reach urine -Adequate absorption and ability to achieve adequate urinary concentrations -Adequate spectrum of activity for likely causative organisms -Well tolerated

What are the ascending routes?

-Infection in women due to the close proximity of the reproductive tract, urinary tract and rectum (urethrea colonized by fecal flora) Spermicides Diaphragms Sexual Intercourse

What ratio of females have a UTI before the age of 25?

1/3

What percentage of females have UTI at some point in their lives?

20%

UTI's are less common in men until age?

65

What is a Complicated UTI's?

A Predisposing lesion of the Urinary Tract

What are two bacterial virulence factors?

Adherence to urinary epithelial cells using fimbriae Biofilms

What are three routes of UTI infection?

Ascending Route Descending Route Lymphatic Pathways

What is asymptomatic bacteriuria?

Bacteria in urine, no symptoms

What does lower tract infection cause?

Cystitis (bladder) Urethritis (urethra) Prostatitis (prostate) Epididymitis (epididymis)

What are the bacterial agents that cause prostatitis in men greater than 30 years old?

E.Coli Klebsiella sp. Proteus sp. P. aeurginosa

A lot of etiological agents cause complicated UTI's but which one is most prevalent?

E.Coli (50%)

What two things are Uncomplicated UTI's caused from?

E.Coli (85%) Staphylococcus Saprophyticus (5-15%)

Which sex has a higher occurence of UTI's?

Females because of close proximity of the reproductive tract, urinary tract and rectum

What is the most common type of bacteria (gram negative or gram positive) that cause UTI's?

Gram Negative

What is fimbrea?

Hairlike appendages on the cell wall

What type of people do Uncomplicated UTI's affect?

Healthy Females age 15-45

What is the descending route?

Hematogenous (the descending of an infection from distant regions)

UTI's are the most common what?

Hospital Acquired Infection or Nosocomial Infection

What is UTI?

Inflammation of the Urinary Epithelium following invasion and colonization by some pathogen within the urinary tract

What is prostatitis?

Inflammation of the prostate

What is an Uncomplicated UTI?

It is when there is a lack of structural or functional abnormalites of the urinary tract that interfere with normal voiding

What do relapse persistant infection UTI's indicate?

Kidney Involvement Structural Problems of the Urinary Tract

What are predisposing factors?

Kidney Stone Indwelling Catheter Pregnancy Mechanical Instruments Spermicides and Diaphragm Use Prostate Enlargement Abnormalities of the Urinary Tract that interfere with normal defense mechanisms

What do bacterialcidal antibiotic do?

Kill the bacteria and eradicate the disease

Who does complicated UTI's affect?

Males and Females

What are three ways to collect urine samples?

Midstream "Clean catch" Catheterization Suprapubic Bladder Aspiration

What are the bacterial agents that cause prostatitis in men younger than 30 years old?

Neisseria gonorrhea Chlamydia trachomatis (Sexually Transmitted Diseases)

What is a relapse persistant infection UTI?

One that has a pesistent infectious source (usually due to infections that have never been cured and become asymptamatic and then flare up again)

What is a Reinfection persistant UTI?

One that is caused by a different organism each time and usually occurs in women

What do bacteriostatic antibiotics do?

Prevents bacteria culture from reproducing and keeps the infection in check but doesn't cure or kill infection.

What is the main cause of UTI's?

Prolonged Urinary Catheters

What does upper tract infection cause?

Pyelonephritis (Kidney)

What are two types of Persistant UTI's?

Reinfection or Relapse

What is the 3rd most common source of UTI's

Sepsis/Severe Sepsis/Shock

What is a Persistant UTI?

UTI that has multiple symptomatic episodes with asymptomatic periods between

What are two laboratory tests?

Urinalysis Urine Culture

What are two methods used to diagnosis UTI's?

Urine Collection Laboratory Tests

What are three host defense mechanisms?

Urine itself - low pH, osmolality, high urea Voiding mechanism Anti adherence mechanisms in bladder

What are signs and sypmptoms of UTI's in elderly?

altered mental status or confusion altered eating habits, GI symptoms

What are signs and sypmptoms of lower UTI?

dysuria, Urgency Frequency Nocturia hematuria

What are biofilms

film of protective mechanism that forms over initial colony of bacteria

What are signs and sypmptoms of upper UTI?

flank pain fever N/V malaise

What are signs and sypmptoms of prostatitis?

pain fever urinary retention problems voiding

What is "Significant Bacteriuria" in Symptomatic females?

≥ 10^2 CFU coliforms/Ml ≥10^3 CFU noncoliforms/mL

What is "Significant Bacteriuria" in Catheterized patients?

≥10^2 CFU bacteria/mL

What is "Significant Bacteriuria" in Symptomatic males?

≥10^3 CFU bacteria/mL

What is "Significant Bacteriuria" in Asymptomatic individuals in 2 consecutive species?

≥10^5 CFU bacteria/mL


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