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18 Cards in this Set
- Front
- Back
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Ports of entrance for UTIs.
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1. Blood
2. Via lymph (esp enteric bacilli) by conxn between intestine and UT 3. Medical devices: catheters, cystoscopes, etc. 4. Injuries, surgical interventions, accidents. 5. Secondary infxns because of urine stasis: calculi, preganancy, tumors. |
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Are most UTIs due to normal flora for exogenous pathogens?
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Normal flora.
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Infxn of urethra:
Infxn of urinary bladder: Infxn of renal pelvis: Infxn of renal parenchyma: |
urethritis
cystitis pyelitis pyelonephritis |
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UTIs, acute vs. chronic:
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Acute: happens suddenly with back pain, frequent urination, and sometimes fever. They are caused by E. coli.
Chronic: milder in symptoms, but they last longer. Usually a mixed infxn - Klebsiella and Psuedomonas aeruginosa |
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What to do with urine if can't be tested immediately?
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Must store in refrigerator to prevent bacterial growth.
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Pyuria:
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Urine containing pus.
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Supra pubic aspiration (SPA):
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A needle is introduced into the bladder through the lower abdominal wall, and urine is withdrawn directly.
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______once attached to urinary tract, infects the kidney more commonly than E. coli.
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Proteus mirabalis
-possesses urease -sensitive to ampicillin and cephalosporins -proteus infxn accounts for 1-2% of UTIs in healthy women and 5% of hospital-acquired UTIs. |
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Sometimes there is no cure for UTIs; why?
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1. the causative microorganism is different from what was isolated
2. the same microorganism, but became resistant 3. antibiotics did not reach bacteria |
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Nitrofurantoin
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Antibiotic usually used in treating urinary tract infxns caused by e. coli.
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Mandelamine
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An antibacterial used to treat/prevent recurring UTIs. Should be used only after usual antibiotics have been used to cure the infection first.
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Nalidixic acid
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This is the basis for quinolone antibiotics. Is effective against gram neg and gram pos bacteria. It is especially useful in treating UTIs caused, for example, by Escherichia coli, Proteus, Shigella, Enterobacter, and Klebsiella..
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Can beta-lactams be used against UTIs?
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Yes, but >50% of gram-negative rods causing UTI are beta-lactamase producers and therefore resistant.
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Which beta-lactams are more effective against UTIs and which are less (two of each)?
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-ampicillin and amoxicillin are not resistant to beta-lactamase, so will not be useful if causative bacteria contains beta-lactamase
-cefalexin and cefuroxime are relatively beta-lactamase stable, so are therefore more effective |
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Co-amoxiclav
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Useful against gram-neg rods that are ampicillin-resistant due to beta-lactamase.
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The most common type of UTI is a ______ infection which is also often called ______.
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bladder
cystitis |
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roughly 10% of UTIs are caused by the following four bacteria:
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Klebsiella
Proteus Pseudomonas Enterobacter |
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UTI due to staph aureus, TB, and viruses is thought to be via ______. Most infxns, though, are caused by gram neg rods, which are thought to initiate infxn by the ______.
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bloodstream
“ascending” route |
