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23 Cards in this Set
- Front
- Back
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What are three routes by which bacteria may enter the urinary tract
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1. Hematogenous
2. Lymphatics 3. Extension from adjacent infected tissues |
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What are 5 normal host defenses against bacterial UTIs
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Normal micturition!!!! (v. impt)
Normal fxnl anatomy Mucosal defenses- GAGs, IgA Antibacterial properties of urine Normal immune system |
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What two bugs are most bacterial UTIs d/t
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E. coli
Staph spp. |
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True/False: Most bacterial UTIs in small animals are d/t more than one bug
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False
75% dogs and 85% of cats w/ bacterial UTIs have only one bug responsible for the infection |
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How common are UTIs in cats
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Very UNcommon!
Especially if see "LUT" signs Cats are NOT small dogs! |
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What are the signs of a feline UTI
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NOT LUT signs
More likely PU/PD, or you have found it incidentally |
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What is the definition of a complicated UTI
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All intact males (prostate involved)
Bacterial UTIs in all cats Usually are d/t urine retention and foreign objects (stone, catheters, etc.) |
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True/False: An animal w/ impaired host defenses is considered to have a complicated UTI
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True
Includes PU, Micturition disorders, immuno-suppression, DM, Cushing's, and CRF |
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True/False: Lack of bacteriuria Rs/O bacterial UTI
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False
Bacteria are not typically seen until #s > 100,000/mL |
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What are 5 reasons for performing a urine culture
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1. Confirm infection
2. ID organism responsible 3. Pattern of bacteriuria 4. Susceptibility in vitro 5. Tx efficacy |
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What are the criteria for interpretation of urine culture based on method obtained
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Cysto: Any growth abnormal
Catheter: >10,000/mL dogs >1,000/mL cats Voided: >100,000/mL dogs >10,000/mL cats In general, do not culture voided!!! |
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What is the definition of MIC
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Minimum Inhibitory Concentration
Least [drug] sufficient to prevent growth of bacteria in vitro Determine by serial dilutions |
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What is a good rule of thumb for determining whether or not your Abx is going to reach effective [ ]s in urine
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If the [ ] achieved in urine is 4x the MIC (via concentration by kidneys), the tx is likely to be effective
This is why drugs that are labeled as (I) on C&S may work |
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What findings suggest that a UTI has renal or prostatic involvement
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Systemic signs (fever, pain, inappetance, leukocytosis, PU)
PE- lumbar or prostatic pain Lab abnormalities like leukocytosis, isosthenuria, azotemia |
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What are some reasons why skipping a urine culture may be all right
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1st time or infrequent LUT signs w/o apparent complications (in female or NM)
OR if owner cannot afford it |
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What is the ideal way to treat a mixed bacterial UTI
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Ideally, want to choose one drug
But, if all involved bugs are not susceptible to one drug, treat in sequential order |
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What are first line Abx for UTIs
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Those chosen for 1st time OR uncomplicated OR highly sensitive infections
Penicillins, TMPS, Tetracyclines |
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What are second line Abx for UTIs
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Reserved for complicated and chronic/recurrent infections
Use only when necessary so do not encourage resistance Quinolones, 1st Gen Cephalosporins, Penicillins w/ Penicillinase inhibitors (Clavulanic acid- Clavamox, Sulbactam- Unasyn), Nitrofurantoin |
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What are third line Abx for UTIs
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Reserved for infections w/ known resistance to first and second line Abx
$$$, usually parenteral, and have higher risk of SEs 2nd and 3rd Gen Cephalosporins, Imipenem, Aminogylcosides |
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By which route should Abx be given for bacterial UTIs
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Oral
Unless: Acute Pyelonephritis (L/T) Acute Prostatitis (L/T) |
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How often should Abx be given for the tx of bacterial UTI
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Generally, TID
But, BID for TMPS and Quinolones since longer T1/2 SID for Aminoglycosides b/c SEs (nephrotoxic) |
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How long should bacterial UTIs be tx'd w/ Abx
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Uncomplicated- 10-14d
Complicated- 4-6wks (or 2wks past resolution of complicating factor) |
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How should cultures be used in uncomplicated and complicated bacterial UTI tx monitoring
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Uncomplicated- do 7-10d after tx ends
Complicated- 5-7d INTO course of meds, and 7-10d AFTER course of meds is over |
