UTIs

Question 1

What bacteria is the dominant cause of UTIs?

Answer 1

• Uropathogenic E. coli (UPEC)
• Opportunistic pathogen
• resides in the gut
• gram negative

Question 2

What is the definition of a UTI?

Answer 2

Refers to the presence of microbes in the urinary tract (bladder, kidney or urine)

Question 3

What are the presenting symptoms of UTIs?

Answer 3

• Symptoms include pain whilst urinating, bacteriuria, sepsis. We refer to UTIs in a normal GI tract as “uncomplicated” whereas “complicated refers to structural or functional abnormality, eg catheter

Question 4

What is Asymptomatic bacteriuria (ASB)?

Answer 4

• No systemic symptoms

Question 5

What are uncomplicated UTIs?

Answer 5

(otherwise healthy individuals):

1. Cystitis (lower UTIs)
2. Pyelonephritis (upper UTIs) - more serious, infection has reached the kidneys via bladder - nephritis

Question 6

What are complicated UTIs?

Answer 6

• Associated with factors that compromise the gut
• urinary obstruction, urinary retention caused by neurological disease, immunosuppression, renal failure, renal transplant, pregnancy.
  In the US up to 80% of complicated UTIs are associated with catheters. Catheter associated UTIs are associated with increased morbidity and mortality and commonly associated with infection of the blood stream,. at risk – females, elderly and diabetics

Question 7

What are the risk factors for cystitis?

Answer 7

• female
• prior UTI
• sexual activity
• vaginal infection
• diabetes
• obesity
• genetic susceptibility

Question 8

Susceptibility to UTI factors? (4)

Answer 8

1. Genetic eg blood antigens - ABO blood antigens increase susceptibility to UTIs, urinary obstruction and previous UTI history – bacteria can bind to blood antigens and are more likely to colonise
2. Biological eg diabetes (bacteria love sugar in the blood – nutrients), incontinence
3. Behavioural, use of condoms, spermicides
4. Other eg hormone deficiency (post menopausal), surgery

Question 9

What people are susceptible to UTIs? (6)

Answer 9

1. Infants
2. Pregnant women
3. The elderly
4. Catheterised
5. Diabetics
6. AIDS patients

Question 10

What other bacteria are implicated in UTIs?

Answer 10

Staphylococcus saprophyticus, klebsiellas, Proteus and Enterococcus faecalis

Question 11

How are UTIs diagnosed?

Answer 11

• dipstick urine test