Urinary Tract Infection (UTI)
Urinary tract infection (UTI) is infection of the urinary tract by microorganisms, which normally originate in the gastrointestinal tract and ascend into the urinary tract. It is important to distinguish between uncomplicated and complicated UTIs as the length of treatment differs.
• Uncomplicated UTI is an infection in a structurally and functionally normal urinary tract
• Complicated UTI is an infection in a structurally and / or functionally abnormal urinary tract
- UTIs in men, pregnancy and children are also ALL complicated
Catheter associated UTIs have similar symptoms to uncomplicated or complicated UTIs but different causes and therefore different treatment.
Urethral syndrome is a form of UTI that only occurs in women and is characterised by urgency and pain on passing urine. It is important to make the distinction of urethral syndrome from other types of UTI because although the causes are the same, the treatment is different.
• Uncomplicated UTI is an infection in a structurally and functionally normal urinary tract
• Complicated UTI is an infection in a structurally and / or functionally abnormal urinary tract
- UTIs in men, pregnancy and children are also ALL complicated
Catheter associated UTIs have similar symptoms to uncomplicated or complicated UTIs but different causes and therefore different treatment.
Urethral syndrome is a form of UTI that only occurs in women and is characterised by urgency and pain on passing urine. It is important to make the distinction of urethral syndrome from other types of UTI because although the causes are the same, the treatment is different.
Clinical Features
• Polyuria
• Hesitancy
• Incontinence
• Suprapubic pain
• Loin-to-groin pain e.g. flank and back
• Fever or chills
• Rigors
• Tachycardia
• Sepsis
• Hesitancy
• Incontinence
• Suprapubic pain
• Loin-to-groin pain e.g. flank and back
• Fever or chills
• Rigors
• Tachycardia
• Sepsis
Causes
|
Common
• Escherichia coli • Proteus sp. • Klebsiella sp. • Enterobacter sp. |
Pregnancy
As for common plus: • Staphylococcus saprophyticus |
Catheter Associated
As for common plus:
• Pseudomonas sp.
• Enterococcus sp.
• Staphylococcus aureus
• Candida sp.
As for common plus:
• Pseudomonas sp.
• Enterococcus sp.
• Staphylococcus aureus
• Candida sp.
Investigations
• Urine- Mid-stream urine (MSU), clean catch urine or supra-pubic aspirate (SPA)
- Urine dipstick (bacterial nitrites PLUS leucocytes)
- Negative Predictive Value (NPV) ≈ 97% CAN rule out UTI
- Positive Predictive Value (PPV) ≈ 60% CANNOT prove UTI
• Blood cultures if systemic symptoms
- Urine dipstick (bacterial nitrites PLUS leucocytes)
- Negative Predictive Value (NPV) ≈ 97% CAN rule out UTI
- Positive Predictive Value (PPV) ≈ 60% CANNOT prove UTI
• Blood cultures if systemic symptoms
Total Duration
Uncomplicated UTI (women only): 3 days
Complicated UTI (including pregnancy): 7 days
Pyelonephritis: 7 days
Pyelonephritis in pregnancy: 14 days
Dosing
See section - Antibiotics, Empirical Antibiotic Guidelines.
Uncomplicated UTI (women only): 3 days
Complicated UTI (including pregnancy): 7 days
Pyelonephritis: 7 days
Pyelonephritis in pregnancy: 14 days
Dosing
See section - Antibiotics, Empirical Antibiotic Guidelines.
Prognosis and Complications
UTI can result in impairment of renal function, especially in young children with recurrent infections and vesico-ureteric reflux.
Prophylaxis and Prevention
Prophylactic antibiotics are used in children who experience recurrent UTIs in order to try and preserve renal function.
UTI can result in impairment of renal function, especially in young children with recurrent infections and vesico-ureteric reflux.
Prophylaxis and Prevention
Prophylactic antibiotics are used in children who experience recurrent UTIs in order to try and preserve renal function.
Examples of Urology Requests, Results and Interpretations
Other Urogenital Conditions:
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• Sexually Transmitted Diseases (STDs)
• Prostatitis
These conditions are covered in the book,
"Microbiology Nuts & Bolts".
• Prostatitis
These conditions are covered in the book,
"Microbiology Nuts & Bolts".