Flashcards: Urinary Tract Infections — 54 cards

What is the second most frequent site of community-acquired infections?

Urinary tract infections.

In which gender are urinary tract infections more frequent overall?

Women.

When do urinary tract infections peak in women?

At the beginning of sexual activity and after menopause.

Why do urinary tract infections occur mainly in men after age 50?

Because of benign prostatic hyperplasia.

What does a urinary tract infection often indicate in children?

A malformation of the urogenital tract.

Which bacteria cause 60–80% of urinary tract infections?

Escherichia coli.

Which bacteria cause 5–10% of urinary tract infections besides Escherichia coli?

Staphylococcus saprophyticus and Proteus.

Which bacteria are less commonly responsible for urinary tract infections?

Other Enterobacteriaceae or enterococci.

Which part of the urinary tract is normally colonized by digestive flora?

The distal urethra.

How does urinary infection most often occur?

By an ascending route starting with bladder invasion.

Is hematogenous spread a common cause of urinary infection?

No, it is less common.

Name one natural defense of the urinary tract against infection.

Urethral length.

What urinary characteristic helps defend against infection?

Acidic urine.

What role do prostatic secretions play in urinary defense?

They have an antibacterial effect.

Which anatomical feature in women is a risk factor for urinary tract infections?

A short urethra–anus distance.

What urinary tract abnormalities increase risk for urinary infections?

Any urinary tract abnormality increases risk.

What Quick SOFA score indicates severe sepsis as a severity criterion?

A Quick SOFA score above 2.

Which recent antibiotic use increases risk of ESBL-producing bacterial infection?

Use of amoxicillin–clavulanate, second- or third-generation cephalosporins, or fluoroquinolones within 6 months.

What prior condition within 6 months increases risk for ESBL bacterial infection?

Previous colonization or infection with ESBL-producing bacteria.

What defines simple acute cystitis in women?

A lower urinary tract infection in a woman without fever or flank pain.

Which factors associate with cystitis with complication risk?

Urinary tract abnormalities, comorbidities, male sex, pregnancy, or advanced age with comorbidities.

How is recurrent cystitis defined?

At least 4 episodes over 12 months.

Name one factor that promotes recurrent cystitis.

Sexual intercourse.

What are typical initial symptoms of pyelonephritis?

Unilateral flank pain, fever, chills, and pain on lumbar percussion.

What complications can pyelonephritis cause?

Bacteremia, septic shock, or renal abscess.

What symptoms combine in prostatitis or orchiepididymitis?

Lower urinary symptoms with fever, chills, pelvic pain, and prostate tenderness.

List typical urinary symptoms.

Frequent small-volume urination, painful urination, cloudy or bloody urine, dysuria, incontinence, acute retention, and lumbar, pelvic, or testicular pain.

What does the urine dipstick detect first-line in urine testing?

Leukocytes and nitrites.

What do leukocytes detected by urine dipstick indicate?

An inflammatory response.

Which bacteria produce nitrites detected by urine dipstick?

Enterobacteriaceae.

What is the sensitivity of the urine dipstick test?

97%.

What is the specificity of the urine dipstick test?

33%.

How should the urine sample be collected for a dipstick test?

Collect the second urine stream in a clean, dry, nonsterile container.

When should the urine dipstick test be read after collection?

After 1–2 minutes according to instructions.

What leukocyturia level supports urinary infection?

Greater than $10/mm^3$ or $10^4/ml$.

What is the first-line treatment for simple acute cystitis?

Single-dose fosfomycin-trometamol.

When is urine culture recommended in simple acute cystitis?

Only if treatment fails.

What should be done before treating cystitis with complication risk?

Treatment should preferably await the antibiogram.

What is the first-line antibiotic if antibiogram is unavailable for complicated cystitis?

Nitrofurantoin.

Which antibiotics treat simple acute pyelonephritis parenterally?

Third-generation cephalosporin or fluoroquinolone.

What is an alternative treatment for simple acute pyelonephritis if contraindications exist?

An aminoglycoside.

What does severe pyelonephritis treatment require?

Hospital treatment and dual therapy.

How must probabilistic antibiotic treatment be managed after antibiogram results?

It must always be adapted to the antibiogram result.

What defines asymptomatic bacteriuria?

Bacteria in urine without symptoms.

In which group is asymptomatic bacteriuria treated with antibiotics?

Pregnant women only.

How does age affect the frequency of asymptomatic bacteriuria?

It becomes more frequent with age.

What percentage of nosocomial infections are urinary tract infections?

40% of nosocomial infections are urinary tract infections.

What is the main cause associated with nosocomial urinary tract infections?

Bladder catheterization is mainly associated with nosocomial urinary tract infections.

What percentage of urinary catheters are colonized by bacteria on day 3?

Approximately 30% of urinary catheters are colonized by bacteria on day 3.

By which day are 100% of urinary catheters colonized by bacteria?

By day 30, 100% of urinary catheters are colonized by bacteria.

What are key steps in catheter prevention?

Limiting indications, daily reassessment, early removal, and preferring intermittent catheterization.

When should a catheter be removed or changed in catheter-associated urinary infection?

Remove if possible or change if in place at least 14 days.

How should antibiotic treatment be chosen for catheter-associated urinary infection?

Based on infection type and susceptibility results.

When are contact precautions required for catheter-associated urinary infections?

When the infection involves multidrug-resistant bacteria.