Infectious Diseases

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DEFINITION: Bacteriuria vs UTI?

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ETIOLOGY: Ascending vs. Descending UTI?

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PARACLINIC in UTIs?

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CYSTITIS vs. PYELONEPHRITIS: Compare the Etiology & Tx.

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SPECIAL PATIENTS:

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	Bacteriuria	UTI
Definition	Presence of microorganisms in urine (same germs as UTI → see below ** extra: P (+ Enterococ)→ in male; K (+all other) + Gardneralla → in female)	Microbial invasion of any of the tissues extending from the urethral orifice to the renal cortex
Significance	Significant bacteriuria: the number of bacteria in the urine collected ≥ 10^5 CFU / ml; CATHETER-related BACTERIURIA -> 10^2 CFU / ml	Clinical symptoms may include frequent urination, painful urination, and lower abdominal pain. Upper UTI might present with positive giordano, oliguria, fever or signs of sepsis.
Asymptomatic cases	Asymptomatic bacteriuria: significant bacteriuria without clinical symptoms Prevalence: - Catheter - UT abnormalities - Elderly - Hemodialysis	Asymptomatic UTI can occur but is less common
Diagnosis	Urine culture test	Urine culture test and/or imaging tests such as CT scan or ultrasound
Treatment	Only if symptoms!	Antibiotics are usually prescribed for symptomatic UTI

Infection Type	Etiology	Predominant Bacteria	Favoring Factors
↑ Ascending (97%)	Mainly Gram-negative bacteria	E.Coli (80%), Proteus spp, Klebsiella spp, Enterobacter spp, Serratia marcescens, Pseudomonas aeruginosa ØGram neg (Enterococcus, Staph epidermidis, Candida)	OBSTRUCTION: Vesicoureteral reflux, foreign bodies, instrumentation of urinary tract/endoscopy, bladder catheterisation
↓ Descending (3%) (hematogenous spread → microabscesses)	Gram-positive bacteria & Fungi	Staphylococcus spp, Streptococcus spp, Candida spp	Kidney trauma, obstructions, diabetes, immunosuppression