Risk factors for UTI in postmenopausal women include all of the following, EXCEPT:
In older, often-institutionalised female patients, urinary tract catheterisation and functional status deterioration appear to be the most important risk factors associated with UTI. The other risk factors include non-secretor status of blood group antigens, UTIs before menopause, urinary incontinence, atrophic vaginitis, cystocele and large post-voiding residual urine.
Screening for asymptomatic bacteriuria should NOT be performed in all of the following, EXCEPT:
Screening for asymptomatic bacteriuria is not recommended for the following patients:
Regarding the diagnosis of asymptomatic bacteriuria all the following are true, EXCEPT:
For asymptomatic bacteriuria in women a count of ≥105 cfu/mL in voided volume in two consecutive samples is diagnostic, whereas only one sample is needed to be diagnostic for a man with no urinary symptoms In a single catheterised sample, a count may be as low as 102 cfu/mL to be diagnostic. The count can be slightly higher at 103 cfu/mL for an ‘in and out’ catheter or convene/condom catheter sample to be diagnostic.
Asymptomatic bacteriuria should only be treated in pregnant women or prior to transurethral surgery with a risk of mucosal bleeding. Essential read: EAU guidelines on Urological Infections and NICE Quality Standards (QS90), List of Quality Statements (Urinary tract infections in adults).
Concerning UTI in pregnancy all the following are true, EXCEPT:
Pregnancy does not alter the diagnostic criteria; therefore, in an asymptomatic pregnant woman, bacteriuria is considered significant if two consecutive voided urine specimens grow >105 cfu/mL of the same bacterial species on quantitative culture; or a single catheterised specimen grows >105 cfu/mL of a uropathogen.
Pregnant women should be screened for bacteriuria during the first trimester. Asymptomatic bacteriuria detected in pregnancy should be eradicated with antimicrobial therapy, with a standard short course. Trimethoprim is a dihydrofolate reductase inhibitor preventing DNA replication. Sulfamethoxazole inhibits bacterial use of para-aminobenzoic acid (PABA) for synthesis of folic acid, needed in DNA synthesis.
In patients with renal transplant all are true, EXCEPT:
After the kidney is removed from its storage box, the effluent from the renal vein and surrounding fluid in the sterile plastic bags that contain the excised kidney should ideally be cultured because microorganisms are likely to have been introduced during the donation process. Six months low-dose co-trimoxazole is recommended in renal transplant patients to prevent UTI.
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