urine cultures should be obtained for which of the following patients course hero

Urine cultures are positive in 90 percent of patients with acute pyelonephritis, and cultures should be obtained before antibiotic therapy is initiated. The use of blood cultures should be reserved for patients with an uncertain diagnosis, those who are immunocompromised, and those who are suspected of having hematogenous infections.

Full Answer

When are urine cultures indicated in the treatment of pyelonephritis (kidney infection)?

All tutors are evaluated by Course Hero as an expert in their subject area. The correct option is A. (Suspected urinary tract infection in pregnancy) Step-by-step explanation Urine Culture should be obtained from the patient when there is a suspect of any Urinary Tract Infection and from the person who is at a high risk for pyelonephritis.

How often should a urine culture be repeated after antibiotic treatment?

The following groups of patients should have urine cultures obtained when bacteriuria is present: All men (because of the likelihood of structural or functional abnormalities). All children Women with a history of compromised immune function or renal problems Patients with diabetes Patients who have undergone recent instrumentation (including catheterization) of urinary tract. …

Do infection control programmes reduce hospital-acquired urinary tract infections (UTIs)?

Nov 11, 2017 · Urine cultures should be obtained for which of the following patients? a. All of the above (suspected urinary tract infection in pregnancy, febrile patients, young men) All of the above is correct. Urine culture is a test to detect any bacteria found in the urine and to diagnose Urinary Tract Infection. UTIs are common in pregnant women.

What is the microbial spectrum associated with urinary tract infections (UTIs)?

Katzen, RN 7/9/19 PEDIATRIC CONSIDERATIONS Urine culture results from specimens collected in a bag applied to the perineum frequently have false positive results; only negative results should be considered valid in this case. 1 If a child is 2 to 24 months of age, is febrile with no apparent source of the fever, and requires antibiotics, urine specimens for culture and …

Is delirium a UTI?

Bacteriuria and delirium are both independently common in the elderly. Although patients with a symptomatic UTI may present with delirium, no evidence suggests that delirium, falls, or confusion are symptoms of a UTI in the absence of urinary symptoms.

Does urine cloudy indicate UTI?

Foul-smelling or cloudy urine does not indicate a UTI. Mental status changes alone do not indicate a UTI. Pyuria can be seen in patients with a UTI but is not diagnostic of a UTI in the absence of urinary symptoms. Asymptomatic Bacteriuria, Continued . Population.

Can bacteriuria be treated with antibiotics?

Uncomplicated cystitis should be treated with a short course of an oral antibiotic. UTIs in men are rare in the absence of urinary tract pathology.

How long after antibiotics should you repeat a urine culture?

Urine culture should be repeated one to two weeks after completion of antibiotic therapy. Treatment failure may be caused by resistant organisms, underlying anatomic/functional abnormalities, or immunosuppressed states. Lack of response should prompt repeat blood and urine cultures and, possibly, imaging studies.

How many patients have positive blood cultures?

Blood cultures have been recommended for hospitalized patients; up to 20 percent of these patients have positive cultures. 1 In two studies, 24, 25 however, completion of blood cultures did not result in changes in management strategies in patients with acute pyelonephritis.

How long does it take for a UTI to respond to antibiotics?

Men younger than 60 years without obstruction, renal abnormalities, or prostatitis respond well to 14 days of antibiotic therapy. 2 Men who have recurrent UTIs require a six-week regimen.

What is the best antibiotic for pyelonephritis?

Outpatient oral antibiotic therapy with a fluoroquinolone is successful in most patients with mild uncomplicated pyelonephritis. Other effective alternatives include extended-spectrum penicillins, amoxicillin-clavulanate potassium, cephalosporins, and trimethoprim-sulfamethoxazole.

What is the CFU of pyelonephritis?

The consensus definition of pyelonephritis established by the Infectious Diseases Society of America (IDSA) is a urine culture showing at least 10,000 colony-forming units (CFU) per mm 3 and symptoms compatible with the diagnosis. 13 Lower counts (1,000 to 9,999 CFU per mm 3) are of concern in men and pregnant women. Urine specimens generally are obtained by a midstream clean-catch technique, and one study 14 showed that cleansing does not decrease contamination rates in adults.

Can pyelonephritis cause renal failure?

Acute pyelonephritis is considered uncomplicated if the infection is caused by a typical pathogen in an immunocompetent patient who has normal urinary tract anatomy and renal function. Misdiagnosis can lead to sepsis, renal abscesses, and chronic pyelonephritis that may cause secondary hypertension and renal failure.

Can staphylococcus pyelonephritis spread to kidneys?

Metastatic staphylococcal or fungal infections may spread to the kidney from distant foci in the bone or skin. In more than 80 percent of cases of acute pyelonephritis, the etiologic agent is Escherichia coli. 7 Other etiologic causes include aerobic gram-negative bacteria, Staphylococcus saprophyticus, and enterococci.

How long does ciprofloxacin last?

Fluoroquinolones (e.g., ciprofloxacin for 7 days or levofloxacin [Levaquin] for 5 days) and trimethoprim/sulfamethoxazole for 14 days are appropriate first-line oral antibiotic therapies for uncomplicated acute pyelonephritis in women when the causative organism is susceptible. 7, 30. A.

What antibiotics should be given to patients with sepsis?

Patients admitted to the hospital should receive parenteral antibiotic therapy, and those with sepsis or risk of infection with a multidrug-resistant organism should receive antibiotics with activity against extended-spectrum beta-lactamase–producing organisms.

What antibiotics are used to treat Escherichia coli?

In locations where Escherichia coli resistance to empiric oral therapy is likely greater than 10%, an initial broad-spectrum, long-acting parenteral antibiotic such as ceftriaxone, ertapenem (Invanz), or an aminoglycoside should be given concurrently. 7.

How is choice of antibiotic informed?

Choice of antibiotic is informed by the clinical presentation, the patient's individual risk factors, and local resistance patterns. Therapy should be directed by urine culture susceptibility testing when available. 7

Is pyelonephritis an outpatient?

Outpatient management is appropriate in patients with uncomplicated pyelonephritis who are able to tolerate oral antibiotics and do not have clinical signs of sepsis. Indications for hospitalization are listed in Table 3. 8, 9

How many hospital admissions are there for acute pyelonephritis?

Acute pyelonephritis, a serious and relatively common bacterial infection of the kidney and renal pelvis, accounts for approximately 250,000 office visits and 200,000 hospital admissions annually in the United States. 1 – 3.

When to use contrast enhanced computed tomography?

Contrast-enhanced computed tomography of the abdomen and pelvis is indicated in septic patients, when urinary obstruction is suspected, or when patients do not respond to appropriate therapy within 48 to 72 hours. 23. C.