Snapshot A 25-year-old, G1P0, woman who is 14 weeks pregnant presents to her obstetrician for routine prenatal screening. She reports feeling well except for mild nausea. She denies any dysuria, urinary frequency, or abnormal bleeding from the vagina or seen in the urine. A clean catch mid-stream urine sample is collected for urine culture. Urine culture reveals bacteriuria of ≥ 105 cfu/mL. She is started on oral nitrofurantoin for 5 days. (Asymptomatic bacteriuria in pregnancy) Introduction Clinical definition login to view 12 more bullets Epidemiology Incidence login to view 2 more bullets Demographics login to view 1 more bullet Location login to view 3 more bullets Risk factors login to view 28 more bullets ETIOLOGY Pathogenesis login to view 12 more bullets Classification It is important to distinguish between uncomplicated and complicated UTI login to view 4 more bullets Microbiology of Urinary Tract Infections Microbe Findings Comments E. coli Green metallic sheen on EMB agar Most common cause of UTI S. saprophyticus Second most common cause in sexually active women K. pneumoniae Large mucoid capsule and viscous colonies Third most common cause S. marcescens Red pigment production by select strains Third most common cause Enterococcus Typically a nosocomial infection that is drug-resistant P. mirabilis - "Swarming" appearance on agar - Urease positive - Can result in struvite stone formation P. aeruginosa Blue-green pigment Typically a nosocomial infection that is drug-resistant Presentation Symptoms/physical exam/findings login to view 24 more bullets Imaging Ultrasound login to view 7 more bullets Voiding cystourethrogram login to view 5 more bullets Studies Labs login to view 17 more bullets Histology login to view 2 more bullets Differential Acute hemorrhagic cystitis login to view 1 more bullet Urethritis Nephrolithiasis Genitourinary malignancy Treatment Medical login to view 19 more bullets Operative login to view 7 more bullets Complications Uncomplicated UTI login to view 1 more bullet Complicated UTI login to view 10 more bullets UTI in pregnancy login to view 6 more bullets UTI in men login to view 4 more bullets Prognosis ASB in elderly or catheterized patients does not increase the risk of death Recurrent UTI in children and adults does not result in chronic pyelonephritis or renal failure login to view 1 more bullet