B5-080 Renal Infections Flashcards by Felicia Jones

gradual onset of internal dysuria
sexually active patient with new partner
no hematuria

clamydia

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UTI in men, pregnant women, and children is usually considered

complicated

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causes 80% of UTIs

E. coli (UPEC)

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2nd most common UTI in sexually active young women

Staph. sapro

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causes renal and urinary stones

proteus mirabilis

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UTI pathogen associated with catheterized patients

klebsiella pneumoniae

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UTI pathogens associated with immunocompromised patients

enterobacter
enterococcus faecalis

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cause renal stones, chronic prostatitis, and more common in catherized patients

pseudomonas aeruginosa

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gram negative bacilli, lactose fermentors

E coli
Klebsiella
Enterobacter

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gram negative bacilli, lactose negative, glucose fermentor

1 that we talked about

proteus

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gram negative bacilli, does not ferment glucose

1 that we talked about

pseudomonas

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gram positive cocci
clusters
catalase +

staphylococcus

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common culture contaminants

lactobacilli
a-hemolytic strep

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nitrate production on dipstick indicates

gram negative bacteria

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greater than 10 WBC/hpf

pyuria

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greater than 100,000/hpf is diagnostic of

bacterial infection

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treatment for uncomplicated UTI

nitrofuratoin or Bactrim

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treatment of complicated UTI

1-2 weeks of oral antibiotic and possibly..
IV initial dose of ceftriaxone, aminoglycoside or fluroquinolone

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epididymitits, acute/chronic prostitis should be treated for […] weeks

3-12

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why is designing a vaccine for UTI based on pilli very difficult?

pili undergo phase variation in response to environment

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FimH binds to

uroplakins (glycoproteins)

adhesin and invasin

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exfoliation of infected cells is largely triggered by

LPS

innate immune response

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critical for clearance of bacteria
presence in urine is a hallmark of UTI

neutrophils

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what populations should be treated for asymptomatic bacteriuria?

pregnant women
before GU procedure
renal transplant patients for first 6 months

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prevention of EPEC UTI

* hydration * voiding after SI

DOC for EPEC UTI

* nitrofurantoin or bactrim * fosfomycin

does cranberry juice help prevent UTIs?

does D-mannose help prevent UTIs?

yes, some evidence preventing recurrent UTIs | novel treatment: D-mannose antagonists

aerobactin conjugated to cationized BSA

siderophore vaccine protect mice against EPEC, but no antibodies | novel vaccine treatment

gram + coagulase - novobiocin resistant

S. sapro

adhere to UT epithelium via hemagglutinin

S. sapro

DOC S. sapro

bactrim, b lactams

gram - lactose - urease +

proteus mirabilis

"swarming motility" on agar

proteus mirabilis | plate looks kind of like a target

treatment of proteus, enterobacter, pseudomonas, and enterococcus requires

antibiotic sensitivity testing

gram - lactose + non- motile prominent capsule

klebsiella pneumoniae

forms large mucoid colonies

klebsiella pneumoniae

gram - motile capsule moist colonies

enterobacter

DOC klebsiella

aminoglycoside + b lactam

gram - rod oxidase + non-fermenter fruity odor blue-green pigment

pseudomonas

DOC for pseudomonas

piperacillin, ticarcillin | **MDR: need sensitivity testing**

gram + variable hemolysis salt-tolerant (6.5% NaCl)

enterococcus faecalis

due to displacement of normal vaginal flora

bacterial vaginosis

fishy odor of discharge whiff test clue cells

DOC for BV

metronidazole

free living spirochetes

leptospira

rodents, dogs, and farm animals can carry [...] asymptomatically in kidneys

leptospria | occupation exposures

cause meningitis, hepatitis, nephritis, hemorrhage | damage of small vessels

leptospira

* cases spike in warmer months * can be spread through contaminated water

lepto

gold standard for diagnosis of lepto

aggultination test | novel: IgM assay

DOC leptospirosis

IV penicillin | doxy can be preventative

causative pathogen of acute bacterial prostitis in >35 year olds

enterobacteriacea | less than 35: bacterial STDs

what antibiotics should be avoided in the treatment of asymptomatic bacteriuria in pregnancy?

* fluoroquinolones * sulfa drugs in 3rd trimester

most important treatment in CAUTI

remove catheter

a urine sample that contains leukocytes and bacteria that are not cultivable using standard urinary tract culture media

sterile pyuria

the presence of enzyme leukesterase indicates

pyuria

presence of nitrates indicates

gram- bacteria

is nitrofurantoin ok in pregnancy?

yes until 36 weeks

are cultures diagnositic of BV?

no | Whiff test and clue cells

what is used to diagnose BV?

* Whiff test * clue cells

urease positive bacteria that raise pH of urine | 2

* klebsiella * proteus

supplemental D-mannose is thought to disrupt

adhesion via pili

anti-LPS antibodies can be used to serotype

leptospira

top two infectious agent in uncomplicated UTIs in sexually active young women

E coli S sapro