CPRS 85: Urinary Tract Infection

Question 1

Which gender has the higher prevalence of Urinary Tract Infection?

Answer 1

Female

Question 2

Male has rare Urinary Tract Infection Prevalence until obstruction from _______

Answer 2

Benign Prostate Hyperplasia

Question 3

What is the most common type of Hospital Acquired Infections

Answer 3

Urinary Tract Infection

Question 4

Name 2 pathogens for UTI

Answer 4

Escherichia coli

Proteus mirabilis

Question 5

Name 3 virulence factors for E. coli

Answer 5

Type I & P Fimbriae
Toxins
Lipopolysaccharide capsular polysaccharides

Question 6

What factors will make people more prone to UTI in terms of bacterial entry?

• length
• immunocompromised
• Hormonal effect

Answer 6

Length of Urethra (shorter = easier infection)
Immunocompromised = Easier infection
Hormonal Effect: Post-menopausal woman has higher chance of infection, as oestrogen and progesterone are important in maintenance of healthy urothelium and mucosa

Question 7

What factors will make people more prone to UTI in terms of bacterial spread?

• R
• P
• O
• I

Answer 7

Reflux
Pregnancy
Obstruction from stones (Much harder for urine to flow)
Immunocompromised

Question 8

How does urease lead to stone formation

Urea becomes _____ by _____
Raises the ____ of urine
Facilitates ________
Reduces ______ and increases chance of UTI

Answer 8

Urea becomes ammonia by urease
Raises the pH of urine
Facilitates precipitation
Reduces urine flow and increases chance of UTI

Question 9

Host defense of UTI
Name 3

• ______ of urine
• ______ immunity
• ______ immunity

Answer 9

Flushing effect of urine
Humoral immunity
Cell mediated immunity

Question 10

Uncomplicated UTI VS Complicated UTI

• What type of Urinary Tract do they infect?
• What type of people are involved?

Answer 10

Uncomplicated UTI VS Complicated UTI

• What type of Urinary Tract do they infect- Normal Urinary Tract VS Compromised Urinary Tract
• What type of people are involved- Non pregnant healthy women VS Infection in men/ pregnant women

Question 11

Name 5 syndromes of UTI

1. Asymptomatic bacteriuria
2. ________ (Inflammation of the kidney)
3. ________ (Inflammation of prostate gland)
4. ________ (Inflammation of urinary bladder)
5. ________ abscess, common in which type of disease?

Answer 11

Name 5 syndromes of UTI

1. Asymptomatic bacteriuria
2. Acute pyelonephritis (Inflammation of the kidney)
3. Prostatitis (Inflammation of prostate gland)
4. Cystitis (Inflammation of urinary bladder)
5. Perinephric abscess- common in Diabetes Mellitus

Question 12

Relapse and reinfection

What is the difference

Answer 12

Relapse VS Reinfection

Infection by the same bacterial strain VS Infection by a different organism

Question 13

What are the 2 microbiological diagnosis of UTI?

Answer 13

Pyuria- Sample of Urine under Microscope showing increased WBCs in urine

Significant bacteriuria

Question 14

Urine dipstick test for UTI

What 2 things will there be an increased level?

Answer 14

Nitrite

Leukocyte Esterase

Question 15

In Urine Dipstick test for UTI, there will be an increased level of Nitrite and Leukocyte Esterase. Why will there be increased nitrite?

Answer 15

E. Coli and Proteus mirabilis reduces nitrate in urine to nitrite

Question 16

What is the limitation of using nitrite level increase as the indicator of UTI

Answer 16

Some bacteria may not have the enzyme to reduce nitrate to nitrite

Urine may not be staying in the bladder for long enough

Question 17

How to detect bacteriuria
Use a standard loop
Culture urine on _____ agar that inhibits ______
What bacterial counts are higher than the specific number that will indicate bacteriuria

Answer 17

How to detect bacteriuria
Use a standard loop
Culture urine on CLED agar that inhibits swarming
What bacterial counts are higher than the specific number: 10^5 that will indicate bacteriuria

Question 18

During urine collection, we should avoid cleaning the area with _______ because it may cause contamination of the urine which leads to _______ results

Answer 18

During urine collection, we should avoid cleaning the area with antiseptic because it may cause contamination of the urine which leads to false negative results

Question 19

When does Asymptomatic Bacteriuria require Treatment? Name 3 scenarios

• P… women
• Before…
• C…

Answer 19

• Pregnant women
• Before urological operation
• Children smaller than 5 years of age

Question 20

Acute Bacterial Prostatitis
Name 3 clinical presentations
- D
- H F
- Urinary...

Answer 20

Dysuria
High fever
Urinary retention common

Question 21

What are the 3 risk factors for Acute Bacterial Prostatitis

Answer 21

Unprotected anal intercourse
Indwelling urinary catheter use
Prostate biopsy

Question 22

Name 2 Pathogens for Chronic Bacterial Prostatitis

Answer 22

E. coli

Pseudomonas aeruginosa

Question 23

Urine collection method (4 cups)

VB1
VB2
\_\_\_\_\_\_\_ for 1 minute
EPS
VB3

Answer 23

Urine collection method (4 cups)

VB1: 1st voided 10mL (discarded)
VB2: Midstream from urinary bladder
Prostate massage for 1 minute
EPS: Prostatic secretion
VB3: 1st voided 10mL after massage

Question 24

Urine collection method (2 cups)

Answer 24

VB1: 1st voided 10mL (pre-massage)
Prostatic massage
Pro-massage collection