E3- UTIs Flashcards

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1
Q

How are UTIs dx?

A
  • Gram stain
  • Culture (EMB/CLED)
  • UA
  • Prostate exam
  • +/- imagaing
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2
Q

What type of culture media is selective for gram negative organisms?

A

EMB

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3
Q

What type of culture media is not selective for either gram positive or gram negative, but is used to determine the organisms ability to ferment lactose?

A

CLED

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4
Q

What type of culture medias should be used to dx UTIs?

A

EMB/CLED

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5
Q

What findings on UA microscopy are consistent with a UTI?

A

> 2 WBC or 15 bacteria

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6
Q

Who might require imaging to dx a UTI?

A
  • Children
  • Adults with recurrent infections
  • Pts with blood in their urine
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7
Q

What are the 7 causative agents of UTIs?

A
  • E. coili
  • Klebsiella spp
  • Proteus spp
  • Enterococcus spp
  • Staphylococcus saprophyticus
  • Streptococcus agalactiae
  • Pseudomonas aeruginosa
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8
Q

What are the gram negative causative agents of UTIs?

A

-E. coili
-Klebsiella spp
-Proteus spp
-Pseudomonas aeruginosa
“Every Kid Pees Pants”

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9
Q

What are the gram positive causative agents of UTIs?

A

-Enterococcus spp
-Staphylococcus saprophyticus
-Streptococcus agalactiae (GBS)
“Especially Slutty Girls”

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10
Q

What is the most common cause of UTIs?

A

E. coli

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11
Q

Is E. coli gram positive or gram negative? What shape?

A

Gram negative bacillus

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12
Q

What stain of E. coli causes UTIs?

A

UPEC strains

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13
Q

What is the lifecycle of E. coli?

A
  • Access urinary tract following introduction of fecal contamination
  • Use P fimbriae and Dr adhesions to bind to uroepithelial cells and erythrocytes
  • Produce alpha and beta hemolysins
  • Result in lysis of the uroepithelial cells and erythrocytes
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14
Q

UPEC have the ability to produce what?

A

K (capsular) antigen

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15
Q

Is Proteus gram positive or negative? What shape?

A

Gram negative bacillus

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16
Q

What species of Proteus is commonly community acquired?

A

Proteus mirabilis

17
Q

What species of Proteus predominantly infects immunocompromised patients?

A

Proteus vulgaris

18
Q

What is seen on agar with Proteus infections?

A

“Swarming” (except on CLED agar)

19
Q

What structure do Proteus have that promote the attachment of bacteria to uroepithelial cells?

A

Fimbriae

20
Q

What does Proteus produce that makes the urine more alkaline? How?

A

Urease

Hydrolyzes urea to ammonia

21
Q

What can the increased pH caused by Proteus lead to?

A

Struvite stones

22
Q

Is Straphlococcus saprophyticus gram positive/negative? What shape?

A

Gram positive cocci

23
Q

Is Straphlococcus saprophyticus coagulase positive/negative?

A

Coagulase negative

24
Q

What organism is associated with “honeymoon cystitis”

A

Straphlococcus saprophyticus

25
Q

When do most cases Straphlococcus saprophyticus occur?

A

24 hours after sex

“honeymoon cystitis”

26
Q

How can you differentiate Straphlococcus saprophyticus from other coagulase negative staphs?

A

Based on its novobiocin resistance

27
Q

Is Streptococcus agalactiae gram positive/negative? What shape?

A

Gram positive cocci

28
Q

What is seen on culture with Streptococcus agalactiae?

A

Gray/white colonies with narrow zone of beta-hemolysis

29
Q

How do neonates get a Streptococcus agalactiae UTI?

A

Streptococcus agalactiae colonies the vaginia and can be passed during delivery

30
Q

What are the virulence factors of Streptococcus agalactiae? (4)

A
  • Capsular polysaccharide
  • Hyaluronidase
  • Collagenase
  • Hemolysin
31
Q

How is Streptococcus agalactiae dx?

A
  • Detection of CAMP factor

- Definitive dx requires isolation from urine, blood, or CSF