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Unit 3 Microbio > L18: UTI > Flashcards

L18: UTI Flashcards

1
Q

3 things that are a UTI

A

Pyelonephritis (kidneys and ureters)
Urethritis
Cystitis

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2
Q

In whom are UTIs most common?

A

Female adults

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3
Q

What causes UTIs in children?

A

Poor hygiene

Partial blockage

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4
Q

Signs of upper UTI (pyelonephritis)

A

HIGHER FEVER >101 F
Flank pain
Shaking, chills
N/V

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5
Q

Signs of UTI in a newborn

A

Fever or hypothermia
Poor feeding
Jaundice

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6
Q

Signs of UTI in an infant

A

V/D

Poor feeding

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7
Q

Signs of UTI in children

A 
Irritability
Eating poorly
*Unexplained fever*
Loss of bowel control/loose stools
Change in urination patterns
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8
Q

URI-cult CLED/EMB

A

paddles used to make a presumptive identification of the pathogen

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9
Q

EMB

A

contains bile salts that kill G+

Selective for G-

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10
Q

CLED

A

allows growth of both G+ and G-

determines ability to ferment lactose

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11
Q

Hallmark UTI pathogens

A

are G- and ferment lactose

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12
Q

Why are CFU used in diagnosis of UTI?

A

Many of the pathogens are normal flora, so we need a threshold to indicate overgrowth/infection

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13
Q

Who usually gets urine cultures?

A

Men and children

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14
Q

A positive urine culture is

A

5 x 10^4 CFU

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15
Q

A positive urine microscopy is

A

2-5+ WBCs
15 bacteria
per high powered field in centrifuged urine sample

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16
Q

What else to do for a UTI in men?

A

prostate exam

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17
Q

Who gets imaging (US/CT/fluoroscope)?

A

Children
Adults with recurrent infections
Blood in urine

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18
Q

Why do we image children?

A

50% of infants with UTI have an anatomic abnormality

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19
Q

Most common causative agent of UTI

A

E Coli

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20
Q

How do you get a candida UTI?

A

catheterization

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21
Q

What can an adenovirus UTI cause? (rare causative agent)

A

Hemorrhagic cystitis

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22
Q

E coli morphology

A

G-

Flagellated

23
Q

E coli associated with meningitis

A

Encapsulated K1 stains

24
Q

Why would you get meningitis from E coli?

A

It’s rare: following neurosurgical trauma

25
Q

Which E coli strain causes UTIs?

A

UPEC: Uropathogenic E coli

26
Q

UPEC virulence factors

A

P fimbriae (Pili)
Dr adhesions
alpha and beta hemolysins
+- K (capsular) antigen (biofilms)

27
Q

Dr adhesions

A

UPEC
binds to uroepithelial cells and erythrocytes.
form complex structures surrounding bacteria

28
Q

Why does UPEC cause blood in urine?

A

alpha and beta hemolysins

29
Q

when are UPEC more likely to produce K (capsular) antigen?

A

Upper UTI
Chronic UTI
Cause biofilms

30
Q

2 Proteus species

A

P mirabilis

P vulgaris

31
Q

Proteus which infects the immunocompromised

A

Proteus vulgaris

32
Q

Proteus which is community acquired

A

Proteus mirabilis

33
Q

“Swarming” on agar

A

proteus species

34
Q

when don’t proteus swarm

A

CLED test inhibits it so you can actually count colonies

35
Q

Proteus usually are found in

A 
normal flora (intestin)
long term care facilities hospitals
36
Q

Proteus virulence factors

A

fimbriae promote attachment to uroepithelial cells

induce apoptosis

37
Q

If proteus spreads

A

sepsis

38
Q

Urease

A

proteus

makes urine alkaline by hydrolyzing urea to ammonia

39
Q

Increased pH, as caused by urease from proteus

A

formation of struvite stones (magnesium ammonium phosphate)

40
Q

proteus gram stain

A

G-

41
Q

Staph saprophyticus characteristics

A 
G+
Coagulase negative
Novobiocin resistant 
Lactosamine (adhesin) 
Not that virulent, normal flora,
42
Q

Second leading cause of UTI

A

Staph saprophyticus

43
Q

Staph saprophyticus usually infects

A

Female 17-27, sexually active

44
Q

Honeymoon cystitis

A

Staph saprophyticus

45
Q

Why is Staph saprophyticus difficult to diagnose?

A

Low bacterial numbers, less than 10^5

46
Q

No exotoxins

A

Staph saprophyticus

47
Q

Group B strep (GBS) aka

A

Strep agalactiae

48
Q

Gray-white colonies with a narrow zone of beta hemolysis

A

Strep agalactiae (group B strep)

49
Q

where is Strep agalactiae (group B strep) normally found?

A

Vagina
GI tract
Upper respiratory tract
Makes prevention difficult

50
Q

If a mother has Strep agalactiae (group B strep) colonizaiton of her vagina, will her neonate get it?

A

50% will

but only 1-2% actually get infected

51
Q

So who gets Strep agalactiae (group B strep)

A

Immunodeficient

52
Q

Strep agalactiae (group B strep) virulence factors

A

Capsular polysaccharide
Hyaluronidase
Collaginase
Hemolysin

53
Q

CAMP factor

A

test for Strep agalactiae (group B strep)

Accentuation of hemolysis due to interaction with staph beta-lysin (s aureus?)

54
Q

Presumptive tests for diagnosis of Strep agalactiae (group B strep)

A

DNA probe

group CHO identification is insensitive

Unit 3 Microbio (13 decks)

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