MICRO Urine

Question 1

Describe MSU specimen type

Answer 1

• midstream urine, “clean catch”
• collected first thing in the morning
• received in laboratory within 2 hours of collection OR <24 hours if refrigerated

Question 2

Where are transient organisms found in the female urinary tract ?

Answer 2

lower end of female urinary tract
- near skin

Question 3

__, __, and __ of the normal individual are bacteria free

Answer 3

KIDNEYS, URETERS, and BLADDER of the normal individual are bacteria free

Question 4

Why are suprapubic needle aspirates a useful specimen type ?

Answer 4

• urine collection from babies (cannot pee on command)
• only technique used for suspected anaerobic infections

Question 5

Why are suprapubic needle aspirates a useful specimen type ?

Answer 5

• urine collection from babies
• only technique used for suspected anaerobic infections

Question 6

Common pathogens of the urinary tract

Answer 6

• Enterobacteriaceae
• β hem Strep (A and B)
• S. saprophyticus
• S. aureus
• P. aeruginosa (+ other non-fermentative bacilli)
• Enterococcus sp.

Question 7

Contaminating flora in the urinary tract

Answer 7

• Non-hem Streptococcus
• CNS
• Viridans group Streptococcus
• Diphtheroids
• Lactobacillus sp.

Question 8

Clinical significance of Enterobacteriaceae in urine

Answer 8

UTIs

Question 9

Clinical significance of S. pyogenes in urine

Answer 9

UTI

Question 10

Clinical significance of S. agalactiae in urine of pregnant mother

Answer 10

• potential neonatal infection
• mom = carrier

Question 11

Clinical significance of S. saprophyticus in urine

Answer 11

UTI infection in YOUNG WOMEN

Question 12

Tests to confirm Enterococcus faecalis

Answer 12

PATHOGEN:

cat wk+/-
PYR +
BEA +
NaCl +

Question 13

Test & results to differentiate group A from group B strep

Answer 13

S. pyo is PYR +
Latex grouping A vs B
S. pyo is CAMP -
Taxos A = S
Hippurate = neg

NOTE:
- “P” for “PYR Pos”
- “pyogenes” has no c = CAMP neg
- strep throat is readily susceptible to antibiotics
- is not “hip” with pregnant moms

Question 14

Which of the following mechanisms protect the lower urinary tract from infection?

Select all that apply:

a.
Low urine pH

b.
High urine osmolarity

c.
Flushing action from urination

d.
High urine normal flora counts

Answer 14

Which of the following mechanisms protect the lower urinary tract from infection?

a.
Low urine pH

b.
High urine osmolarity

c.
Flushing action from urination

Question 15

Which of the following antimicrobials is only used for UTIs?

a.
Penicillin G

b.
Amphotericin

c.
Sulfamethoxazole

d.
Nitrofurantoin

Answer 15

d.
Nitrofurantoin

Question 16

Which of the following organisms match an A/A TSI?

Select all that apply:

a.
Morganella morganii

b.
Enterobacter cloacae

c.
Klebsiella pneumoniae

d.
Proteus mirabilis

Answer 16

Which of the following organisms match an A/A TSI?

b.
Enterobacter cloacae

c.
Klebsiella pneumoniae

NOTE: LACTOSE/ SUCROSE FERMENTERS

Question 17

Which of the following reagents is used for a test that has a green reaction with a positive organism?

a.
Ferric chloride

b.
Kovac’s reagent

c.
Para-dimethylaminocinnameldahyde

d.
Tetramethyl-p-phenylenediamine dihydrochloride

Answer 17

a.
Ferric chloride

Question 18

Which of the following descriptions best fit a “typical” strain of Escherichia coli?

a.
Motile, anaerogenic, non-lactose fermenting, indole positive

b.
Motile, aerogenic, lactose fermenting, indole positive

c.
Motile, aerogenic, non-lactose fermenting, citrate negative

d.
Non-motile, aerogenic, lactose fermenting mucoid colony

Answer 18

b.
Motile, aerogenic, lactose fermenting, indole positive

Question 19

Which organism is the most common cause of urinary tract infections?

a.
Streptococcus bovis

b.
Escherichia coli

c.
Enterococcus faecalis

d.
Staphylococcus saprophyticus

Answer 19

b.
Escherichia coli

Question 20

Which of the following urine specimens is acceptable for bacterial culture?

a.
Unpreserved midstream urine at 4°C for 12 hours

b.
Midstream urine with SAF at 22°C for 2 hours

c.
24 hour urine at 4°C for 12 hours

d.
Collection bag urine at 22°C for 2 hours

Answer 20

a.
Unpreserved midstream urine at 4°C for 12 hours

Question 21

List 3 antibiotics routinely used for UTIs

Answer 21

1. Fosfomycin
2. Nitrofurantoin
3. Sulfamethoxazole-trimethoprim