Microbio Flashcards
Which urine sample is collected in people with UTI?
washout the 1st part distal end of urethra and the middle part collected
In whom should dipstick not be done?
older patients and catheterised patients
Which urine sample is collected in those with genital infections?
the 1st bit
biggest cause of UTI?
bacillus –> ECOLI (lactose fermenters0
What are the other coliform lactose fermenters that cause UTI?
E.coli Klebsiella sp. Serratia ap. Proteus Citrobacter sp.
is pseudomonas a coliform?
No
What makes E.coli the biggest cause of UTI?
Endotoxin
Fibriae - helps it stay on and go up the UTI
Another common
Proteus
Which individuals have a higher chances of getting a proteus infection?
Big stones - staghorm calculi
produces ammonia and precipitates salt in the urinary tract
Smell of proteus plate
burnt chocolate –> produces ammonia and precipitates salt s in the urinary tract
Features of Pseudomonas aeruginosa
Gram negative bacillus
NOT COLIFORM
ONly quinolone
How do quinolones work on
prevents supercoiling of the bacterial DNA
Side effects of ciprofloxacin
reduces seizure threshold
Gram positive organisms which cause UTI
Enterococcus spp.
Enterococcus faecalis
Entercoccus faecium
S. aureus
Most common g. positive
Enterococcus faecalis
Who are the individuals who gets enterococcus faecalis?
hospital associated
UTI in women of child-bearing age caused by>
Staphylococcus saphrophyticus
Symptoms and signs of UTI
dysuria (pain passing urine)
frequency of urination
nocturia
haematuria
fever }
loin pain } suggest involvement of
rigors } upper urinary tract
What should be considered if someone has fever, loin pain and rigors associated with UTI?
Upper tract UTI
Best Specimen collection in UTI
midstream specimen of urine
Staph aureus in UTI
not common
bacteriaemia
Where does the balloon of the catheter sit?
neck of the baldder
Which container is used if the time to orevent bacterial multiplication esp in places where it can’t reach the lab within 2 hours of collection?
Boricon container -
is CSU useful?
not much unless there is UTI
Dipstick urine testing used only in which patients?
Younger patients who might have cyctitis
When is microscopy of urine done?
specific renal manifestations –> casts
rarely upfront, if done after culture
causes of mixed culture sample results
poor sample, or semi-treated infection
What is a significant result in a culture?
> 10 raised to 5/ ml
What are the ideal antibiotics in uncomplicated lower UTI?
Ideal antibiotic should be: excreted in urine in high concentration oral inexpensive few side effects
How many days should individuals with UTI be treated for?
3 days
Abacterial urethral syndrome
early phase of UTI
urethral trauma - honeymoon cystitis
urethritis due to clamydia or gonorrhoea
When is abacterial bacteriuria treated?
PREGNANT WOMEN
even if they are asymptomatic
When should catheterised patients be given antibiotics?
only if they have symptoms that are consistent with catheter
higher rates of antibiotic resistance
which antibiotic for Female lower UTI?
Nitrofurantoin or trimethoprim orally (3 days)
Which antibiotic for Uncatheterised male UTI?
(get cultures !!)
nitrofurantoin or trimethoprim orally (7 days)
Which drugs are needed for Complicated UTI or pyelonephritis (GP)?
Co-amoxiclav or co-trimoxazole (14 days)
Which drug for Complicated UTI or pyelonephritis (Hospital)?
Amoxicillin(40% of our g.negatives are resistant for it) and gentamicin (for all g.negative) IV for 3 days
(cotrimoxazole and gentamicin if penicillin allergy), stepdown as guided by antibiotic sensitivities
Not useful mostly
co-trimoxazole
Which drugs for ESBLS?
pivmecillinam (oral)
temocillin (IV)
cefalexin (oral)
co-amoxiclav = amoxicillin + clavulanic acid (IV, oral)
ciprofloxacin (IV, oral)
When should blood be checked for gentamicin after it’s admin?
6-14 hrs later to make sure gentamicin is completely removed from the blood
Why is the blood checked after gentamicin?
to check for nephrotoxicity
How should gentamicin be administered?
IV
Gentamicin contraindication
Pregnancy
What is the dosing for gentamicin?
7 mg/kg
