Microbiology

Question 1

what is a UTI?

Answer 1

the presence of pathogens in the urinary tract

Question 2

what are the two main types of UTI?

Answer 2

upper and lower

Question 3

what is a complicated UTI?

Answer 3

one complicated by either systemic symptoms or urinary structural abnormalities/stones

Question 4

what is bacteriuria?

Answer 4

bacteria in the urine

Question 5

in what situations can bacteriuria often not mean infection?

Answer 5

elderly patients

catheter use

Question 6

what is cystitis?

Answer 6

inflammation of the bladder - not always due to infection

Question 7

what is the microbiological state of normal urine?

Answer 7

sterile

Question 8

what bacteria is found at the lower end of the urethra?

Answer 8

commensals from the large bowel

coliforms, enterococci

Question 9

which sex is more commonly affected by UTI’s and why?

Answer 9

women

have a short, wide urethra that is close to the anus

Question 10

what are the two routes of infection in a UTI?

Answer 10

ascending - moves up the urethra

haematogenous

Question 11

what is the most common causative pathogen of a UTI?

Answer 11

e coli

Question 12

name three gram negative causative organisms of UTI

Answer 12

coliforms
proteus
pseudomonas aeruginosa

Question 13

what are coliforms?

Answer 13

gram negative bacilli

Question 14

name a coliform

Answer 14

e coli

Question 15

what is a common complication of proteus sp UTI?

Answer 15

struvite stones

Question 16

what is produced by proteus sp and what effect does this have in UTIs?

Answer 16

produces urease

breaks down urea to ammonia = increased urinary pH

Question 17

what type of bacteria is pseudomonas aeruginoas?

Answer 17

gram negative bacillus

Question 18

what is pseudomonas UTI associated with?

Answer 18

catheters

immunosuppression

Question 19

what antibiotic can be used to manage UTI due to pseudomonas aeruginosa?

Answer 19

ciprofloxacin

Question 20

how can ciprofloxacin be administered?

Answer 20

oral or IV

Question 21

who should not receive ciprofloxacin?

Answer 21

young children

pregnant women

Question 22

what is the mechanism of action of ciprofloxacin?

Answer 22

inhibits bacterial DNA gyrase

Question 23

why is use of ciprofloxacin limited?

Answer 23

to reduce number of C Diff infections

Question 24

what two gram positive organisms can cause UTI?

Answer 24

enterococcus

staphylococcus

Question 25

what is the most common enterococcus in UTI?

Answer 25

enterococcus faecalis

Question 26

what is enterococcus UTI often associated with?

Answer 26

hospital acquired infection

Question 27

what staph is a cause of UTI?

Answer 27

staph saprophyticus

Question 28

what are some common symptoms of UTI?

Answer 28

dysuria frequency nocturia haematuria

Question 29

what is dysuria?

Answer 29

pain when passing urine

Question 30

what are some symptoms that suggest upper involvement in a UTI?

Answer 30

fever loin pain rigors

Question 31

what type of urine specimen should be collected?

Answer 31

a midstream specimen of urine

Question 32

what type of containers can be used for urine specimens?

Answer 32

boricon container | sterile universal container

Question 33

what does a positive leucocyte on urinalysis show?

Answer 33

presence of leucocytes in the urine

Question 34

what does positive nitrites on urinalysis show?

Answer 34

presence of bacteria in the urine

Question 35

who should not have urinalysis for UTI done?

Answer 35

elderly | those with catheters

Question 36

how can lab diagnosis of a UTI be done?

Answer 36

microscopy of urine | culture of urine

Question 37

what criteria is applied to women of childbearing ge to determine if they have a UTI?

Answer 37

kass's criteria

Question 38

according to kass's criteria, what suggests a probable UTI?

Answer 38

>10x5 organisms/ml

Question 39

how long should antibiotics be given for to women with uncomplicated lower UTI's?

Answer 39

three days course

Question 40

when would antibiotics be given for asymptomatic bacteriuria?

Answer 40

if pregnant

Question 41

what is the empirical treatment for a female with a lower UTI?

Answer 41

nitrofurantoin or trimethoprim orally for 3 days

Question 42

what is the empirical treatment for an uncatheterised male with a UTI?

Answer 42

get cultures nitrofurantoin or trimethoprim for 7 days

Question 43

what is the empirical treatment for an uncomplicated UTI or pyelonephritis

Answer 43

co-amoxiclav or co-trimoxazole for 7 days

Question 44

what is the empirical treatment for a complicated UTI or pyelonephritis?

Answer 44

amoxicillin + gentamicin IV for three days | co-trim + gent if penicillin allergic