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Renal > Microbiology > Flashcards

Microbiology Flashcards

1
Q

The lower end of the urethra is colonised by:

A

Coliforms and Enterococci from large bowel

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2
Q

Definition of UTI

A

Microorganisms in urinary tract causing infection

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3
Q

Define pyelonephritis

A

Inflammation of kidneys due to infection

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4
Q

Complicated UTI

A

UTI complicated by sepsis, structural abnormality or stones = longer course of antibx

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5
Q

Bacteriuria

A

Presence of bacteria in urine, but no infection

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6
Q

Cystitis

A

Inflammation of bladder (not always due to LUTI)

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7
Q

Causal organisms

A 
Coliforms: E. coli, Klebsiella, Enterobacter, Proteus
Enterococcus (GI Strep)
Staph saphrophyticus
Staph aureus
Pseudomonas aeruginosa
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8
Q

Proteus

A

Coliform associated with renal stones
Foul smelling urine
Produces ammonia = increased pH

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9
Q

Staph saphrophyticus

A

Women child bearing age

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10
Q

Pseudomonas aeruginosa

A

Associated with catheters

Tx: Ciprofloxacin

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11
Q

Symptoms and signs of UTI

A

Dysuria, frequency, nocturia, haematuria

Fever, rigors, loin pain (UUTI)

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12
Q

MSSU

A

Mid stream specimen urine

Wash perineum, middle stream

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13
Q

Clean catch urine

A

Nurse catches MSSU, kids and elderly

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14
Q

Bag urine

A

Mini bag over urethra in babies, often contaminated

Only negative results useful

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15
Q

CSU

A

Catheter specimen urine - often colonised, only send if symptoms

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16
Q

Suprapubic aspiration

A

Babies if positive bag urine

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17
Q

Boricon container

A

Red top
Boric acid stops bacteria multiplying
24 hours

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18
Q

Sterile universal container

A

White top

2 hours

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19
Q

Leukocyte esterase

A

Indicates presence of WBCs or pus

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20
Q

Nitrites

A

Indicates presence of bacteria - Coliforms (NOT Enterococcus)

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21
Q

Which bacteria does not give positive nitrites?

A

Enterococcus

22
Q

What to look for on microscopy?

A

Polymorphs - pus cells (multi-lobed nucleus)
Bacteria
RBCs

23
Q

Less than 104

A

Not significant

24
Q

104

A

May be contamination
Early UTI
= repeat

25
Q

> 105

A

Significant

26
Q

Mixed growth >105

A

Probably not significant

27
Q

ESBL

A

Extended Spectrum Beta Lactamase

Makes bacteria resistant to Cephalosporins and almost all Penicillins

28
Q

Useful antibiotics for ESBL strains

A

Nitrofurantoin
Pevmecillinam
Fosfomycin
Merepenem

29
Q

CPE

A

Carbapenemase Producing Enterobacteriae
Coliforms (gram neg bacilli) resistant to merepenem (last choice antibx)
India travel

30
Q

Length of antibx course in uncomplicated UTI in women and men

A

Women: 3 days
Men: 7 days

31
Q

1st line for UTI

A

Amoxicillin
Trimethoprim
Nitrofurantoin
Gentamicin

32
Q

2nd line for UTI

A

Pevmecillinam
Temocillin
Co-amoxiclav
Ciprofloxacin

33
Q

Trimethoprim inhibits:

A

Folic acid synthesis = avoid 1st trimester

34
Q

Trimethoprim can also be given as:

A

Co-trimoxazole BUT risk of SJS

35
Q

Nitrofurantoin is only useful in:

A

Uncomplicated LUTI

36
Q

When should you avoid nitrofurantoin?

A

Third trimester
Breast feeding
Kids

37
Q

Gentamicin risks

A

Renal and VIII toxicity

38
Q

Gentamicin can only be given for:

A

3 days

39
Q

Risk of using Co-amoxiclav

A

C.diff

40
Q

Risks of Ciprofloxacin

A 
C. diff
Damages cartilage (not used in kids/pregnancy)
41
Q

Female LUTI Tx

A

Trimethoprim or Nitrofurantoin 3 days

42
Q

Uncatheterised male UTI Tx

A

Trimethoprim or Nitrofurantoin 7 days

43
Q

Complicated UTI or pyelonephritis Community Tx

A

Co-amoxiclav or Co-trimoxazole (14 days)

44
Q

Complicated UTI or pyelonephritis Hospital Tx

A

Amoxicillin and Gentamicin (3 days) - cotrimoxazole and gen in pen allergic

45
Q

Bacteriuria in pregnancy

A

TREAT - many progress to pyelonephritis = IUGR

46
Q

Abacterial cystitis/urethral syndrome

A

Symptoms but no growth on culture
Early phase UTI
Urethral trauma (honeymoon cystitis)
Chlamydia/Gonorrhoea cystitis

47
Q

Treatment of abacterial cystitis

A

Alkalinise urine - lemon bicarbonate of soda
Empty bladder before/after sex
Cotton/loose pants

48
Q

When do you give antibiotics in catheterised patient?

A

> 105 and supporting evidence (fever, symptoms)

49
Q

Dose of gentamicin

A 
7mg/kg
Online calculator (height, weight, creatinine)
50
Q

How to treat C.diff

A 
Oral Metronidazole (10 days)
No improvement = Oral Vancomycin (10 days)

Renal (19 decks)

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