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Renal > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what bacteria are normally found in the urine?

A

urine is normally sterile

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2
Q

What colonises the distal urethra?

A

coliforms and enterococci

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3
Q

What is a UTI?

A

the presence of microbes in the urinary tract that are causing clinical infection

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4
Q

What is a lower UTI?

A

infection confined to the bldder

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5
Q

What is an upper UTI?

A

infection involving the ureters +/- the kidneys

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6
Q

What is a complicated UTI?

A

UTI complicated by systemic sepsis or urinary structural abnormality or stones

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7
Q

When is bacteriuria often not significant?

A

in elderly patients or patients with catheters

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8
Q

Why do women get UTIs more than men?

A

have a short wide urethra; proximity of urethra to anus

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9
Q

When is there an increased risk of UTI in women?

A

with sexual activity or pregnancy

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10
Q

What is the most common route of infection for UTIs?

A

ascending infection

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11
Q

What is the blood-born route of infection?

A

bacteraemia–seeded into kidneys–mulitple small abscesses–bacteria in urine

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12
Q

What are the most common type organisms causing UTI?

A

coliforms

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13
Q

What are coliforms?

A

aerobic gram negative bacilli

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14
Q

What is the most common organism cauing UTI?

A

E.coli

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15
Q

What organism that isn’t a coliform can also cause UTI?

A

pseudomonas

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16
Q

What is proteus infection associated with?

A

calculi

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17
Q

How does proteus infection lead t o calculi?

A

produces urease which breaks urea to form ammonia which increases urinary pH and allows the precipitation of sals

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18
Q

What is the typical sign of proteus infection?

A

foul smelling

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19
Q

What is the most common cause of enterococcus causing UTI?

A

enterococcus faecalis

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20
Q

What type of stones does proteus result in?

A

triple phophate stones

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21
Q

Describe staphylococcus saphrophyticus?

A

coag negative staph

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22
Q

Who does staph. saphrophyticus affect?

A

women of child bearing age

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23
Q

What is pseudomonas infection associated with?

A

catheters and UT instrumentation

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24
Q

What is the only oral antibiotic that pseudomonas is sensitive to?

A

ciprofloxacin

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25
Q

What are the signs of UTI?

A

dysuria; frequency; nocturia; haematuria

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26
Q

What symptoms suggest involvemnt of the upper UT?

A

fever; loin pain and rigors

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27
Q

What does staph. aureus UTI suggest?

A

caused by bacteraemia- need to look for primary infection

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28
Q

What is important about the collcection of urine specimens?

A

first urine voided is very likely to be contaminated with bacteria from the perineum or lower urethra

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29
Q

What are the 4C antibiotics?

A

co-amoxiclav; clindamycin; cephalosporins and ciprofloxacin

30
Q

What is the best method for collecting a MSSU?

A

wash perineum/ urethral meatus; sterile foil bowl- first void into toilet then into bowl

31
Q

How can you get a urine specimen from a baby?

A

bag urine

32
Q

What is the most helpful result from a bag urine from a baby?

A

a negative culture- positive is very often contamination and hard to tell

33
Q

How long do you have to get a boricon container to the lab?

A

24 hours

34
Q

How long must a sterile universal container reach the lab by?

A

2 hours of collection

35
Q

What bacteria can convert nitrates to nitrites?

A

coliforms mainly

36
Q

What type of bacteria will not give a positive nitrite on dipstick?

A

enterococcus spp.

37
Q

Who is microscopy of urine done with?

A

selected urine cases eg renal transplant to look for polymorphs, bacteria nad red cells

38
Q

What is the common method of lab diagnosis of UTI?

A

culture of urine

39
Q

How is significant bacteriuria calculated?

A

semi-quantitative- number of bacteria cultured using Kass’s criteria

40
Q

How many organisms per ml indicates a probable UTI?

A

> 10^5 organisms

41
Q

What does 10^4 organisms indicate?

A

?contaminated; ?infection- repeat specimen

42
Q

What does a mixed growth indicate?

A

probably insignificant- contaminant, unless an abnormality of UT

43
Q

What does ESBL do for bacteria?

A

makes bacteria resistant to all cephalosporings and almost all penicillins

44
Q

What is a carbapenemase-producing enterbacteriaceae?

A

gram negative bacilli resistant to meropenem

45
Q

What is the significance of carbapenemase producing enterbacteriaceae?

A

resistant to all current antibiotics

46
Q

What hsould the ideal antibiotic for tx of uTI be?

A

excreted in urine in high conc. ; oral; inexpensive; few SE

47
Q

How long is a course of Abx for an uncomplicated lower UTI in women?

A

3 days

48
Q

What are the 1st line antibiotics for UTI?

A

amoxicillin; trimethoprim; nitrofurantoin; gentamicin

49
Q

What is trimethroprim give IV?

A

cotrimoxazole

50
Q

What is the problem with amoxicillin in TUI?

A

> 50% of E.coli are now resistant

51
Q

How does trimethorprim work?

A

inhibits bacterial folic acid synthesis

52
Q

When should trimethoprim be avoided?

A

1st trimester

53
Q

What is co-trimaxazole?

A

suplhamethoxazole and trimethoprim

54
Q

What is the risk associated with co-trimoxazole?

A

stevens-john syndrom from sulphonamide

55
Q

When should nitrofurantoid be avoided?

A

late pregnancy; breast feeding and children <3 months

56
Q

What is gentamicin useful for treating?

A

coliforms; pseudomonas; MRSA

57
Q

How long should gentamicin be prescribed max?

A

3 days

58
Q

What is pivmecillinam and temocillin useful for?

A

ESBLs

59
Q

How does ciprofloxacin work?

A

inhibits bacterial gyrase, preventing supercoiling of bacterial DNA

60
Q

How long are antibiotics given for male UTIs?

A

7 days

61
Q

What is given for female or male uncomplicated UTIs?

A

trimethoprim or nitrofurantoin

62
Q

What antibiotics are given fro complicated UTIs or pyelonephritis in GP?

A

co-amoxicalv or co-trimoxazole for 14 days

63
Q

What is given for complicated UTI or pyelonephritis in hospital?

A

amoxicillin and gentamicin IV for 3 days

64
Q

What is the treatment for compicated UTI or pyelonephritis in hospital if penicillin allergic?

A

cotrimoxazole and gentamicin

65
Q

What is significant about asymptomatic bacteriuria in pregnancy?

A

can progress to pyelonephritis and intra-uterine growth retardation or premature labour

66
Q

When are all prengnat women screened for bacteriuria?

A

1st antenatal visit

67
Q

What is urethral syndrome?

A

patient has symptoms of UTI and there are pus cells in urine but no signifcant growth on culture

68
Q

What causes urethral syndrome?

A

may be early phase of UTI; urethral trauma; urethritis caused by chlamydia and gonorrhoea

69
Q

What can give symptomatic relief in urethral syndrome?

A

alkalinising the urine

70
Q

When shoudl catheterised patients be given an antibiotic?

A

if >10^5 organims and symtpoms of UTI

Renal (33 decks)

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