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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
What are the signs of UTI?
dysuria; frequency; nocturia; haematuria
26
What symptoms suggest involvemnt of the upper UT?
fever; loin pain and rigors
27
What does staph. aureus UTI suggest?
caused by bacteraemia- need to look for primary infection
28
What is important about the collcection of urine specimens?
first urine voided is very likely to be contaminated with bacteria from the perineum or lower urethra
29
What are the 4C antibiotics?
co-amoxiclav; clindamycin; cephalosporins and ciprofloxacin
30
What is the best method for collecting a MSSU?
wash perineum/ urethral meatus; sterile foil bowl- first void into toilet then into bowl
31
How can you get a urine specimen from a baby?
bag urine
32
What is the most helpful result from a bag urine from a baby?
a negative culture- positive is very often contamination and hard to tell
33
How long do you have to get a boricon container to the lab?
24 hours
34
How long must a sterile universal container reach the lab by?
2 hours of collection
35
What bacteria can convert nitrates to nitrites?
coliforms mainly
36
What type of bacteria will not give a positive nitrite on dipstick?
enterococcus spp.
37
Who is microscopy of urine done with?
selected urine cases eg renal transplant to look for polymorphs, bacteria nad red cells
38
What is the common method of lab diagnosis of UTI?
culture of urine
39
How is significant bacteriuria calculated?
semi-quantitative- number of bacteria cultured using Kass's criteria
40
How many organisms per ml indicates a probable UTI?
>10^5 organisms
41
What does 10^4 organisms indicate?
?contaminated; ?infection- repeat specimen
42
What does a mixed growth indicate?
probably insignificant- contaminant, unless an abnormality of UT
43
What does ESBL do for bacteria?
makes bacteria resistant to all cephalosporings and almost all penicillins
44
What is a carbapenemase-producing enterbacteriaceae?
gram negative bacilli resistant to meropenem
45
What is the significance of carbapenemase producing enterbacteriaceae?
resistant to all current antibiotics
46
What hsould the ideal antibiotic for tx of uTI be?
excreted in urine in high conc. ; oral; inexpensive; few SE
47
How long is a course of Abx for an uncomplicated lower UTI in women?
3 days
48
What are the 1st line antibiotics for UTI?
amoxicillin; trimethoprim; nitrofurantoin; gentamicin
49
What is trimethroprim give IV?
cotrimoxazole
50
What is the problem with amoxicillin in TUI?
>50% of E.coli are now resistant
51
How does trimethorprim work?
inhibits bacterial folic acid synthesis
52
When should trimethoprim be avoided?
1st trimester
53
What is co-trimaxazole?
suplhamethoxazole and trimethoprim
54
What is the risk associated with co-trimoxazole?
stevens-john syndrom from sulphonamide
55
When should nitrofurantoid be avoided?
late pregnancy; breast feeding and children <3 months
56
What is gentamicin useful for treating?
coliforms; pseudomonas; MRSA
57
How long should gentamicin be prescribed max?
3 days
58
What is pivmecillinam and temocillin useful for?
ESBLs
59
How does ciprofloxacin work?
inhibits bacterial gyrase, preventing supercoiling of bacterial DNA
60
How long are antibiotics given for male UTIs?
7 days
61
What is given for female or male uncomplicated UTIs?
trimethoprim or nitrofurantoin
62
What antibiotics are given fro complicated UTIs or pyelonephritis in GP?
co-amoxicalv or co-trimoxazole for 14 days
63
What is given for complicated UTI or pyelonephritis in hospital?
amoxicillin and gentamicin IV for 3 days
64
What is the treatment for compicated UTI or pyelonephritis in hospital if penicillin allergic?
cotrimoxazole and gentamicin
65
What is significant about asymptomatic bacteriuria in pregnancy?
can progress to pyelonephritis and intra-uterine growth retardation or premature labour
66
When are all prengnat women screened for bacteriuria?
1st antenatal visit
67
What is urethral syndrome?
patient has symptoms of UTI and there are pus cells in urine but no signifcant growth on culture
68
What causes urethral syndrome?
may be early phase of UTI; urethral trauma; urethritis caused by chlamydia and gonorrhoea
69
What can give symptomatic relief in urethral syndrome?
alkalinising the urine
70
When shoudl catheterised patients be given an antibiotic?
if >10^5 organims and symtpoms of UTI

Renal (33 decks)

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