Microbiology of UTI

Question 1

the lower end of the urethra is colonised by what 2 main types of bacteria?

Answer 1

coliforms

enterococci

Question 2

complicated UTI is a UTI complicated by..

Answer 2

systemic symptoms
structural abnormality
stones

Question 3

most common route of infection?

Answer 3

ascending from bowel -> urethra up to kidneys potentially

Question 4

what bacteria can travel in the bloodstream to cause a UTI?

Answer 4

staph aureus

Question 5

most common UTI bug?

Answer 5

e coli

Question 6

how does e coli stay in the urinary tract?

Answer 6

fimbriae which help it cling to surfaces

Question 7

urinalysis is mainly only used for ruling out infection in UTI T or F

Answer 7

T, you want a culture to confirm infection

Question 8

what are you expecting to see on microscope in a common UTI?

Answer 8

gram negative bacilli (E coli)

Question 9

lipopolysaccarides live in gram _ve cell walls

Answer 9

negative

Question 10

which coliform bacteria causes stones?

Answer 10

proteus

Question 11

“swarming cultures” are a sign that ___ has grown

Answer 11

proteus

Question 12

what does proteus smell of?

Answer 12

burnt chocolate

Question 13

how does proteus cause stones?

Answer 13

produces urease which increases pH

Question 14

which non-coliform can cause UTIs?

Answer 14

pseudomonas aeruginosa

Question 15

pseudomonas is resistant to most oral antibiotics except ___

Answer 15

ciprofloxacin

Question 16

what does ciprofloxacin inhibit?

Answer 16

DNA gyrase

Question 17

most common gram +ve cause of UTI?

Answer 17

enterococcus faecalis

Question 18

what 2 types of bacteria cause an upper UTI?

Answer 18

coliforms

gram +ves (e. faecalis mainly)

Question 19

staph saphrophyticus can be found in who?

Answer 19

women of child bearing age

Question 20

symptoms of UTI?

Answer 20

dysuria
frequency
nocturia
haematuria

Question 21

what symptoms make you think upper UTI?

Answer 21

fever
loin pain
rigors

Question 22

how should urine be collected in UTI?

Answer 22

get a mid stream sample:
wash urethra with saline
pee into toilet
pee into bowl mid pee
finish pee in toilet

Question 23

what colour container is used to collect urine in the community

Answer 23

red top

Question 24

urine can only be collected in a white container if it reaches the lab within _ hrs

Answer 24

2

Question 25

nitrites confirm the presence of what bacteria?

Answer 25

coliforms

Question 26

who shouldnt get urinalysis?

Answer 26

elderly

people with catheters

Question 27

main Ix for UTI?

Answer 27

urine culture

Question 28

UTI is caused by a single organism T or F

Answer 28

T

Question 29

Tx for female uncomplicated UTI?

Answer 29

trimethoprim 3 days

Question 30

Tx for male uncomplicated UTI?

Answer 30

trimethoprim or nitrofurantoin 7 days

Question 31

Tx for complicated UTI in primary care?

Answer 31

co-trimoxazole or co-amoxiclav 7 days

Question 32

Tx for complicated UTI in hosp?

Answer 32

amoxicillin + gentamicin IV 7 days

Question 33

Tx for complicated UTI in hosp (pen allergic)

Answer 33

co-trimoxazole PO + gentamicin IV 3 days

Question 34

gentamicin has a __ therapeutic index making it likely to become toxin

Answer 34

narrow

Question 35

what drug should be used for ESBL bacteria?

Answer 35

meropenem

Question 36

what should be used 2nd line if the patient has renal problems and cant have gentamicin?

Answer 36

aztreonam

Question 37

why cant pregnant women use trimethoprim in the 1st trimester?

Answer 37

inhibits folic acid synthesis