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Renal > Microbiology UTI > Flashcards

Microbiology UTI Flashcards

1
Q

What bacteria is normally in the kidney?

A

None.

Ureter and bladder should also be sterile

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2
Q

What kind of bacteria inhabit the urethra?

A

Coliforms and enterococci

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3
Q

What is a lower UTI?

A

Confined to the bladder

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4
Q

What is an upper UTI?

A

Involves ureters/ kidneys

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5
Q

What is the name for an upper UTI?

A

Pyelonephritis

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6
Q

True or False

The presence of bacteria in the urinary tract is the definition of a UTI

A

False.

Only if causes symptoms.

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7
Q

What is a complicated UTI?

A

Systemic sepsis
Stones
Structural abnormality

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8
Q

Why does bacteruria not mean infection?

A

Only infection if symptomatic.

Bacteria in urine common due to bacteria at urethra

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9
Q

What is cystitis?

A

Inflammation of the bladder.

Not always an infection

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10
Q

Who tends to get UTI?

A 
Women
Pregnancy
Sexual activity
Catheterised
Abnormal urinary tracts
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11
Q

Why does pregnancy cause UTI?

A

Incomplete bladder emptying causes stasis and encourages infection.
Urethra also more dilated

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12
Q

Where does bacteria in UTI come from?

A

Bacteria from bowel gets onto perineal skin and into lower end of urethra

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13
Q

Which bacteria are most common?

A

E Coli
Klebsiella
Enterobacter
Proteus

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14
Q

What is special about Proteus sp.?

A

Associated with calculi.

Foul smelling

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15
Q

Which organism is common in women of child bearing age?

A

Staph saphrophyticus

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16
Q

What bacteria is associated with catheters and instrumentation?

A

Pseudomonas

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17
Q

What abx is given for pseudomonas?

A

Ciprofloxacin

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18
Q

Which symptoms are associated with upper urinary tract infection?

A

Fever
Rigors
Loin pain

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19
Q

What is the issue with giving ciprofloxacin?

A

Precipitates C diff

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20
Q

What is MSSU?

A

Mid stream specimen of urine

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21
Q

How is a MSSU carried out?

A

Wash perineum with sterile saline
First urine to be passed into toilet
Second urine to be collected
Last urine to toilet

22
Q

Why would you not use antiseptic before an MSSU?

A

May inhibit bacteria

23
Q

What is a clean catch urine?

A

Nurse tries to catch mid stream.

Common in children or in elderly

24
Q

When is bag urine used?

A

In babies.

Useful for negative culturing

25
Q

When is suprapubic aspiration used?

A

Babies

26
Q

How should a catheter specimen be taken?

A

Aspirated from catheter ports and not from the bag itself

27
Q

What colour of container should be used for urine specimen?

A

Red topped

28
Q

Why is it important to get the sample to the lab asap?

A

Bacteria multiply rapidly!

29
Q

Why can an absence of nitrites not rule out an UTI?

A

Enterococci do not give a positive test

30
Q

What does a mixed organism growth mean?

A

Not significant.

Likely to get a single bacteraemia.

31
Q

How many bacteria are required to be significant?

A

10 to the power of 5

32
Q

What are ESBL producing bacteria?

A

Extended spectrum beta lactamase

33
Q

What does ESBL do?

A

Breaks down the beta lactam rings.

Resistance to many abx

34
Q

True or False

ESBL is a hospital acquired issue

A

False.

From community.

35
Q

What is CPE?

A

Carbapenemase producing enterobacteriaecae

36
Q

What is the problem with CPE?

A

Resistant to meropenum, basically all abx.

Spreads easily

37
Q

Where did CPE come from?

A

India

38
Q

How long should an abx course last for?

A

3 days for LUTI in women

39
Q

What is the firstline abx for UTI?

A

Amoxicillin
Trimethoprim
Nitrofurantoin

40
Q

What is given empirically for UTI?

A

Trimethoprim

41
Q

Why is amoxicillin not given empirically?

A

Not always effective

42
Q

Why is trimethoprim not given in 1st trimester?

A

Inhibits folic acid synthesis

43
Q

Why is nitrofurantoin not given empirically?

A

Only in uncomplicated LUTI

Not in pregnancy, breastfeeding or young children

44
Q

When is gentamicin given for UTI?

A

In hospital

45
Q

What is the limitations of gentamicin when given?

A

3 days only
Not in pregnancy
Can cause deafness

46
Q

When is temocillin given?

A

In hospital
When renal function is too poor for gentamicin
For Coliforms

47
Q

What is given for LUTI in men?

A

Trimethoprim 7 days

48
Q

What is given for LUTI in men?

A

Trimethoprim 3 days

49
Q

What is given for pyelonephritis?

A

Co-trimaxozole or co-amoxiclac 14 days

50
Q

Asymptomatic bacteruria is not treated, except when?

A

In pregnancy.

Causes IUGR

Renal (16 decks)

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