Microbiology UTI Flashcards
What bacteria is normally in the kidney?
None.
Ureter and bladder should also be sterile
What kind of bacteria inhabit the urethra?
Coliforms and enterococci
What is a lower UTI?
Confined to the bladder
What is an upper UTI?
Involves ureters/ kidneys
What is the name for an upper UTI?
Pyelonephritis
True or False
The presence of bacteria in the urinary tract is the definition of a UTI
False.
Only if causes symptoms.
What is a complicated UTI?
Systemic sepsis
Stones
Structural abnormality
Why does bacteruria not mean infection?
Only infection if symptomatic.
Bacteria in urine common due to bacteria at urethra
What is cystitis?
Inflammation of the bladder.
Not always an infection
Who tends to get UTI?
Women Pregnancy Sexual activity Catheterised Abnormal urinary tracts
Why does pregnancy cause UTI?
Incomplete bladder emptying causes stasis and encourages infection.
Urethra also more dilated
Where does bacteria in UTI come from?
Bacteria from bowel gets onto perineal skin and into lower end of urethra
Which bacteria are most common?
E Coli
Klebsiella
Enterobacter
Proteus
What is special about Proteus sp.?
Associated with calculi.
Foul smelling
Which organism is common in women of child bearing age?
Staph saphrophyticus
What bacteria is associated with catheters and instrumentation?
Pseudomonas
What abx is given for pseudomonas?
Ciprofloxacin
Which symptoms are associated with upper urinary tract infection?
Fever
Rigors
Loin pain
What is the issue with giving ciprofloxacin?
Precipitates C diff
What is MSSU?
Mid stream specimen of urine
How is a MSSU carried out?
Wash perineum with sterile saline
First urine to be passed into toilet
Second urine to be collected
Last urine to toilet
Why would you not use antiseptic before an MSSU?
May inhibit bacteria
What is a clean catch urine?
Nurse tries to catch mid stream.
Common in children or in elderly
When is bag urine used?
In babies.
Useful for negative culturing
When is suprapubic aspiration used?
Babies
How should a catheter specimen be taken?
Aspirated from catheter ports and not from the bag itself
What colour of container should be used for urine specimen?
Red topped
Why is it important to get the sample to the lab asap?
Bacteria multiply rapidly!
Why can an absence of nitrites not rule out an UTI?
Enterococci do not give a positive test
What does a mixed organism growth mean?
Not significant.
Likely to get a single bacteraemia.
How many bacteria are required to be significant?
10 to the power of 5
What are ESBL producing bacteria?
Extended spectrum beta lactamase
What does ESBL do?
Breaks down the beta lactam rings.
Resistance to many abx
True or False
ESBL is a hospital acquired issue
False.
From community.
What is CPE?
Carbapenemase producing enterobacteriaecae
What is the problem with CPE?
Resistant to meropenum, basically all abx.
Spreads easily
Where did CPE come from?
India
How long should an abx course last for?
3 days for LUTI in women
What is the firstline abx for UTI?
Amoxicillin
Trimethoprim
Nitrofurantoin
What is given empirically for UTI?
Trimethoprim
Why is amoxicillin not given empirically?
Not always effective
Why is trimethoprim not given in 1st trimester?
Inhibits folic acid synthesis
Why is nitrofurantoin not given empirically?
Only in uncomplicated LUTI
Not in pregnancy, breastfeeding or young children
When is gentamicin given for UTI?
In hospital
What is the limitations of gentamicin when given?
3 days only
Not in pregnancy
Can cause deafness
When is temocillin given?
In hospital
When renal function is too poor for gentamicin
For Coliforms
What is given for LUTI in men?
Trimethoprim 7 days
What is given for LUTI in men?
Trimethoprim 3 days
What is given for pyelonephritis?
Co-trimaxozole or co-amoxiclac 14 days
Asymptomatic bacteruria is not treated, except when?
In pregnancy.
Causes IUGR
