MLSCI340 Urines Flashcards
Describe MSU specimen type
- midstream urine, “clean catch”
- collected first thing in the morning
- received in laboratory within 2 hours of collection or refrigerated <24 hours
Describe suitable specimen types
- MSU
- catheterization
- suprapubic needle aspiration of bladder
- cytoscopy
Where are transient organisms found in the female urinary tract ?
lower end of female urinary tract
__, __, and __ of the normal individual are bacteria free
KIDNEYS, URETERS, and BLADDER of the normal individual are bacteria free
The ureter connects the __ and the __.
The ureter connects the KIDNEY and the BLADDER.
Why are suprapubic needle aspirates a useful specimen type ?
- urine collection from babies
- only technique used for suspected anaerobic infections
Indwelling catheters is notorious for __ and __.
Indwelling catheters is notorious for GRAM NEG BACTERIURIA and SEPSIS.
Common pathogens of the urinary tract
- Enterobacteriaceae
- β hem Strep (A and B)
- P. aeruginosa (+ other non-fermentative bacilli)
- Aerococcus sp.
- Enterococcus sp.
- S. aureus
- S. saprophyticus
Contaminating flora in the urinary tract
- Non-hem Streptococcus
- CNS
- Viridans group Streptococcus
- Diphtheroids
- Lactobacillus sp.
- Neisseria sp.
Clinical significance of Enterobacteriaceae in urine
Urinary tract infections
Clinical significance of S. pyogenes in urine
Urinary tract infections
Clinical significance of S. agalactiae in urine of pregnant mother
- neonatal infection
- mom = carrier
Clinical significance of S. saprophyticus in urine
UTI infection in YOUNG WOMEN
Outline the rationale for selection of media
Explain the relevance of culture quantitation
Describe colonial and microscopic morphology of common organisms (both normal and
pathogenic
Explain tests and media performed, with results, to identify each organism
Define cystitis
inflammation of bladder
Define dysuria
abnormalities in urinations (pain, burning, frequency, dripping, pyuria)
Define glomerulonephritis
- inflammation of kidney glomeruli
- “allergic/hypersensitivity reaction after S. pyogenes infection”
Define non-specific urethritis
inflammation of urethra
Define pyelonephritis
inflammation of both kidneys and pelvis (parenchyma)
Define cytoscopy
examination of bladder lining and urethra lining
Tests to confirm Aerococcus urinae
cat wk+/-
PYR -
BEA -
NaCl +
Tests to confirm Enterococcus faecalis
cat wk+/-
PYR +
BEA +
NaCl +
Test & results to differentiate group A from group B strep
S. pyo is PYR +
Latex grouping A vs B
S. pyo is CAMP -
Taxos A = S
NOTE:
- “P” for “PYR Pos”
- “pyogenes” has no c = CAMP neg
- strep throat is readily susceptible to antibiotics
Which of the following mechanisms protect the lower urinary tract from infection?
Select all that apply:
a.
Low urine pH
b.
High urine osmolarity
c.
Flushing action from urination
d.
High urine normal flora counts
Which of the following mechanisms protect the lower urinary tract from infection?
a.
Low urine pH
b.
High urine osmolarity
c.
Flushing action from urination
Which of the following antimicrobials is only used for UTIs?
a.
Penicillin G
b.
Amphotericin
c.
Sulfamethoxazole
d.
Nitrofurantoin
d.
Nitrofurantoin
Which of the following organisms match an A/A TSI?
Select all that apply:
a.
Morganella morganii
b.
Enterobacter cloacae
c.
Klebsiella pneumoniae
d.
Proteus mirabilis
Which of the following organisms match an A/A TSI?
b.
Enterobacter cloacae
c.
Klebsiella pneumoniae
Which of the following reagents is used for a test that has a green reaction with a positive organism?
a.
Ferric chloride
b.
Kovac’s reagent
c.
Para-dimethylaminocinnameldahyde
d.
Tetramethyl-p-phenylenediamine dihydrochloride
a.
Ferric chloride
Which of the following descriptions best fit a “typical” strain of Escherichia coli?
a.
Motile, anaerogenic, non-lactose fermenting, indole positive
b.
Motile, aerogenic, lactose fermenting, indole positive
c.
Motile, aerogenic, non-lactose fermenting, citrate negative
d.
Non-motile, aerogenic, lactose fermenting mucoid colony
b.
Motile, aerogenic, lactose fermenting, indole positive
Which organism is the most common cause of urinary tract infections?
a.
Streptococcus bovis
b.
Escherichia coli
c.
Enterococcus faecalis
d.
Staphylococcus saprophyticus
b.
Escherichia coli
Which of the following urine specimens is acceptable for bacterial culture?
a.
Unpreserved midstream urine at 4°C for 12 hours
b.
Midstream urine with SAF at 22°C for 2 hours
c.
24 hour urine at 4°C for 12 hours
d.
Collection bag urine at 22°C for 2 hours
a.
Unpreserved midstream urine at 4°C for 12 hours
How can Aerococcus urinae be differentiated from non-hem Strep?
%= gpc tet/ cl
pos 6.5% NaCl
List 3 antibiotics routinely used for UTIs
- Fosfomycin
- Nitrofurantoin
- Sulfamethoxazole-trimethoprim
