Urinary Tract Infections

Question 1

What is a mechanism that helps resistance to bladder infection?

Answer 1

Urea that has a high osmolality and low ph

Question 2

What is the incidence of UTIs that are HAIs and who is most susceptible?

Answer 2

23% of HAI (hospital-acquired infections) are UTI
And there is a higher incidence in females compared to males

Question 3

What is the age range for males with UTIs?

Answer 3

<3months
>60yrs

Question 4

What is the age range for females with UTIs?

Answer 4

<5yrs
15-50yrs
>60yrs

Question 5

What is Catheterisation a risk factor and what does it result in?

Answer 5

Catheterisation a risk factor for UTI
Introduces bacteria into the body
Causes risk of biofilm formation

Question 6

Give examples of symptoms Lower UTIs

Answer 6

Dysuria – pain on passing urine
Cystitis – inflammation of bladder
Bacteriuria in severe cases – bacteria present in urine

Question 7

What can upper UTI be caused by and give examples of symptoms?

Answer 7

Can be caused by ascending UTI
Kidney infection & inflammation:
Loin pain & tenderness
Pyrexia
Bacteriuria
Pyuria (pus in urine)

Question 8

Give three examples of bacterial UTIs and which one is most commonly acquired in hospitals?

Answer 8

E. coli, P.mirabilis, other Enterobacteriaceae
E. coli is the most common:
75% community acquired
40% HAI’s

Question 9

Give 3 examples of non-bacterial UTIs

Answer 9

Viruses, Parasites and Fungi

Question 10

Give an example of a microorganism that’s a parasite and which infection it causes.

Answer 10

Trichomonas vaginalis and it causes Urethritis

Question 11

Give an example of a microorganism that’s a fungi and which infection it causes.

Answer 11

Candida albicans which makes you immunocompromised

Question 12

Give an example of a microorganism that’s a virus and which infection it causes.

Answer 12

Human polyoma virus (HPV), causes kidney and ureter infections

Question 13

Sample collection & transport

Answer 13

Avoiding contamination is key – Especially faecal.
Need rapid transport to lab to avoid bacterial overgrowth.
– Refrigeration 4°C – Boric acid (preservative)

Question 14

Give 3 collection methods for Urine

Answer 14

Catheter stream urine
Absorbent pad - infants nappy
Clean catch urine - young children

Question 15

What can be used for Point of care testing and what does it show?

Answer 15

Commercial dipstick tests
Rule out infection if –ve for:
Leucocyte-esterase (test for wbcs) White blood cells
Nitrites - Many bacteria

Question 16

Laboratory diagnosis techniques for UTis:

Answer 16

Microscopy
Culture
Automated techniques: automated microscopy and Flow cytometry

Question 17

What is the advantage of automated urinalysis?

Answer 17

It can replace manual microscopy and can process 100 specimens an hour

Question 18

What can be used to culture urine?

Answer 18

• CLED
• Chromogenic agar
• Calibrated loop
• Multipoint inoculator (pin)
• Sterile filter paper strip

Question 19

What is observed from the microscopy of urine?

Answer 19

Pyuria
Haematuria – for RBC abornalities
Epithelial cells – indicative of urine-skin contact

Question 20

Culture results for utis

Answer 20

• Significant bacteriuria
  – >105 CFU ml-1 of MSU
• A pure isolate with 104
  -105 cfu/mL
  – evaluated based on clinical information
  – confirmed by repeat culture