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Microbiology IV > Urinary tract infections > Flashcards

Urinary tract infections Flashcards

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1
Q

What are the symptoms of urethritis and cystitis?

A

Dysuria, frequency, urgency

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2
Q

What are symptoms of pyelonephritis?

A

Pain in the flanks, fever

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3
Q

How are UTIs diagnosed?

A

Symptoms and dipstick test

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4
Q

What kind of sample is required for UTI diagnosis?

A

Clean voided midstream urine

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5
Q

What does a dipstick test look for?

A

Leukocyte esterase and nitrite

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6
Q

What does a positive leukocyte esterase result indicate?

A

Pyuria (WBC in urine)

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7
Q

What is the gram stain for enterobacteriaceae?

A

Gram negative

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8
Q

What is the shape of enterobacteriaceae?

A

Rod

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9
Q

What is the oxidase test for enterobacteriaceae?

A

Oxidase negative

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10
Q

What is the catalase test for enterobacteriaceae?

A

Catalase positive

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11
Q

Serology for enterobacteriaceae is based on what antigens?

A

O-polysaccharide of LPS, K and H antigens

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12
Q

What are the virulence factors associated with enterobacteriaceae?

A

Endotoxin, capsule, T3SS, sequestration of growth factors, antigenic phase variation

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13
Q

What is responsible for the degree of virulence of different strains of E. coli?

A

Acquisition of plasmids, prophages, and pathogenicity islands

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14
Q

What is responsible for E.coli adherence to host mucosal surfaces?

A

Fimbriae or pili

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15
Q

What can differentiate E. coli from salmonella or shigella?

A

Most E. coli spp. ferment lactose

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16
Q

What is the most common gram negative rod isolated from patients with sepsis?

A

E. coli

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17
Q

What is the most common cause of UTIs?

A

E. coli

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18
Q

What is the reservoir in E. coli UTI?

A

Patient’s intestinal flora

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19
Q

What are the virulence factors of E. coli UTI?

A

Adhesins, hemolysin, endotoxin

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20
Q

What do most E. coli strains possess to aid in attachment to epithelial surfaces?

A

Type I pili

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21
Q

What is the type I pili?

A

Present on most E. coli strains - binds to mannose residues commonly present on epithelial surfaces

22
Q

What is the P pili?

A

Expressed by some subpopulations of E. coli - binds sugar residues specifically on uroepithelial cells

23
Q

E. coli strains that cause pyelohnephritis usually possess which type of pili?

A

P pili

24
Q

What is the shape of staphylococcus?

A

Clusters

25
Q

What is the shape of streptococcus?

A

Pairs or chains

26
Q

What is the gram stain for staphylococcus?

A

Gram positive

27
Q

What is the second leading cause of UTIs?

A

S. saprophyticus

28
Q

How can S. saprophyticus be differentiated from other CoNS?

A

Novobiocin resistant

29
Q

What are the common hospital acquired UTI pathogens?

A

Proteus, pseudomonas, enterococcus

30
Q

What is the gram stain for proteus?

A

Gram negative

31
Q

What is the prevalence of proteus for UTI isolates in chronically catheterized patients?

A

20-45%

32
Q

How does proteus cause kidney stones?

A
  1. Produces urease
  2. Urease hydrolyzes urea to ammonia - alkalizes urine
  3. Alkalinization leads to precipitation of organic and inorganic compounds - kidney stones
33
Q

Does proteus produce biofilms?

A

Yes

34
Q

What is the treatment for proteus?

A

TMP-SMX

35
Q

What is the gram stain for pseudomonas?

A

Gram negative

36
Q

What is the shape of pseudomonas?

A

Motile rod

37
Q

What is the oxidase test for pseudomonas?

A

Oxidase positive

38
Q

How can pseudomonas be differentiated from enterobactericeae?

A

Oxidase test

39
Q

Which bacteria produce a blue-green pigment?

A

Pseudomonas aeruginosa

40
Q

Pseudomonas aeruginosa is typically seen in what patient profile?

A
  1. Long term indwelling catheters
  2. Obstruction of GU system or urinary tract instrumentation / surgery
  3. Multiple courses of abx
41
Q

Enterococcus are what group of streptococci?

A

Group D streptococci

42
Q

What is the gram stain for enterococcus?

A

Gram positive

43
Q

What is the catalase test for enterococcus?

A

Catalase negative

44
Q

How can enterococcus be differentiated from S. pneumoniae?

A
  1. Tolerates high salt and bile

2. Not sensitive to optochin

45
Q

What are the risk factors for enterococcus?

A
  1. Prolonged hospitalization

2. BSA

46
Q

What are the clinical diseases associated with enterococcus?

A

UTI, peritonitis, endocarditis

47
Q

What is the diagnosis for asymptomatic bacteriuria?

A

Significant bacteriuria on two successive urine cultures in women or from a single culture in men from catheterized urine specimen

48
Q

When is treatment for asymptomatic bacteriuria indicated?

A
  1. Pregnant women
  2. Prior to urologic surgery
  3. After renal transplantation
49
Q

What is the treatment for uncomplicated cystitis?

A

Trimethoprim / sulfamethoxazole

50
Q

What is the treatment for pyelonephritis?

A

Aggressive - fluoroquinolones for gram negatives, amoxicillin for gram positives

51
Q

What is the treatment for asymptomatic bacteriuria?

A

Cephalexin, nitrofurantoin

Microbiology IV (6 decks)

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