Urinary Tract Infections Flashcards

1
Q

What are the symptoms of urethritis and cystitis?

A

Dysuria with increased frequency and urgency. Will have positive urine culture.

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2
Q

What are the symptoms of prostatitis?

A

Lower back pain in perirectal area and testicles. Will have positive urine culture.

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3
Q

What bacterial count must be made for a urine test to show positive for a UTI?

A

The presence of at least one bacterium per microscopid oil-immersion field. Correlates to 100,000 CFU/mL.

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4
Q

A positive nitrite test in urine correlates to infection by what sort of bacteria?

A

A positive nitrate test correlates to infection by gram negative organism (Typically E.coli)

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5
Q

Because Cystitis in men is rare, a male with cystitis is often indicitive of what?

A

Indicitive of infected stones, prostatitis, or chronic urinary retention requiring further investigation.

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6
Q

What attribute does E.coli have that is unique compared to shigella and salmonella?

A

E. coli ferments lactose.

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7
Q

What sort of bacteria are the family Enterobacteriaceae and where are they most often found?

A

These are gram-negative rods that are normal intestinal flora of most animals.
Can ferment glucose, reduce nitrate, are catalase positive, and oxidase negative!

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8
Q

What is the number one bacterial cause of UTI?

A

Eschericia Coli followed by Coagulase negative staphylococci.

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9
Q

What are the virulence factors for E.coli UTI?

A

Adhesins (P. pilli)
Hemolysin (HlyA) - RBC lyse
Endotoxin - inflammation

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10
Q

Most E.coli express what type of pili and what are they responsible for?

A

Type 1 pilli responsible for binding to mannose residues on epithelial surfaces.

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11
Q

What does P. pili bind specifically to?

A

Bind to sugar residues specifically on uroepithelial cells.

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12
Q

S. epidermidis is known to infect what specifically in Humans?

A

Typically infects implanted devices causing bacteremia/ device failure through formation of Biofilms.

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13
Q

S. saprophyticus is known for what two attributes?

A

Second most common bacteria to cause UTI and is Novobiocin resistant (inhibitor to bacterial DNA gyrase)!!

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14
Q

What is unique about proteus mirabilis?

A

This bacteria is found among UTI isolates from chrpnically catheterized patients (20-45%)

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15
Q

How does Proteus mirabilis cause kidney stones?

A

Proteus species employ urease which changes urea into ammonia. This causes alkalization of the urine increasing the chances of inorganic compounds appearing in the renal calculi.
Also produces biofilms.

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16
Q

TMP - SMX displays excellent activity against what species of bacteria?

A

Proteus species in which 90-100 isolates are suceptible.

17
Q

What species are Group D cell wall positive?

A

Enterococcus faecalis, and faecium as well as S. Bovis.

18
Q

How is Enterococcus seperated from S pneumo?

A

Tolerates high salt and bile content and is not sensitive to optochin culturing.

19
Q

What are the risk factors for enterococcus?

A

Prolonged hospitilization with treatment of broad spectrum antibiotics.
Allows spread from GI to other surfaces as highly resistant to most antibiotics.

20
Q

What sorts of pt will display a UTI caused by Enterococcus?

A

Pt with long indwelling catheters that are under broad spectrum antibiotics.

21
Q

What population of pt is asymptomatic bacteruria typically found in?

A

Eldery women and men.

22
Q

Under what three conditions is it reccomended to treat asymptomatic bacteriuria?

A

Pregnant women
Prior to urological surgery
And after renal transplant surgery.

23
Q

What is the recommended treatment for uncomplicated cystitis?

A

Trimethoprim/Sulfamethoxazole

24
Q

What is the recommended treatment for pyelonephritis?

A

Agressive antimicrobial treatment, possibly inpatient care.
Fluoroquinones for gram negatives.
Amoxicillin for Gram posiives

25
Q

Asymptomatic bacteriuria is treated with what?

A

No treatment or amoxicillin, cephalexin or nitrofurantoin.

26
Q

What does MacConkey agar select for?

A

Gram negative bacteria that are able to lactose ferment (Form pink coloration if can ferment lactose)