Urine and Gastrointestinal Cultures Flashcards

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1
Q

List organisms commonly isolated from urinary tract infections

A

Enterococcus, Strep agalactiae, E. coli, Strep progenies, Staph aureus, Staph Saprophyticus, Candida

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2
Q

If you are using a 0.001 ml loop, each colony on the urine culture represents how many colony forming units in the urine?

A

1000 col/ml

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3
Q

If you are using a 0.01 ml loop, each colony on the urine culture represents how many colony forming units in the urine?

A

100 col/ml

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4
Q

When three or more organisms are each > 100,000 col/ml, what should you suspect?

A

Contamination and long term sitting out at room temp

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5
Q

Generally, if there are three or more colony types each less than 10,000 col/ml, what is the most likely way you will interpret the results?

A

Probably contaminants

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6
Q

Generally, if there is one colony type between 10,000-50,000 col/ml, what is the most likely way it will be interpreted if it came from a general practitioner clinic: if it came from a hospital patient: if it came from a urology clinic?

A

General clinic: likely no treatment-thinking contaminant

Hospital patient: likely no treatment-thinking contaminant

Urology clinic: depending on diagnosis

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7
Q

Generally, if there is one colony types between 50,000-100,000 col/ml, what is the most likely way it will be interpreted if it came from a general practitioner clinic: if it came from a hospital patient: if it came from a urology clinic?

A

General clinic: probable treatment depending on symptoms, WBCs, etc.

Hospital patient: treatment likely

Urology clinic: treatment likely

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8
Q

Generally, if there is one colony types >100,000 col/ml, what is the most likely way it will be interpreted if it came from a general practitioner clinic: if it came from a hospital patient: if it came from a urology clinic?

A

General clinic: treatment

Hospital patient: treatment

Urology clinic: treatment

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9
Q

List some reasons why a low count of 10,000 col/ml may be significant:

A

Chronic condition, unique diagnostic problems, immunocompromised patient

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10
Q

How is a clean catch midstream urine specimen collected?

A

Patient cleanses area, begins voiding in toilet for discard, and then collects rest of specimen.

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11
Q

Explain the pathogenicity of Staph saprophyticus in urine cultures:

A

Problem with infertility in child bearing aged women, UTI

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12
Q

How do you identify Staph saprophyticus in a urine culture?

A

Catalase pos, coagulase neg, C biochem or novobiocin resistant.

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13
Q

If an infection is located in the renal parenchyma it is called:

A

Pyelonephritits

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14
Q

If an infection is located in the bladder it is called:

A

Cystitis

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15
Q

What is pyuria?

A

WBCs in urine

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16
Q

Describe the most effective means of preserving a specimen for bacterial culture:

A

Refrigeration, Sodium borate

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17
Q

According to CLSI what is the group of antibiotics used in treatment of UTI?

A

Group U

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18
Q

Describe terms and abbreviations often used in urinary tract disease:

A

UTI, U-UTI, L-UTI, Bacteruria, Pyelonephritis, Glomerulonephritis

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19
Q

Proper specimen collection for a catheter.

A

Insert the needle gently into catheter at a 45 degree angle, twist on a sterile syringe to the port and slowly withdraw 20-30 mL of urine. Remove needle from catheter and push urine into sterile specimen container

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20
Q

Proper specimen collection from supra pubic aspiration

A

Involves putting a needle through the skin just above the pubic bone into the bladder

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21
Q

After antibiotic treatment, a single anaerobic organism may appear in the GI tract as the main growth and cause significant problems. What is this anaerobe? How do we screen for its presence?

A

Clostridium difficile, C serological screen

22
Q

If a fresh stool specimen cannot be plated within 1-2 hours how should it be handled?

A

The stool should be placed in a transport medium such as Cary-Blair for bacteria investigation and other transport media if looking for virus or parasites

23
Q

Identify the reactions on the following media that suggest either Salmonella or Shigella are present:

Salmonella

XLD
HE
Te7
TSI
LIA
Urea
A
XLD: H₂S (black) Red
HE: H₂S (black) Green
Te7: Red
TSI: K/A H₂S+
LIA: K/A H₂S+
Urea: Neg
24
Q

Identify the reactions on the following media that suggest either Salmonella or Shigella are present:

Shigella

XLD
HE
Te7
TSI
LIA
Urea
A
XLD: Red/Clear
HE: Green
Te7: Red
TSI: K/A
LIA: K/A
Urea: Neg
25
Q

Discuss the course of illness and method of infection for Salmonella and Shigella:

Salmonella

Shigella

A

Salmonella: Ingestion of contaminated or undercooked poultry, beef, unpasteurized milk and eggs and person to person, gastroenteritis-usually self-limited up to serious septicemia.

Shigella: bloody stool, person-to-person self limiting

26
Q

What media and environment is needed to isolate Campylobacter jejuni?

A

Media: Campy BAP/Brucella agar, 10% sheep blood with antibiotics

Environment: 42°C and N 80-85%

27
Q

What are the specific biochemicals or reactions that will confirm Campylobacter jejuni in a GI culture?

A

Curved neg rod
Growth on Campy BAP
Catalase pos
Nitrate pos

Sensitive to 30 ug disk of nalidixic acid
Resistant to 30 ug disk cephalothin

28
Q

Discuss the course of the illness and method of infection for Campylobacter jejuni:

A

Source: Inadequately cooked poultry, untreated water, unpasteurized milk. Exposure to animals with diarrhea (puppies/kittens)

Frequency: most common cause of diarrhea in US

Illness: Fever, pain, 1-7 day incubation, self-limiting

29
Q

What media, reactions on that media, and temperature of incubation are needed to isolate Yersinia enterocolitica?

A

Media: CIN agar has cefsulodin, Irgasan, novobiocin. Bile salts and crystal violet are inhibitory agents for normal colon organisms. The colony morphology of the organism looks like a bulls eye-dark red or burgundy center surrounded by a translucent border. Aeromonas will produce similar colonies, but are oxidase pos (Yersinia is oxidase neg)

Temp of incubation: optimal growth 25-30°C

30
Q

Discuss the symptoms, method of infection, and course of the disease associated with Yersinia enterocolitica:

A

Source: Domestic animals, cats, dogs, undercooked meat

Disease: Acute enteritis, appendicitis-like syndrome, bloody stool

31
Q

What media, reactions on that media and temperature of incubation are needed to isolate Vibrio cholera?

A

Media: TCBS, which contains thiosulfate citrate bile salts sucrose

Temp: 35°C curved neg rods

32
Q

What is the course of illness and method of infection associated with Vibrio cholera?

A

Transferred through contaminated water, seafood

Enterotoxin production is severe C stimulates intestines to secrete water and electrolytes rice water stool

33
Q

Discuss the following-

Enterotoxigenic E. coli:

A

Secrete enterotoxins, symptoms similar to Chloera

Travelers diarrhea diagnose by elimination of everything else

34
Q

Discuss the following-

Enterohemorrhagic E. coli:

A

O157:H7 hemorrhagic diarrhea

can be fatal among young and elderly

35
Q

Discuss the following-

Enteropathogenic E. coli:

A

cause of infantile diarrhea

36
Q

Discuss the following-

Enteroinvasive E. coli:

A

bloody diarrhea has invasive properties

37
Q

What media will be useful and what will colonies look like in the isolation of E. coli O157:H7?

A

Sorbital MacConkey Agar

E. coli O157:H7 does not utilize sorbial (clear colony)

38
Q

What are the symptoms, method of infection and course of the disease associated with E. coli O157:H7?

A

Hemorrhagic diarrhea, no pus in stool
Contaminated undercooked meat
HUS has low plt. count, hemolytic anemia and possible kidney failure

39
Q

What are the symptoms, method of infection and course of the disease associated with Aeromonas?

A

Gastroenteritis usually from some aquatic exposure, untreated well water, raw oysters or clams. Self limiting

40
Q

How do you isolate and recognize the pathogen Aeromonas?

A
  • Straight neg rods
  • Oxidase pos on BAP
  • Beta hemolysis on BAP
41
Q

Discuss the pathogens, course of the illness source of infection, concerning food poisoning caused by the following organisms:

Staphylococcus aureus

A

Usually from infected food handler
Symptoms 2-8 hrs. after ingestion of food
No fever, but nausea, abdominal pain, severe cramping

42
Q

Discuss the pathogens, course of the illness source of infection, concerning food poisoning caused by the following organisms:

Clostridium botulinum:

A

Ingestion of preformed toxins very severe
Attacks neuromuscular junction of affected nerves
Home canning
Incubation time varies, need antitoxins

43
Q

Discuss the pathogens, course of the illness source of infection, concerning food poisoning caused by the following organisms:

Clostridium perfringens:

A
  • Relatively mild self limiting

- 8-12 hrs. incubation resolves in 24 hrs.

44
Q

Discuss the pathogens, course of the illness source of infection, concerning food poisoning caused by the following organisms:

Bacillus cereus:

A
  • Ingestion of contaminate rice, poultry, meat

- Incubation 8 to 16 hrs. after ingestion, lasts 24 hrs.

45
Q

Discuss the pathogen Helicobacter pylori in respect to isolation, identification and illness it is responsible for:

A
  • Causative agent for most gastric ulcers
  • Urease pos
  • Serologic tests for antibodies available
46
Q

What organisms make up the normal flora in the GI tract? Which ors are most predominant, aerobes or anaerobes?

Upper small intestine:

Lower intestine:

A

Upper small intestine: Strep, Lactobacilli, yeast

Lower intestine: Enterobacteriaceae, Enterococcus, Bacteroides, Clostridium, Peptostreptococcus, Bifidobacterium and Eubacterium

Anaerobes (1000) to Aerobes (1)

47
Q

What is the direct gram stain evaluated for on stool specimens?

A

Presences or absence of WBC, RBC, and mucus

48
Q

List the common viral pathogens that cause gastrointestinal infections:

A
  • Rotavirus
  • Enteric adenovirus
  • Calcivirus
  • Astrovirus
49
Q

List the common parasitic pathogens that cause gastrointestinal infections:

A
  • Giradia lambda
  • Entamoeba histolytica
  • Cryptosporidium parvum
  • Cyclospora caytanensis
  • Microsporidia
50
Q

Colony morphology, biochemical reactions Edwardsiella

A
  • Small straight rods

- Citrate =, methyl red +, Voges-Proskauer =, hydrogen sulfide + (tarda)

51
Q

Colony morphology, biochemical reactions Plesiomonas

A
  • Round ended, straight rods
  • Oxidase-positive.
  • Catalase-positive.
  • LOA-positive.
  • Indole-positive.
  • Lipase-negative.
52
Q

How to detect Clostridium difficile

A

Horse stable odor, yellow/orange on CCFA media