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Microbiology Rotation > Urine Bench > Flashcards

Urine Bench Flashcards

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1
Q

Procedure for CCMS specimens

  • calibrated loops?
  • How is colony count determined?
A

Clean genitals, expel fists 1/3 of urine, collect middle 1/3 for culture, and expel the remaining 1/3

  • use .001 ml cal loop
  • 10, 000 CFU/ml (of 1 or 2 organisms)= identify and do susceptibilities (3 or more organisms is contamination)
  • > 100,000 CoNS is treated like pathogen
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2
Q

Procedure for foley (indwelling) cath specimens

  • calibrated loops?
  • How is colony count determined?
A

Clamp cath for 1/2 to 1 hour, take the specimen from catcher tubing (not cath bag). Cath tips will not be culturedClean genitals, expel fists 1/3 of urine, collect middle 1/3 for culture, and expel the remaining 1/3

  • use .001 ml cal loop
  • 10, 000 CFU/ml (of 1 or 2 organisms)= identify and do susceptibilities (3 or more organisms is contamination)
  • > 100,000 CoNS is treated like pathogen
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3
Q

define: in-and-out catheter
- calibrated loops?
- How is colony count determined?

A

Obtained by catheterizing the patient to obtain the sample

  • use .001 ml cal loop
  • 10, 000 CFU/ml (of 1 or 2 organisms)= identify and do susceptibilities (3 or more organisms is contamination)
  • > 100,000 CoNS is treated like pathogen
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4
Q

Define: - cystoscopy

A

Obtained at time of cystoscopy, sometimes collected from meters at time of cystoscopy. These are labeled right or left kidney urine.

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5
Q

Define: suprapubic aspirate

  • calibrated loops?

- How is colony count determined?

A

Collected directly from the bladder by using a syringe and needle entering the bladder through the skin

  • divide BAP, MAC and CNA into two segments (“2” and “3”) using .001 ml loop streak “3” side, .01 ml loop break “2” side and Inoculate a thio tube.
  • if growth, perform colony count and identify all organisms and perform susceptibilities
  • if thio only is growing, Gram stain and set up appropriate media
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6
Q

Recommended media for CCMS

- purpose of medium

A

MAC - selective for GNRs (lactose)

CNA - Selective for GPC/GPRs

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7
Q

Recommended media for Foley cath

- purpose of medium

A

MAC - selective for GNRs (lactose)

CNA - Selective for GPC/GPRs

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8
Q

Recommended media for in-and-out

- purpose of medium

A

BAP - All purpose medium (hemolysis)
MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs

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9
Q

Recommended media for suprapubic

- purpose of medium

A

BAP - All purpose medium (hemolysis)
MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs
THIO - Enhances aerobes, facultative, and obligate anaerobes

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10
Q

Recommended media for cytoscopy

- purpose of medium

A

BAP - All purpose medium (hemolysis)
MAC - selective for GNRs (lactose)
CNA - Selective for GPC/GPRs
THIO - Enhances aerobes, facultative, and obligate anaerobes

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11
Q

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: CCMS

A

> or = to 10,000 CFU/mL

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12
Q

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: foley cath

A

> or = to 10,000 CFU/mL

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13
Q

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: in-and-out

A

> or = to 1,000 CFU/mL

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14
Q

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: suprapubic

A

> or = to 1,000 CFU/mL

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15
Q

What colony count is suggestive of infection and requires complete identification/susceptibility of the organism: cystoscopy

A

> or = to 1,000 CFU/mL

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16
Q

What most common Staph causes UTIs?

  • what tests should you run?
  • results?
A

Staph aureus

Staph saprophyticus

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17
Q

What most common Strep causes UTIs?

  • what tests should you run?
  • results?
A 
Enterococci 
Streptococcus agalactiae (group B) 
Strep pyogenes (Group A)
18
Q

What most common GNR causes UTIs?

  • what tests should you run?
  • results?
A 
Enterobacteriaceae: 
E. coli 
Pseudomonas
Proteus 
Klebiella
19
Q

What most common GPR causes UTIs?

  • what tests should you run?
  • results?
A

Clostridium species

Bacillus species: (almost always considered contamination)

20
Q

What most common Corynebacterium causes UTIs?

  • what tests should you run?
  • results?
A

ureliticum

21
Q

What most common Yeast causes UTIs?

  • what tests should you run?
  • results?
A

Candida species

22
Q

What most common Staph causes UTIs?

  • what tests should you run?
  • results?
A

*

23
Q

What most common Staph causes UTIs?

  • what tests should you run?
  • results?
A

*

24
Q

Correlate the number of organisms seen on a gram stained direct smear of urine with the overall colony count

A

presence of one or more organisms per OIF correlates with a colony count of > 10^5

25
Q

Correlate the presence of many squamous epithelial cells in a direct smear with specimen quality

A

presence of many squamous epithelial cells indicates contamination

26
Q

List 5 most common contaminants found in urine cultures due to improper collection technique

A
  1. CoNS
  2. Cornebacterium
  3. Lactobacillus
  4. Viridans Strep
  5. Bacillus species
27
Q

Colony/gram stain morphologies of: CoNS

A

GPC

28
Q

Colony/gram stain morphologies of: Corynebacterium

A

GPR

29
Q

Colony/gram stain morphologies of: Lactobacillus

A

GPR - skinny

30
Q

Colony/gram stain morphologies of: Viridans strep

A

GPC

31
Q

Colony/gram stain morphologies of: Bacillus species

A

GPR - boxcar

32
Q

List the criteria for establishing an unsatisfactory urine (contaminated specimen warranting a repeat specimen), based on culture results

A

if not in boric acid tube, or if in tube longer than 48 hours and if not in a sterile container and on ice

(? 3 or more organisms with > or = 10,000 CFU/mL (or>1,000 for group 2) ?)

33
Q

What screening medium and rapid biochemical test may be used in smaller labs to identify Escherichia coli in urine cultures

A

*

34
Q

What is the proper method for transporting and holding urine specimens?

A

> 2 hours: transport in a urine transport with boric acid at room temp, otherwise refrigerate or keep on ice until culture can be done

35
Q

What antibiotic is only tested on urine pathogens (and is only used in treatment of urinary tract infections

A

*

36
Q

What are the more common, non-culture, screening methods employed for detecting urinary tract infections
- overall general sensitivity/specificity of these methods

A

*

37
Q

clinical signs and symptoms of urinary tract infections involving the upper urinary tract

A

flank pain, nausea, vomiting, fevers, chills, night sweats, and costovertebral angle tenderness

38
Q

clinical signs and symptoms of urinary tract infections involving the lower urinary tract

A

uncomplicated: dysuria, frequency, urgency, suprapubic pain, and hematuria

39
Q

effects of various host facts on the predisposition for urinary tract infections

A

gender: mostly women
age: 65 and older, incidence increases dramatically
indwelling caths: bad care/ length of time/ patient susceptibility
pregnancy: enlarged uterus pressure & hormones
disease:
sexual activity: usually uncomplicated UTIs in sexually active young women
stones:

40
Q

complications that can arise from an untreated or undiagnosed urinary tract infection

A

*

Microbiology Rotation (7 decks)

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