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Microbiology test 3 > UTI > Flashcards

UTI Flashcards

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Biology 101 flashcards
1
Q

Community Acquired vs. Nosocomial rule

A

48 hours

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2
Q

recurrent UTIs definition

A

3 or more symptomatic bacteria within 1 year

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3
Q

Uncomplicated UTI organisms

A

E. coli (most common)
P. mirabilis
K. pneumonia

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4
Q

P miribalis characteristics & type of UTI

A

swarming, urease producer

Uncomplicated uti

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5
Q

Staphylococcus saprophyticus

A

Urease producer

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6
Q

Enterococcus faecalis

A

gram-positive UTI microbe

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7
Q

CoNS

A

S. epi, novobiocin sensitive UTI microbe

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8
Q

S saprophyticus

A

gram POSITVIE, urease producer, biofilm producer

S. sapro, novobiocin resistant UTI microbe

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9
Q

Pseudomonas auerginosa

A

gram negative UTI microbe

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10
Q

Name the Enterobacteria strains

A

PESSKY Strains

Proteus, Escherichia, Shigella, Salmonella, Klebsiella, Yersinia & Serratia

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11
Q

Menstrual predisposing UTIs explanation and microbes

A

increased risk due to loss of vaginal & uro-epithelia + normal flora
E.coli
S. saprophyticus

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12
Q

postemenopausal predisposing factors for UTIs

A

bladder or uterine prolapse (STASIS)

loss of estrogen-changes in vaginal flora

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13
Q

Men predisposing factors for UTIs

A

Uncircumsized-colonization by gram-negative bacilli
new sex partner, anal intercourse
urinary tract obstruction (BPH)

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14
Q

Predisposing factor for UTI (both genders)

A

congenital abnormality (vesicoureteral reflux)

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15
Q

2 common fimbrial adhesis of E.coli

A
  1. mannose-sensitive fimbra-FimH protein

2. P fimbria

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16
Q

Mannose-sensitive fimbria: a/w which microbe, which condition, what it binds

A 
E.coli
FimH protein
helps colonize LOWER UT-acute cystitis
binds mannose-residues on proteins of bladder mucosa
mannose sensitive
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17
Q

P fimbra: a/w which microbe, which condition, what it binds

A 
E.coli
a/w acute pyelonephritis
Binds P blood group antigen
enhances persistence of infection & inflammation in UT
mannose resistant
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18
Q

Other uropathic virulence facors

A
  1. Hemolysin-cytotoxic enzyme
  2. Endotoxin-(LPS of gram-negative bacteria)
  3. Aerobactin- (siderophore,scavenges iron)
  4. Urease (raises pH of urine, can form Struvite crystals in kidneys; ureters
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19
Q

Urease forms what?

A

struvite crystals

these can congregate as a type of biofilm on foley urinary catheters

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20
Q

Capsular polysaccharides are responsible for what (2)?

A

biofilm formation in catheters

capsular K antigen (ONLY gram NEGATIVE Enterobacteriacea)

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21
Q

Which microbes can form biofilm (6)?

A

E. coli, Proteus mirabilis, Klebsiella pneumonia, S. epidermidis, Enterococcus faecalis, Pseudomonas aeruginosa

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22
Q

Capsular K antigen:
what does it do?
which type of microbes have it?

A

protects from phagocytosis

ONLY gram-negative Enterobacteriacea

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23
Q

Why would a UTI microbe want a flagellum?

A

to facilitate movement

swarming (coating of catheter)

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24
Q

What is the route of entry for the MAJORITY of UTIs? cause by what (uncomplicated, complicated)

A 
ascending
most common pathogen: E. coli
UPEC
Uncomplicated: GI contamination
Complicated: Iatrogenesis
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25
Q

<5% UTI pathogenesis, source, most common microbes (3)

A 
Descending
hematogenous & lymphatic
-S. aureus
-Mycobacterium tuberculosis
-Candida albicans
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26
Q

Signs & Symptoms of UTI

A

dysuria, pyuria (cloudy urine), hesitancy, increased frequency/urge to urinate
Females-concurrent cystitis
Males-concurrent prostatitis

27
Q

STD UTI agents

A

Chlamydia trachomatis, Neisseria gonorrhoeae & Trichomonas vaginalis

28
Q

Cystitis definition, signs & sxs

A

aka: lower UTI, LOCALIZED infection/inflammation of bladder

urethritis, bacteria, pyuria, suprapubic tenderness, hematuria

29
Q

Pyelonephritis def, presentation

A

upper UTI renal infection
localized Infection w/SYSTEMIC effects
can be ascending or descending
MAY precipitate premature labor

30
Q

pyelonephritis signs and sxs

A 
hallmark pain in flank (latus)
costoverteral angle (CVA) tenderness
lower UTI symptoms
spiking fever (104-5 F)
systemic effects (N/V, HA, malaise)
31
Q

normal microbiota contaminants of urine sample (3)

A

Sta. epidermidis
Cornebacterium sp.
Lactobacillus sp.

32
Q

Dx of UTI (classic quantities)

A

positive urine culture (at least 10^5 CFU/ml)
AND
pyuria-leukocyte count (at least 10^5 WBC/mL)

33
Q

Accepted for UTI dx

A

at least 10^2 CFU/mL + acute sxs & pyuria

34
Q

describe Kirby Bauer test for UTI

A

determines antibiotic susceptibility
standardized (Mueller-Hinton Agar)
requires a pure culture

35
Q

Rapid dipstick components for UTI

A

pH: normal urine is acidic, UREASE producers RAISE pH to neutrality
leukocyte esterase: detects pyuria, detects esterases released from degraded WBC
Nitrate reductase: indirect test for bacteria, DIRECT detection of NITRITES
produced by E. coli, Proteus & Klebseilla

36
Q

Uncomplicated UTI tx length (cystitis, pyelonephritis)

A

duration depends on drugs prescribed
Cystitis: 3 days
Pyelonephritis: 10 days

37
Q

Uncomplicated cystitis main antibiotics (4)

A
  1. Cephalosporin (B-lactam)
  2. TMP/SMX (inhibit tetrahydrofolate synthesis)
  3. Nitrofurantoin-reactive intermediates (inhibits several bacterial enzyme systems)
  4. Fosfomycin (inhibits cell wall synthesis

depends on level of resistance in the area

38
Q

Uncomplicated Pyelonephritis main antibiotic

A

Ciprofloxacin/Levofloxacin

Fluoroquinolones-inhibit DNA replication

39
Q

UTI Urease producers (2)

A 
Proteus Miribalis (swarming)
Staphylococcus saprophyticus
40
Q

UTI w/ Nitrite Reductase (3)

A

uropathogenic E. Coli
Proteus Mirabilis
Klebsiella pneumoniae

41
Q

P. Mirabilis morph/characteristics

A

gram NEGATIVE
urease producer
biofilm former

42
Q

UTI biofilm formers

A 
E. Coli
P,Miribalis
Klebsiella pneumonia
Staphylococcus saprophyticus
Enterococcus faecalis
43
Q

Klebsiella pneumonia gram stain & spec. characteristics

A

gram NEGATIVE
urease positive (UPs form struvite crystals)
biotin formers

44
Q

S. Saprophyticus gram stain/characteristics

A

Gram POSITIVE
Urease producer
biofilm former

45
Q

Enterococcus faecalis gram stain/charactersitics

A

gram POSITIVE

biofilm former

46
Q

CoNS

A

gram POSITIVE

S. eip- Novobiocin sensitive

47
Q

Descending UTI bacteria: 3 most common

A

S. aureus, Mycobacterium tuberculosis, Candida albicans

48
Q

Urethritis definition

A

LOCALIZED inflammation of urethra (NOT confirmatolry sign of UTI)

49
Q

STI agents of UTI (3)

A

Chlomydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis

50
Q

Cystitis definition & signs/sxs

A

Localized infection/inflammation of bladder
Urethritis 
Bacteriuria–significant (10^5CFU/mL) from clean-voided midstream-catch urine 
Pyuriaor odiferous urine 
Suprapubic tenderness 
Hematuria –blood in the urine

51
Q

Pyelonephritis definition

A

Upper UTI
Renal infection 
Localized infection with SYSTEMIC effects 
Entry of pathogen: Ascending or Descending
May precipitate premature labor

52
Q

Pyelonephritis: Signs and Symptoms

A

Hallmark pain in flank (latus)*-not always present
Costovertebral angle (CVA)tenderness
Lower UTI Symptoms -bacteriuria; dysuria; urgency; pyuria 
Spiking fever40-41 oC (104-5 oF)
Systemic effects 
Nausea; vomiting; headache; malaise

53
Q

Asymptomatic Bacteruia

A

UTI w/out specific symptoms
Risk Factor for Upper UTI 
Treatments for:
1.Pregnant women –lower infant birth weight 2.Preschool children –renal scarring

54
Q

Urine sampling techiques

A

Prevent contamination with normal microbiota
Midstream Clean Catch -most commonCatheter “in -out” 
Suprapubic Bladder Aspiration -children
Work up samples immediately or store at 4oC

55
Q

name 3 normal microbiota that may contaminate urine samples

A

Staphylococcus epidermidis, Corynebacterium sp, Lactobacillus sp.

56
Q

What would you use a uricult test kit for?

A

to quantify & tentatively ID bacteria

57
Q

Kirby-Baur test

A

determines antibiotic susceptibility
standardized (Mueller-Hinton Agar)
requires a pure culture

58
Q

What can you detect with rapid urine dipstick?

A
  1. pH (normal urine pH=6 {acidic})
    - UREASE producers RAISE pH to near neutrality
  2. Leukocyte esterase detects pyuria (detects esterases released from degraded WBC)
  3. Nitrate reductase; indirect test for bacteria, DIRECT detection of NITRITES, produced by E.coli, Proteus & Klebsiella
59
Q

Which UTI bacteria produce nitrites?(3)

A

E coli
Proteus
Klebsiella

60
Q

How do you chose a UTI antibiotic?

A 
Antibiotic sensitivity (BOTH Patient & Microbe) Levels achieved in urine 
Ability to penetrate renal tissue (in Pyelonephritis)
61
Q

Uncomplicated cystitis: length of treatment

A

3 days

62
Q

Uncomplicated pyelonephritis length of treatment

A

10 days

63
Q

Main antibiotics for uncomplicated cystitis (4)

A
  1. Cephalosporin
  2. TMP/SMX
  3. Nitrofurantoin-reactive intermediates
  4. Fosfomycin
    (2-4 depend on level of resistance in area of US)
64
Q

Main antibiotics for uncomplicated pyelonephritis

A

Ciprofloxacin/Levofloxacin
(fluoroquinolones inhibit DNA replication)
-depends on level of resistance in area of US

Microbiology test 3 (8 decks)

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