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Bacteriology > UTI > Flashcards

UTI Flashcards

1
Q

Bacteriuria

A

Presence of bacteria in urine

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2
Q

Pyuria

A

Presence of WBCs in urine

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3
Q

Cystitis

A

UTI associated with bladder mucosa

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4
Q

Pylenephritis

A

UTI of renal parenchyma -kidneys

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5
Q

Urethritis

A

Urethra infection

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6
Q

Normal flora of Urinary Tract

A 
Coagulase-negative staphylococci
Diphtheroids
Lactobacilli
Bacillus species
Enterococci Saprophytic yeast
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7
Q

Significant Bacteriuria Concept

A

Up to 10^4/ml considered normal i.e. Insignificant
Organisms
10^5/ml and above considered to be Significant

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8
Q

Female - Predisposing Factors

A
  • Shortness of female urethra
  • Sexual intercourse (honeymoon cystitis)
  • Pregnancy & Contraceptive devices
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9
Q

Male - predisposing factors

A
  • Prostatic hypertrophy (prostate enlargement)
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10
Q

Common factors - both genders

A 
Presence of foreign body: stone, catheter, surgical instrumentation.
 - Obstruction: Urethral stricture .
 - Neurogenic bladder dysfunction
Spinal cord injury
Diabetes
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11
Q

Hemolytic uremic syndrome (HUS)

A
  • when BVs in kidneys become damaged and inflamed. This damage can cause clots to form in the vessels. The clots clog the filtering system in the kidneys.
  • Linked to O157 EHEC
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12
Q

E coli causing UTI

A

E coli contributes to 90% of UTI strains

01,02,04,07,18,75

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13
Q

Virulence factors - E coli

A
  • Pili/Fimbriae
  • Hemolysins
  • Aerobactin
  • Biofilm
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14
Q

Pathogenicity

A

Ascending route - Colonization of perinium and urethral area by enteric (intestinal) m.o.s

Rarely haematogenous (via blood) - Descending route

Entero-Vesical- Fistula - enterovesical fistula is an abnormal connection between the bowel and bladder - Fistulas form when inflammation causes sores, or ulcers, to form on the inside wall of the intestine or nearby organs

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15
Q

Lower UTI

A

Urethritis & Cystitis

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16
Q

Urethritis

A

Dysuria - burning sensation / pain during micturition & frequent urination.

17
Q

Cystitis

A

Dysuria - characteristic supra pubic pain & tenderness, occasional hematuria. Diminished bladder capacity leads to frequent micturition.

18
Q

Causes of lower UTI

A

Staph.saprophyticus
Appropriate Specimen : Cystitis = Urine (Clean Catch)
{Most Appropriate Abx = Cotrimoxazole }

19
Q

Upper UTI

A

Acute pyelonephritis

20
Q

Acute pyelonephritis

A

Flank / loin pain & fever, renal tenderness on palpation.
Hematuria with fever & chills.
(Sp:Pyelonephritis-Urine)

21
Q

Helminths - UTI

A

Schistosoma haematobium.

Trichomonas vaginalis

22
Q

Fungi - UTI

A

Candida albicans

23
Q

Specimen - UTI

A

Urine- MSU (“clean catch”)
Catheter specimen (CSU)
Suprapubic aspirate

24
Q

Lab ID - UTI

A 
Gram Stain –GNB/GPC  (1 Bacterium / field is significant)
Urinalysis- e.g. Pyuria (>5 WBC/HPF) 
Culture  on  -- CLED  / ( MAC ) , B A.
Biochemical
Antimicrobial Susceptibility Testing
25
Q

Significant results

A

Significant bacteriuria: ≥ 100,000 CFU/ml

26
Q

ID of anaerobic bacteria- UTI

A

Extremely foul smelling urine
No response to aerobic antibiotics
No growth on gram stain

27
Q

E coli - ID

A

Gram: Gram-negative rods/bacilli (pink)
BA (Blood Agar): Large, white, colonies.
MAC (MacConkey): Lactose fermenting, Pink colonies
CLED (Cystine-Lactose-Electrolyte Deficient) : Lactose fermenting, Yellow colonies.
Motile

28
Q

Klebsiella pneumoniae

A

Gram negative bacilli-Non motile
Citrate, Urease positive
Colony-on MC-Lactosfermenting (L.F,), Mucoid ,Large

29
Q

Pseudomonas aeruginosa

A

GNR, motile

30
Q

Proteus spp

A

Gram: Gram-negative rods / bacilli ( pink )
BA: Single colony showing Swarming
MAC: Non-Lactose fermenting ( NLF )
non-pink colonies
CLED: Non-Lactose fermenting-colonies (translucent blue )
MR +ve , Urease +ve
Motile

31
Q

Antimicrobial agents - UTI

A

Co-trimoxazole = ( Most Appropriate Antibiotic ).

Amoxicillin , Tetracycline , Amoxicillin-Clavulanic acid, Cefuroxime , Ciprofloxacin

32
Q

Prevention - UTI

A

Plenty water and frequent voiding
- Voiding after sexual intercourse
- Cranberry Juice → →
↑ - Fluid intake → urine output
- Acidifies urine
- Interferes with bacterial attachment to urothelium
-Phenazopyridine ( urogesic ) relieves symptoms.

Bacteriology (9 decks)

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