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CRRAB II- FINAL > UTI Micro- Debiel > Flashcards

UTI Micro- Debiel Flashcards

1
Q

Why are B-lactam antibiotics not recommended as first line therapy for acute uncomplicated cystitis?

A

Widespread E. coli resistance rates above 20 percent!

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2
Q

What is the key feature distinguishing cystitis and pyelonephritis?

A

Pyelonephritis will have a fever

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3
Q

Only members of what bacterial family convert nitrate to nitrite?

A

Enterobacteriaceae (E. Coli)

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4
Q

What is the gold standard for diagnosing UTI?

A

Detection of bacteria in urine culture

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5
Q

First line treatments for uncomplicated cystitis?

A

Nitrofurantoin

Bactrim (Trimethoprim/sulfamehtoxazole)

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6
Q

First line treatment for acute uncomplicated pyelonephritis?

A

Fluoroquinolones (ciprofloxacin, levofloxacin)

OR

Bactrim or Ceftriaxone

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7
Q

What is the central pathogenesis for catheter associated UTIs?

A

Formation of BIOFILM (a living layer of uropathogens) on the urinary catheter

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8
Q

What are three phrophylactic strategies for UTI management?

A

Continuous Antibiotics
Postcoital antibiotics
Patient- initiated therapy

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9
Q

What are the 4 general defenses of the urinary tract?

A
  1. Mechanical flushing of urination
  2. IgA in urinary mucosa
  3. Urine chemistry = acidity, lysozymes, lactoferrin
  4. Surface proteins are different from other epitheliums
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10
Q

What are the 3 major threats to the urinary tract system?

A 
Normal Biota (often from GI)
Catheters
Glomerular Nephritis (strep pyogenes)
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11
Q

Does strep pyogenes from skin infection AND strep throat both cause damage to the kidneys?

A

YES!

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12
Q

What is the leading cause of both complicated and uncomplicated UTIs?

A

E. Coli

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13
Q

Second leading cause of UTIs, and common in young sexually active females?

A

Staph. saprophyticus

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14
Q

Are E. Coli strains that cause UTIs the same strains that cause diarrhea???

A

NO! THEY ARE NOT! E. coli strains that cause UTIs are NORMAL FLORA of the GI tract

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15
Q

Name two risk factors for UTIs

A

Sexual intercourse

Catheterization

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16
Q

What are the most common type of nosocomial (hospital-related) infections?

A

Catheter- related UTIs

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17
Q

Are UTIs common in children? When would you see a UTI in a child?

A

Not common. If see in child it is usually an anatomic or functional abnormality

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18
Q

UTIs more common in women or men? When would you see a UTI in a man?

A

more common in women

In men, usually underlying urinary tract abnormality = obstruction from an enlarged prostate

19
Q

Define selective media

A

contains compounds that selectively inhibit growth of some microbes but not others

20
Q

Define differential media

A

contains an indicator, usually a dye, that detect particular chemical reactions occurring during growth

21
Q

How do you distinguish staph from strep?

A

Catalase test!
Staph is catalase +
Strep is catalase -

22
Q

What does catalase enzyme do?

A

Converts hydrogen peroxide to water and oxygen

23
Q

How do you perform a catalase test?

A

Putting a small inoculum of bacteria into hydrogen peroxide.

With catalase present there is a rapid release of oxygen bubbles

24
Q

How do you differentiate Staph aureus from Staph saprophyticus?

A

Coagulase test
Staph Aureus = coagulase +
Staph Sapro = coagulase -

25
Q

What are you looking for in a coagulase test?

A
  • Bound coagulase (clumping factor) is bound to bacterial wall
  • It reacts with fibrinogen and results in precipitation of fibrinogen on staph cells
  • This causes cells to clump with bacterial suspension is mixed with plasma
26
Q

How do you determine Staph epidermidis from Staph saprophyticus?

A

Both are catalase positive and coagulase negative

Look at sensitivity to novobiocin!

Sapro = resistant
Epidermidis = sensitive
27
Q

MOA of novobiocin?

A

Inhibits bacterial DNA gyrase in susceptible organisms

28
Q

Gram + cocci
Catalse +
Coagulase -
Novobiocin RESISTANT

A

Staph Saprophyticus

29
Q

When would you use flurorquinolones like ciprofloxacin?

A

Only use with severe symptoms and allergy to 1st line treatments OR
Bactrim was used in the last 3 months for UTI OR bactrim resistance in area is greater than 20%

30
Q

What is the specific 1st line treatment for S. saprophyticus but is NOT suppose to be used empirically?

A

Amoxicillin/clavulanate

31
Q

Gamma hemolysis bug (no clearing)

A

Staph saprophyticus

32
Q

What colonies appear yellow with beta hemolysis when grown on blood agar?

A

Staph aureus

33
Q

Describe MacConkey agar

A

Promotes growth of gram neg (and inhibits gram +)

Determines if they can ferement lactose

If you can ferment lactose colonies will appear pink

If you cannot ferment lactose the colonies will by colorless/translucent

34
Q

Gram negative bacteria
Oxidase negative
Indole positive
Round pink circular colonies on MacConkey agar (can ferment lactose)

A

E. Coli

35
Q

What protein chelates iron away from microorganisms that like to use iron for their ATP-generating reactions?

A

Lactoferrin

36
Q

What component of our urinary tract inhibits most microorganisms from colonizing?

A

Surface proteins on epithelial cells

37
Q

Why is urine cloudy in a UTI?

A

presence of WBCs and bacteria

38
Q

What are the 2 names we use to differentiate categories of E. Coli that cause UTIs vs. diarrhea?

A

Uropathogenic E. Coli = UPEC

Extraintestinal E. Coli = ExPEC

39
Q

What type of hemolysis does Staph saprophytic have?

A

Gamma hemolysis

40
Q

Post-antibiotic course, itching, burning, vaginal discharge that is white like cottage cheese. WHat is the infection?

A

Candida Albicans Yeast Infection

41
Q

What does Trichomonas discharge look like?

A

Yellow-frothy dischare

42
Q

What type of hemoysis does staph aureus have?

A

Beta hemolysis

43
Q

What kind of agar would you grow Klebsiella on?

What test would you then do to differentiate it from E. Coli?

A 
MacConkey agar
Indole testing (Klebsiella is indole negative)

CRRAB II- FINAL (20 decks)

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