UTI OSPE

Question 1

Specimen collection: Urine sample before antimicrobial therapy

Answer 1

1. Midstream urine collection (MSU):
   ▪Ideal specimen
2. Supra-Pubic aspiration(bladder): infants/babies
3. Catheter urine: Catheterized patients
4. Early morning urine (3 consecutive days): M.tuberculosis
5. Terminal part of urine after exercise: Schistosoma haematobium

Question 2

Transport:

Answer 2

➢Should be sent with minimum delay (avoid multiplication)
➢Refrigerate urine – delay of more than 1hr

Question 3

Screening tests: for asymptomatic

Answer 3

▪Griess Nitrite test ***
▪Leukocyte esterase test
▪Dipstick test *
▪Catalase test
▪Triphenyltetrazolium chloride (TTC) test
▪Dip Slide culture test

Question 4

Macroscopic examination

Answer 4

colour, pH, turbidity

Question 5

Microscopic examination

Answer 5

▪ Pus cells(Pyuria) WBCs : More than 10/ml indicates infection
▪ RBCs: Hematuria
▪ Epithelial cells: indicates contamination
▪ Urinary casts: renal tubular damage
▪ Gram’s stain: demonstrate bacteria

Question 6

Semiquantitative method

Answer 6

KASS’ concept of significant bacteriuria

Question 7

Significant Bacteriuria definition * word for word

Answer 7

A colony count of >10 power 5 CFU/ml of a single bacterial species from a properly collected mid stream urine (MSU) is considered as significant

Question 8

Exceptions for Significant Bacteriuria

Answer 8

▪ Supra pubic aspirate
▪ Catheter urine
▪ Any organism causing descending UTI (Staph aureus,
M.tb, S.typhi)
- candida inf in men

Question 9

4 Quadrant streaking: BA and Mac conkey agar with caliberated loop of 0.01 ml

Answer 9

➢ Growth in inoculum : 10000 CFU/ml
➢ Growth in primary : 25,000 CFU/ml
➢ Growth in primary & secondary: 50,000 CFU/ml
➢ Growth upto tertiary : 75000 CFU/ml
➢ Growth upto quaternary : 10power5 CFU/ml

Question 10

staph aureus

Answer 10

gram,culture, biochem

Question 11

E.coli

Answer 11

gram -
indole: +
catalase: +
urease n oxidase:-
imvic: ++–
TSI: A/A,GAS+

Question 12

Kleb. pneumoniae

Answer 12

G- bacilli
mucoid colonies on BA
urease: +
citrate: +
TSI: A/A,GAS+
imvic:- -++

Question 13

proteus

Answer 13

swarming colony on BA
urease:+
TSI:
imvic:-+-+

Question 14

candida

Answer 14

refer notes

Question 15

CLED medium

Answer 15

-identify organism
colony:
E.coli: opaque yellow,slightly deeper centre
kleb: yellow to whitish blue,mucoid
proteus: translucent blue
pseudomonas:green colonies,matted periphery
staph.aureus: deep yellow
CONS:pale yellow