UTIs Flashcards
What are the three defense mechanisms of the UI tract?
- Low pH
- Urea content
- Flushing action
What are the symptoms of urethritis and cystitis? (4)
Dysuria
Hematuria
Frequency
Urgency
What are the symptoms of prostatitis?
LBP
Fever/chills
Is there a positive urine culture in prostatitis?
Yes
Is there a positive urine culture in urethritis? Cystitis?
Yes, and yes
Is there a positive urine culture in pyelonephritis?
Yes
What are the symptoms of pyelonephritis?
Flank pain
Fever
Dysuria, frequency, urgency
What is the complication of pyelo in prego?
Premature birth
Is there discharge associated with UTIs?
Nope
Urine cloudiness is indicative of what?
UTIs
How do you diagnose UTIs?
- WBC in urine (pyuria)
- Leukocyte esterase in urine
- Nitrite test
The presence of at least (BLANK) bacteria per field is indicative of UTIs? What does this correlate to?
one
Correlates to 100,000 CFU/ml
How many more times do women get UTIs compared to men?
10x
Does sex increase the risk for UTIs?
Yep
What common hospital procedure increases the risk for the development of a UTI?
Catheterization
Why do elderly men get UTIs more commonly than women?
Prostatitis, infected stones, BPH
Catheterization
Which two bacteria are community acquired UTIs usually caused by?
E.coli
Staph Saprophyticus
Do enteric bacteria have LPS usually? Are they anaerobics?
Yes
Facultative anaerobes
What gram stain is enterobacteriaceae? Where are these usually found? Oxidase result?
Gram negative
Normal flora of the GI tract
Oxidase negative
What are the virulence factors for the enterobacteria?
endotoxin
capsule
Flagella
True or false: E.coli is part of the normal flora of the intestine
True
The difference in the degree of virulence of different strains of e.coli are correlated with what?
Plasmid acquisution
What are the adhering bits of e.coli?
Fimbrae or pili
What percent of UTIs are caused by E.coli?
80-95%
What is the reservoir of E.coli that cause UTIs?
Intestinal flora
What are the three virulence factors for E.coli?
Adhesins (pili)
Hemolysins
Endotoxins
What is the function of hemolysin that e.coli carry?
Lyses RBCs
Which type of pili do e.coli have? What do these bind to on epithelial cells?
Type 1
binds to mannose
What are the pili on subpopulations of E.coli that bind to sugar residues specifically on uroepithelial cells?
P-pili
How do you differ strep and staph?
Catalase
Is staph motile? Do they form spores?
no
Which staph is coag positive? Which are not?
Positive = Staph Aureus Negative = S. Epiderm, S. Saprophyticus
How does Staph Saprophyticus cause disease (virulence factor)?
hemagglutinin/adhesin
What is the abx that S. Saprophyticus is resistant to?
Novobiocin
What is the significance of the biofilm that staph. saprophyticus produces?
Better colonization of catheters
What are the three major nosocomial UTI infection pathogens?
Klebsiella
Proteus
Pseudomonas
What is the gram stain and morph of proteus mirabilis?
gram negative
What are the virulence factors of proteus?
Urease
How does proteus increase the pH in the urinary tract? What can this cause?
Urease produces ammonia
This may cause renal stones via Mg and Ca precipitation
What is the significance of the biofilm that proteus produces?
better colonization of catheters
What is the treatment for Proteus mirabilis infections?
TMP-SMX
What is the morphology and gram stain of pseudomonas aeruginosa? Oxidase result?
gram negative aerobic rod
Oxidase positive
Does pseudomonas ferment?
Nope
Where can pseudomonas grow?
Wherever water is
Is pseudomonas an opportunistic pathogen?
Yep
Is pseudomonas motile?
Yes
A blue-green culture is indicative of what bacteria?
Pseudomonas
What is the treatment for pseudomonas caused UTIs?
Multiple abx courses
What is the gram stain and catalase result for enterococcus? Morph?
Gram positive cocci
Catalase negative
Can enterococcus grow in bile? What is the significance of this?
Yes, this can be utilized to differentiate between this and E.coli
Is enterococcus sensitive to optochin?
No
What about enterococcus makes it hard to treat?
Very abx resistant
What are the risk factors for enterococcus?
treatment with broad spectrum abx and catheterization
What is asymptomatic bacteriuria? Who is this usually found in? Would you treat this?
Significant bacteriuria without symptoms
Old people get this
No treatment required
What three situations would you treat asymptomatic bacteriuria?
- Prego women
- Prior to urologic survey
- Renal transplant
What is the treatment for uncomplicated cystitis?
Trimethoprim/sulfmethaoxazomle
What is the treatment for pyelonephritis? (gram negative and gram positive are different)
Fluoroquinolones for gram negative
Amox for gram positive
What are the drugs for asymptomatic bacteriuria?
Amox
Cephalexin
Nitrofurantoin
What are the three major clinical diseases that enterococcus causes?
- UTIs
- Peritonitis
- Endocarditis
In what part of the urine stream should urine samples be caught?
Midstream
Why does DM increase the chances of a UTI?
More sugar in the urine
What are the two major problems with treating enterobacteriaceae infections?
- Antigenic mutation of K and H antigens
2. Abx resistance
What chemical do Enterobacteriaceae need to survive?
Fe
How do you differentiate between shigella/salmonella and E.coli?
Lactose fementation
Is Staph. Saprophyticus coagulase positive or negative?
Negative
What is the test that differentiates Staph Saprophyticus from other staph species? What is the result of this test?
Novobiocin test, should be resistant
True or false: Staph Saprophyticus can cause asymptomatic UTIs
True
How do you differentiate between Enterococcus and strep?
Enterococcus grows in high salt/bile
Nitrite in the urine is specific for which bacteria?
E.Coli
Is pseudomonas oxidase positive or negative?
Oxidase positive
