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Micro Final (Lauren, Shelby, and Annie) > UTIs > Flashcards

UTIs Flashcards

1
Q

What are some sx that a UTI now involves the upper urinary tract (pyelonephritis)

A

Fever over 101 F**

Flank Pain**

Chills

Nausea/vomiting

Shaking

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2
Q

Do we see fevers with lower UTIs (simple cystitis)?

A

Yes, mild fevers 101 or below

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3
Q

What are the signs of UTI in newborns?

A

Fever or hypothermia

Poor feeding

Jaundice

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4
Q

What are the signs of UTI in Infants (not newborns)

A

Vomiting

Diarrhea

Poor feeding

(Wow wouldn’t that make you think of a GI problem)

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5
Q

What are the signs of UTI in children?

A

UNEXPLAINED FEVER

Irritability

Loss of bowel control

Change in urination patterns

Eating poorly

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6
Q

What is a URI-cult CLED/EMB?

A

It is a paddle that has 2 types of media on it that is used to make a presumptive ID of the pathogen causing a UTI as well as the number of pathogens

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7
Q

What are the 2 types of culture media on a URIcult CLED/EMB, and what kinds of organisms do they select for?

A

EMB- selective for Gram negative. (Has bile salts)

CLED- grows both G+ and G-, but determines the ability to ferment lactose

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8
Q

What are the 2 things a URIcult EMB/CLEB can tell you?

A
  • the pathogen

- # of pathogens (CFUs/mL)

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9
Q

What are the 2 kinds of urinalysis we can do on a urine sample when evaluating a UTI?

A

Microscopy: (2-5 or more WBCs or 15 bacteria per HPF)

Dipstick

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10
Q

What are the common pathogens that cause UTI?

A

E. coli (75-90%)

Klebsiella

Proteus

Enterococcus

Staph saprophyticus- especially in floozies

Group B Strep- esp in neonates

Pseudomonas

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11
Q

When might you see a UTI caused by candida?

A

Following catheterization

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12
Q

What is the SPECIFIC type of E. coli that causes most UTIs

A

UPEC strains (Uropathogenic E Coli)

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13
Q

E. coli

Gram:

Flagellated?

A

Gram negative

Flagellated

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14
Q

How do UPEC E. coli get to the UTI

A

Fecal contamination

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15
Q

What are the SPECIFIC virulence factors that only UPEC E. coli have?

A

P fimbriae (Pili)

Dr adhesins -lead to formation of complex structures surrounding the bound bacterial cells

Alpha and Beta Hemolysins

K (capsular) antigen

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16
Q

Can UPEC E. coli cause hemolysis?

A

Yes they have Alpha and Beta hemolyins that can lyse RBCs and uroepithelial cells

(Blood in urine? E. coli is our first guess every time)

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17
Q

What is the specific antigen that UPEC E. coli can produce?

A

K antigen- seen in glycocalyx, and is associated with increased formation of Biofilms
**

18
Q

Proteus species:

Gram:

Shape:

A

Gram Negative

Bacilli

19
Q

What are the 2 types of proteus species?

A

P. Mirabilis- community acquired

P. vulgaris- infects immunocompromised *

20
Q

What kind of bacteria will exhibit “swarming” on cuture agar?

A

Proteus species ***

Radiating pattern from initial colony

21
Q

What kind of agar will Proteus NOT “swarm” on

A

CLED- we put an ingredient in CLED to stop swarming so they’re easier to count

22
Q

What happens when you put proteus on culture agar?

A

SWARMING

23
Q

Where do we find proteus in the environment?

A

Normal flora in intestine

Hospitals/nursing homes- can be isolated from mouth and nose of employees

24
Q

What are the virulence factors of Proteus?

A

UREASE

IgA Protease ZapA

Fimbriae

25
Q

What does urease do?

A

It is an enzyme that makes urine more alkaline by hydrolyzing the urine to ammonia

26
Q

What would Struvite kidney stones make you think of

A

A Proteus infection, since proteus makes UREASE which will increase the pH, leading to formation of struvite stones *******

27
Q

Staph saprophyticus

gram:

Shape:

A

Gram +

cocci

(It’s staph duh)

28
Q

Your young female patient has a UTI, and when you do a gram stain of her urine culture, you see a bunch of GRAM POSITIVE COCCI!!
howwwww do you tell if it is from Staph Aureus or a different kind of staph?

A

Coagulase test***

No blood clots= not staph aureus**

29
Q

Where does staph saprophyticus normally live

A

Vagina

30
Q

What is “honeymoon cystitis”

A

It is a UTI caused by Staph saprophyticus

Most cases occur 24 hrs after having sex. Sex feels like razor sharp pains 🔪

31
Q

Who usually gets UTIs caused by staph saprophyticus?

A

Sexually active females age 17-27

32
Q

Is staph saprophyticus very virulent?

A

Not extremely.

Has adhesins and thats about it

33
Q

You’ve done a gram stain of your patients urine culture and its gram positive cocci. You do a coagulase and its negative, so you know its not staph aureus. What’s the next test to do to see if it’s staph saprophyticus?

A

See if it is resistant to Novobiocin (an antibiotic)

If novobiocin does NOTHIGN to the growth of it, it is resistant, and you have staph saprophyticus

34
Q

Gram + cocci

Coagulase negative

Novobiocin resistant

What fo you have

A

Staph saprophyticus

35
Q

When you get a UTI from staph saprophyticus, do you have a LOT of the bacteria or a little

A

Low bacterial numbers, difficult to diagnose

36
Q

what is another name for Strep agalactiae?

A

Group B Strep GBS

37
Q

What will Strep agalactiae look like when you grow it on blood agar

A

Gray-white colonies with a narrow zone of B-hemolysis

38
Q

What are the virulence factors of Strep agalactiae?

A

Capsular polysaccharide

Hyaluronidase

Collagenase

Hemolysin

39
Q

Which lab test is specific for Strep agalactiae ?

A

CAMP factor***

its’ the accentuation of hemolysis due to interaction with staph on blood agar

40
Q

Where does strep agalactiae normally live?

A

Normal flora

Micro Final (Lauren, Shelby, and Annie) (4 decks)

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