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Bacteriology & Mycology > Infections of the Urogenital System V (17) > Flashcards

Infections of the Urogenital System V (17) Flashcards

1
Q

What are urinary tract infections (UTI)?

A

refers to the bacterial colonization (infection) of URINE or ANY URINARY TRACT ORGAN, except distal urethra, which has a normal bacterial flora

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2
Q

What does a UTI not include?

A

the distal urethra (has normal bacterial flora)

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3
Q

What are the most common pathogens of UTIs? They are usually of [single/multi-] species

A

E. coli
proteus
klebsiella

single-species specific

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4
Q

Differentiate gram-[positive/negative] between E. coli, proteus, and klebsiella

A

all Gram-negative

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5
Q

Differentiate urease positive/negative between E. coli, proteus, and klebsiella

A

E. coli: urease negative

proteus: rapid urease positive

klebsiella: urease negative

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6
Q

Staphylococcus is gram-[positive/negative] and streptococcus is gram-[positive/negative.

A

both gram-positive

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7
Q

Staphylococcus is urease-[positive/negative] and streptococcus is urease-[positive/negative.

A

staph: urease-positive (most)

strep: urease negative

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8
Q

What are the most frequently isolated pathogens in UTIs in cats?

A

e. coli
proteus
staphylococcus aureus
pasteurella multocida

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9
Q

What bacteria are UTIs in horses caused by?

A

e. coli
staphylococcus aureus
streptococcus

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10
Q

What bacteria are UTIs in cattle/sheep/goats caused by?

A

e. coli and trueperella pyogenes
corynebacterium renale, c. pilosum, c. cystitidis in cattle

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11
Q

What is the encounter for UTI?

A

normal flora of the lower UT (distal urethra)
subset of common genital and fecal flora

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12
Q

How does bacteria invade the body for UTIs?

A

opportunistically - subset of common genital and fecal flora

normal flora in an abnormal bladder - usually there is an underlying urinary tract problem (bladder is normally sterile)

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13
Q

Explain how UTIs enter the body and where does it spread?

A

bacteria ASCEND through the urethra into normally sterile bladder

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14
Q

Where does bacteria in a UTI colonize and results in infection?

A

the urinary tract due to bacterial virulence factors

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15
Q

What prevents ascension of bacteria regarding UTIs?

A

host urinary tract defenses

both host defenses and virulence factors are important in determining outcome

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16
Q

What is the #1 host defense for UTIs?

A

flushing by urine - prevents access to the bladder

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17
Q

Urinary tract defenses are primarily [specific/non-specific]

A

non-specific

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18
Q

What are other urinary tract defenses against UTIs?

A

urinary oligosaccharides
bladder glycosaminoglycan
epithelial cell exfoliation
urine osmolality

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19
Q

A UTI results how?

A

when bacterial ascension occurs when defenses are disrupted

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20
Q

What are the factors that can impair host defenses?

A

abnormal urine flow is #1 cause of cystitis

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21
Q

What are the factors that impair host defenses for UTI?

A

urinary stasis - locked in house all day
mechanical impediments to flow
damage to epithelial surface that impedes
late gestation - pressure from uterus
disease that decrease urine osmolality

22
Q

What are virulence factors of UTIs and what do they do?

A

prevent bacteria from being washed away

fimbriae (pili)

23
Q

What do fimbriae do regarding UTIs?

A

mediate attachment to epithelium - E. coli, c. renale

is a virulence factor

24
Q

A 3 year old tom cat was experiencing stranguria and was reacting from pain when his bladder was palpated. It was small and firm. A urinalysis was conducted, and these were the results. What likely caused this? What is the mechanism of how this invaded the body?

A

lower urinary tract infection (UTI)

bacteria ascended through the urethra into the sterile bladder, fimbriae prevented bacteria from being washed away

25
Q

What are clinical signs of a lower UTI?

A

dysuria

pollakiuria, oliguria, anuria, stranguria, hematuria, bladder inflamed/thickened

26
Q

What is the difference between polyuria and oliguria?

A

polyuria: LARGE volumes of urine in a given amount of time

oliguria: reduction in daily output

27
Q

What are primary rule out with dysuria?

A

urethrocystitis - most common
pyelonephritis
prostatitis

28
Q

Recurrent cystitis can lead to ____ and ______

A

pyelonephritis
prostatitis

these two can also present as cystitis

29
Q

How do you diagnose a lower UTI?

A

urinalysis - physical/gross examination of urine
etc

30
Q

What physically of urine is suggestive of a lower UTI?

A

red/brown - suggests blood

31
Q

Discuss urinalysis results when one has a lower UTI

A
32
Q

What results does someone with a UTI have when using chemical dipsticks?

A

protein: strong + - may or may not be associated with UTI
glucose: +, diabetes
ketones
bilirubin
occult blood: hematuria, inflammation
urobilinogen
pH: dog usually acidic (5-6)

33
Q

What is very important when diagnosing a lower UTI?

A

microscopic exam

34
Q

What microscopically normally indicates a lower UTI?

A

bacteria + pyuria (leukocytes/pus)

pyuria is seen in bacteriologic culture

35
Q

Differentiate between streptococcus/enterococcus and e.coli in a microscopic evaluation of urinary tract sample

A
36
Q

Differentiate between proteus and staph in a microscopic evaluation of urinary tract sample

A
37
Q

An [acid/alkaline] with urease positive bacteria make ______-

A

alkaline
ammonia

things like proteus, staph

38
Q

In a bacteriologic culture, if one is positive for a lower UTI, what will you see?

A

pyuria: >90% prob. bacterial infection

39
Q

What is the best way of diagnosing a lower UTI? Next best way?

A

cystocentesis - bladder is normally sterile, thus any positive culture is significant

catheterization - though process will introduce genital flora into the urine which could indicate false positive

40
Q

You must interpret lower UTI samples with a ______

A

quantitative culture

41
Q

What quantitative culture number indicates a UTI?

A

> 100,000/mL with signs

1,000 - 100,000 is questionable; if see polyuria too, more significant

42
Q

What is unacceptable in diagnosing a UTI culture?

A

typically has up to 100,000 contaminants per mL

43
Q

You must culture urine as soon as possible, though list the conditions it can be in to still be viable

A

less than 6 hours in fridge
held less than 1 hour at room temp

44
Q

T/F: Multiple species in a culture is normal and not indicative of contamination

A

FALSE - multiple species suggests contamination

45
Q

How do you know when a UTI is present - clinical signs?

A

pollakuria
stranguria
dysuria

46
Q

How do you know when a UTI is present - clinical pathology?

A

hematuria
pyruia
bacteruria

47
Q

How do you know when a UTI is present - microbiology?

A

quantitative culture and sensitivity

48
Q

What is treatment for UTI?

A

antibiotic selection with treatment for 10-14 days
consider toxicity

49
Q

What should antibiotics do regarding a UTI?

A

eliminate within 48 hours
recapture at 48 hr to monitor

50
Q

If after 48 hours on antibiotics treating a UTI and there is growth, what should you do? No growth?

A

if growth: change antibiotic

no growth: continue another 7-10 to prevent relapse

51
Q

What are treatment failures of UTIs?

A

recurrent cystitis

relapse - same organism
reinfection - new organism

52
Q

For chronic bacterial cystitis, you may need antibiotics for ____

A

4-6 weeks

Bacteriology & Mycology (39 decks)

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