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Renal and Urology > UTI Microbiology > Flashcards

UTI Microbiology Flashcards

1
Q

Which part of the urinary system is sterile normally

A

the kidneys
ereter
bladder and the urine contained in it

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2
Q

What bacteria is colonised normally in the urethra

A

coliforms

enterococci

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3
Q

What is a UTI

A

the presence of micro organisim in the urinary tract that are causing clinical infection

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4
Q

Where is a lower UTI

A

infection in the bladder and urethra

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5
Q

where is an upper uti

A

ureters and or the kidney

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6
Q

what is a complicated UTI

A

complicated by systemic sepsis or urinary structural abnormaloties or stones

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7
Q

What is bacteriurea

A

the presence of bacteria in the urine (does not always mean infection esp in eldery or catheterised patients)

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8
Q

what is cystitis

A

inflammation of the bladder

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9
Q

Why are women more likely to get UTIs than men

A

short wider urethra
proximity of urethra to anus
increased risk with sexual activity, pregnancy

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10
Q

what are the two routes of infection

A

ascending

from bloodstream

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11
Q

which organism is associated with calculi

A

proteus

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12
Q

Why does proteus predispose to calculi

A

produces urease which breaks down urea to form ammonia
increased urinary pH
precipiation of salts
foul smelling

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13
Q

What organism is associated with catheter use

A

pseudomonas aeruginosa

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14
Q

what is the only antibiotics which can treat pseudomonas

A

ciprofloxacin

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15
Q

what is the ideal specimen collection method of urine

A

Mid stream specimen of urine

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16
Q

What container is the best to transport urine in

A

boricon - contains boric acid
stops bacteria multipling
works for around 24hrs

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17
Q

how soon must urine in a sterile universal container reach the lab

A

2 hours

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18
Q

what does leukocyte esterase indicate

A

presence of WBC in urine

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19
Q

what indicated bacteria in urine

A

nitrites

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20
Q

What does not give a positive nitirite test

A

enterococcus

21
Q

what group of people is kass;s criteria used for

A

women of child bearing age

22
Q

What do you need to have a genuine UTI

A

more than 10 to the five orgs/mL of pure growth of ONE organism

23
Q

Is a mixed growth significant

A

no growth of 2 or more organisms is not usally significant even if it is more than 10 to the 5 org/mL

24
Q

what is ESBL

A

extended spectrum beta lactamase

25
Q

what is the effect of ESBL

A

makes bacteria resistant to all cephlasporins

26
Q

What is CPE

A

carbapenemase producing enterobacteriaceae

gram negative coliform bacilli that are resistant to meropenem (usually means resistant to all antibiotics)

27
Q

What is the ideal antobiotic for a UTI

A

excreted in the urine i high concentrations
oral
inexpensive
few side effects

28
Q

How does trimethoprim work

A

inhibits bacterial folic acid synthesis

29
Q

What is there a risk of if using co trimoxazole

A

stevens johnson syndrome

30
Q

what organism cannot be treated with trimethoprim

A

pseudomonas

31
Q

Why is niitrofurantoin only useful in lower UTI

A

only reaches effectove concentration in the bladder

32
Q

What can gentamicin cause

A

renal problems

vestibulocochlear nerve damage

33
Q

how long can gentamicin be prescribed

A

three days

34
Q

What is the empirical antibiotic treatment for a female lower UTI

A

trimethoprim or nitrofurantoin for three days

35
Q

What is the empirical treatment of an uncatheterised male UTI

A

same as female but for 7 days

36
Q

What is the treatment of a complicated UTI or pyelonephritis in the commmunity

A

co amoxiclav or cotrimoxazole (14 days)

37
Q

What is the treatment of a complicated UTI or pyelonephritis in hospital

A

amoxicillin and gentamicin IV for 3 days (co trimoxazole and gentamicin if penicillin allergy)

38
Q

What is the risk of an intreated asymptomatic bacterurea iin preganancy

A

pyelonephritis
growth retardation
premature labour

39
Q

what is abacterial cystitis

A

patient has symptoms of a uti and puss cells in urine but no growth on culture

40
Q

what are the possible causes of abacterial cystitis

A

early phase UTI
urethral trauma
STI

41
Q

how can you relieve tthe symptoms of abacterial cystitis

A

alkanising the urine

42
Q

What anti biotics has good activity against ESBLa

A

pivmecillinam

temocillin

43
Q

when is temocillin particularly useful

A

in treating patients who have a renal function that is too poor to cope with gentamicin (its not as good as gentamicint hough)

44
Q

what antibiotic is cefalexin

A

cephlasporin

45
Q

What organisms cannot be treated with nitrofurantoin

A

proteus

pseudomonas

46
Q

What organisms cannot be treated with gentamicin

A

enterococci

47
Q

What antibiotics are safe in pregancy

A

cephlosporins ie cefalexin
co amoxiclav
trimethoprim in 2/3rd trimesters only
nitrofurantoin (avoid in late pregnancy and breasfeeding)

48
Q

What are the risks of cefalexin

A

broad specturum - c difficile

not effective for pseudomonas

49
Q

What antibiotics are safe in pregancy

A

cephlosporins ie cefalexin
co amoxiclav
trimethoprim in 2/3rd trimesters only
nitrofurantoin (avoid in late pregnancy and breastfeeding)

Renal and Urology (20 decks)

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