UTI Small Group Flashcards

1
Q

What agar is used for culturing urine?
What does dark colony mean?
What does colorless colony mean?

A

EMB agar - only grows GNRs.
Dark colony = lactose fermenter.
Colorless = non-lactose fermenter

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2
Q

Does E coli break down lactose?

A

E coli may produce so much acid from lactose breakdown that a metallic green sheen is evident

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3
Q

What are most common causes of CA UTI?

A

E coli causes 80%. Others include Proteus, enterococci, and staph.

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4
Q

What are most common causes of nosocomial UTI?

A

Hospital acquired: E coli, Pseudomonas, Proteus, and Serratia

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5
Q

Which pxs do you screen for UTI’s?

A

Pregnant women and those undergoing urinary tract surgery.

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6
Q

What does suprapubic pain indicate?

A

Cystitis (bladder infection)

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7
Q

What CFU count indicates infection? Contamination?

A

> 100,000 indicates infection

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8
Q

What could cause artificially high / low CFU numbers?

A
  • Artificially low numbers may be seen if pxs are urinating frequently, if urine is dilute, or they were given IV fluids. Collecting first morning void helps avoid this.
  • Artificially high numbers may be present due to contamination or delay in transport (growth).
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9
Q

When are MBC tests done? (4)

A

Usually only done for pxs w/ meningitis, endocarditis, osteomyelitis, or immunocompromised host.

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10
Q

What is most common Gram Pos coccus causing CA UTI’s in sexually active females?

A

Staph saprophyticus

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11
Q

Sxs / Tx of pyelonephritis

A

Pain, fever, rigors, even septic shock.

Must treat w/ IV AB’s for at least 7 days.

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12
Q

What are the 3 classic sxs of cystitis?

A

Painful urination (dysuria), urgency, and increased frequency.

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13
Q

What does cloudy urine mean?

A

UTI; white cells

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14
Q

What if px comes in w/ clear urine but dysuria?

A

STI; less often white cells

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15
Q

What 2 AB’s are best for UTI’s?

A

TMP-sulfa and Nitrofurantoin

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16
Q

When do you culture urine for females? Males?

A

Cost effective to only do a dipstick test in women for first or second UTI. If it doesn’t improve, now you can do a culture.
Always culture right away in males, multiple recurrences, or sepsis.

17
Q

What bugs are associated w/ hematogenous / descending UTI’s?

A

Staph aureus and Candida

18
Q

What do you do for an asymptomatic px w/ long-term indwelling catheter?
Exceptions?

A

Just clean up urethra and replace catheter. No screening / tx b/c almost all have bacteriuria.
Exceptions: neutropenia or symptoms.