Urinary Tract Infections (UTIs)

Question 1

UTIs are more common in _______.

Answer 1

females.

Question 2

UTIs are the most common type of ___________ infection.

Answer 2

nosocomial.

Question 3

What is urethritis?

Answer 3

Infection of the urethra.

Question 4

What is cystitis?

Answer 4

Infection of the urinary bladder.

Question 5

What is ureteritis?

Answer 5

Infection of the ureters.

Question 6

What is pyelonephritis?

Answer 6

Infection of the kidney.

Question 7

Urine normally has a ___ pH and is ______.

Answer 7

low; sterile.

Question 8

What is the most common cause of UTIs?

Answer 8

E. coli.

Question 9

What are 3 symptoms of lower UTIs?

Answer 9

Painful urination (dysuria).
Increased urgency/frequency or urination.
Cloudy urine due to WBCs (pyuria) or bacteria (bacteriuria) in urine.

Question 10

Cather-related lower UTI infections are usually _____________.

Answer 10

asymptomatic.

Question 11

What are 2 unique symptoms that may occur in an upper UTI infection?

Answer 11

Fever.

Back pain.

Question 12

How do we diagnose asymptomatic UTI?

Answer 12

Bacteriuria: presence of significant numbers of bacteria.

Question 13

Why are asymptomatic UTIs dangerous if undiagnosed/untreated?

Answer 13

Can cause complications/scarring.

Question 14

Which demographics are particularly susceptible to complications or scarring?

Answer 14

Young children & pregnant women.

Question 15

What are 5 exceptions to the standard for what we’d consider “significant bacteriuria”?

Answer 15

Catheterized patients.
Infants.
Immunosuppressed.
Urine that has been in the bladder for <4 hours.
Infections with S. saprophyticus.

Question 16

Why are catheterized patients especially susceptible to UTIs?

Answer 16

The catheter can introduce bacteria into the urinary tract if not sterile.
There are many points of contact between the catheter and the urinary tract where biofilms can form and spread bacteria.

Question 17

Why is it hard for us to collect “good specimens” from young children or infants?

Answer 17

There is often fecal flora around the urinary tract because of diapers.

Question 18

How should we take “good specimens” from infants or young children?

Answer 18

Supra-pubic aspiration: drawing urine directly from the bladder.

Question 19

How do E. coli attach to the urinary tract?

Answer 19

P-fimbriae attach to uroepithelial cells.

Question 20

Describe the Gram morphology & characteristics of Staphylococcus saprophyticus.

Answer 20

G+ cocci that lacks coagulase and is novobiocin resistant.

Question 21

Staphylococcus saprophyticus is notorious for causing infections in:

Answer 21

healthy young women.

Question 22

Describe the Gram morphology and grouping of Streptococcus agalactiae.

Answer 22

G+ cocci in chains.
“Group B Strep”.
Beta-hemolytic on BAP.

Question 23

Streptococcus agalactiae is particularly important for infections of:

Answer 23

pregnant women.

Question 24

Streptococcus agalactiae can cause neonatal (3):

Answer 24

meningitis, sepsis & respiratory failure.

Question 25

Describe the Gram morphology of Enterococcus faecalis/faecium?

Answer 25

G+ elongated cocci, often in short chains or pairs.

Question 26

Enterococcus faecalis/faecium is unique because it is ____ & ____ resistant.

Answer 26

bile & salt.

Question 27

What should you do if the urine sample you took cannot be sent to the lab immediately?

Answer 27

Keep it in the fridge.

Question 28

Describe how to take a proper urine sample from a non-catheterized patient.

Answer 28

Mid-stream sample (MSU) in a sterile container, ideally 4 hours after the last urination.

Question 29

How do we collect urine samples from a catheterized patient?

Answer 29

Withdraw from the tube with a syringe.

Question 30

If a urine esterase dip-stick test comes back positive, what does it indicate and why?

Answer 30

Positive = presence of WBCs = infection.

Urine esterase is produced by neutrophils, so if there is some in the urine then neutrophils are attacking something!