Body Sites (Urine)

Question 1

A microorganism responsible for causing infection or infectious disease

Answer 1

Etiologic agent

Question 2

A person who harbors the etiologic agent but shows no apparent signs or symptoms of infection or disease

Answer 2

Carrier

Question 3

The origin of the etiologic agent or location from which it disseminates (e.g., water, food, insects, animals, other humans)

Answer 3

Reservoir

Question 4

Infections acquired as a result of a medical procedure

Answer 4

Health care–associated infection (HAI)

Question 5

Infection for which the etiologic agent was acquired in a hospital or long-term health care center or facility

Answer 5

Nosocomial infection

Question 6

Microorganisms that cause infections or disease

Answer 6

Pathogen

Question 7

Organism’s ability to cause disease

Answer 7

Pathogenicity

Question 8

Measure or degree of pathogenicity of an organism

Answer 8

Virulence

Question 9

Characteristics that enable pathogens cause disease

Answer 9

Virulence factors

Question 10

Organisms which cause infection when one or more of the host’s defense mechanisms are disrupted or malfunction

Answer 10

Opportunistic pathogens

Question 11

Microorganisms that inhabit many surfaces of the human body

• Colonizers, Normal flora, and Transient microbiota
• Are collectively known as the….

Answer 11

Human microbiome

Question 12

The persistent survival of microorganisms on a surface of the human body (with no clinical expression, no immune response)

Answer 12

Colonization

Question 13

______ are able to survive, but do not multiply, on the surface and are frequently shed with the host cells.

Answer 13

Transient colonizers

Question 14

______ not only survive but also thrive and multiply; their presence is more persistent.

Answer 14

Resident microbiota

Question 15

The establishment of a long-lasting, mutually beneficial or harmless relationship between a colonizer and the human host

Answer 15

Possible role of colonizing organisms

Question 16

The first step in the process for the development of infection and disease.

Answer 16

Possible role of colonizing organisms

Question 17

Balance between the normal human microbiome and the appearance of a potentially infectious agent.

Answer 17

Host-pathogen relationship

Question 18

Host factors + Environment + Virulence factor

Answer 18

Host-pathogen relationship

Question 19

Among the most common bacterial infections that lead patients to seek medical care.

Answer 19

UTI

Question 20

Who has a higher incidence of UTI?

Answer 20

Women

Question 21

What factors make women more susceptible to UTIs?

Answer 21

• Short urethra in close proximity to perirectal region,
• Sexual intercourse ↑ contamination of the female urethra.
• Anatomic + hormonal changes favor the development of UTIs

Question 22

What makes older men more susceptible to UTIs?

Answer 22

Enlarged prostate prevents bladder from emptying.

Question 23

What are the routes of transmission for UTI?

Answer 23

Ascending, hematogenous, and lymphatic

Question 24

Does urine north of the urethra contain natural flora?

Answer 24

No; urine is sterile

Question 25

What do we call normal flora that we see in voided urine? Where does it actually reside in the body?

Answer 25

Urogenital flora; comes from the epithelium at the distal end if the urethra

Question 26

What percentage of patients with catheters will develop a UTI?

Answer 26

Up to 20% of patients with catheters will develop a UTI

Question 27

What are three physical properties that act as a defense against UTIs?

Answer 27

- Normal voiding of urine - Valve-like mechanism that prevents backward flow - Uroendothelial cells that initiate an immune response

Question 28

What are three chemical properties of urine that act as defense against UTIs?

Answer 28

- High osmolality, Low pH - High urea content - High organic acid content

Question 29

Isolation of bacteria without signs of infection | Increases with age!

Answer 29

Asymptomatic bacteriuria

Question 30

Cystitis

Answer 30

Infection of the bladder

Question 31

- Primarily in young, sexually active women | - Symptomatic; few isolated organisms (<105 CFU/mL)

Answer 31

Acute urethral syndrome

Question 32

Inflammation of kidney parenchyma, calices, & pelvis

Answer 32

Pyelonephritis

Question 33

What percentage of sepsis originates from the urinary tract?

Answer 33

25% - called urosepsis

Question 34

What is urethritis usually caused by?

Answer 34

An STD - specifically GC

Question 35

``` The following conditions are what? Underlying disease Sickle Cell anemia Diabetes Kidney stones Structural abnormalities of Urinary tract Indwelling catheters Neurogenic bladder ```

Answer 35

Risk factors for complicated UTIs

Question 36

Which common UTI pathogen uses adhesins to facilitate bacterial adhesion?

Answer 36

Uropathogenic E. coli (UPEC)

Question 37

Which common UTI pathogen hydrolyzes urea, which then increases pH and creates an environment favoring the formation of kidney stones?

Answer 37

Proteus spp.

Question 38

Which common UTI pathogen adheres to the uroepithelial cells?

Answer 38

S. saprophyticus

Question 39

In what time frame should a urine culture be delivered to the lab?

Answer 39

Within two hours

Question 40

Name the urine sample type described. Least invasive/ Periurethral area is cleansed before collecting a midstream urine

Answer 40

Clean-catch midstream urine (CCMS)

Question 41

Name the urine sample type described. Urine considered uncontaminated

Answer 41

Straight catheterized urine (“In and Out.”)

Question 42

Name the urine sample type described. Specimen collected from a catheter port, not the collection bag!

Answer 42

Indwelling catheter collection

Question 43

Name the urine sample type described. Most Sterile; A syringe is used to obtain urine from the bladder. Only acceptable urine specimen for Anaerobic culture!

Answer 43

Suprapubic bladder aspiration

Question 44

Name the urine sample type described. When the patient doesn’t have a bladder, they have an nephrostomy.

Answer 44

Nephrostomy and Illeal Conduit

Question 45

May include exam of centrifuged sediment of urine for enumeration of PMNs

Answer 45

Microscopic Urinalysis

Question 46

What specific UTI organism is a nitrate reductase test good for detecting?

Answer 46

Enterobacterales

Question 47

What is a leukocyte esterase test good for detecting?

Answer 47

Inflammatory cells - correlates with hemocytometer counts for pyuria

Question 48

Is a gram stain best for detecting microbes in low or high numbers?

Answer 48

Higher numbers (> or = to 10^5 cfu/mL)

Question 49

T or F. You centrifuge urine before making a gram stain.

Answer 49

False

Question 50

How do we gram stain urine?

Answer 50

Using a 0.01 mL loop, transfer well-mixed urine onto a slide and let air dry without spreading.

Question 51

When is doing a gram stain from a urine sample most useful for the clinician?

Answer 51

When a patient may have acute pyelonephritis, an invasive UTI, or other patients for whom immediate information is necessary for appropriate clinical management.

Question 52

When should you add a CNA or PEA plate for a urinary culture?

Answer 52

Include CNA or PEA when the culture has two types of infections and you need to make sure the gram pos isn’t being masked by gram neg - also used when there’s a straight cath sample.

Question 53

For plating urine, how much does the calibrated loop deliver? How much growth does 1 colony represent?

Answer 53

0.001 mL or 1 uL; 1,000 CFU/per mL

Question 54

For plating urine from a suprapubic aspirate, how much does the calibrated loop deliver? How much growth does 1 colony represent?

Answer 54

0.01 mL or 10 uL; 100 CFU/per mL

Question 55

What 5 organisms (or groups of organisms) require susceptibility testing?

Answer 55

- Enterobacterales - Pseudomonas and other NonFermementers - S.aureus - CNS, not S. saprophyticus - Enterococcus sp. from inpatients or surgical urology