Flashcards in Exam #6: UTI Deck (40):
What are the mechanisms that defend against UTI?
pH below 5.5
Mechanical flushing with urination
What is the difference between nephritis, pyelonephritis, ascending UTI, cystitis, urethrtis, prostatis?
Nephritis= inflammation of the kidney
Pyelonephritis= Inflammation of the kidney & upper urinary tract, also known as an ascending UTI
Cystitis= inflammation of the bladder
Urethritis= inflammation of the urethra
Prostatitis= inflammation of the prostate
What are the symptoms of uretheritis & cysititis?
*Note that there is usually no discharge with these, unlike STD
What are the symptoms of prostatits?
Lower back pain
Pain in perirectal area
What are the symptoms of pyelonephritis?
Sx of cystitis
Why is pyelonephritis dangerous in pregnant women?
Can cause premature birth
How are UTI's diagnosed?
What is leukocyte esterase? What is pyuria?
Presence of WBCs
>10 wbc per cubic millimeter
What does a positive nitrite test indicate?
Some bacteria can reduce nitrate to nitrite
Why is UTI more common in women than men?
*****Note that cystitis in [young] men is rare & implies a pathological process, such as renal stones, prostatitis, or chronic urinary retention
What increases the risk for UTI?
What are community acquired UTIs associated with?
Colonization of the urinary tract by fecal flora
- E. coli
- Staphylococcus saprophyticus
What are hospital acquired UTIs associated with?
- Klebsiella, Enterobacter, Serratia, Pseudomonas aerugenosa, Enterococcus
What are enteric bacteria?
Bacteria routinely found in the GI tract of human or other animals
- Gram -
How can the enterobacteriaceae be identified serologically?
O= polysaccharide antigens of LPS
K= capsular antigens
H= flagellar antigens
What are the common virulence factors associated with Enterobacteriae?
What causes most of the community acquired UTIs?
What else can E. coli cause?
What is the second most common cause of community acquired UTI?
Coagulase negative staph i.e. S. saprophyticus
What are the virulence factors of E. Coli?
Hemolysin= lyses erythrocytes --> inflammation
What special characteristics of UPEC allows for attachment?
- Type I pili that binds to mannose residues commonly present on epithelial surfaces
- P pili that binds sugar residues on uroepithelial cells
What is the difference between Staph & strep?
Staph = +
What is the difference between coagulase +/- staph?
What are the characteristics of S. saprophyticus?
Normal GI flora
Novobiocin resistance (vs. epidermidis)
What the most common causative agents of HAC UTI?
List the characteristics of proteus mirabilis.
Gram negative enteric
What virulence factors are associated with Proteus?
- Hydrolyzes urea to ammonia & results in alkanalization of urine
- Alkalization-->precipitation of organic & inorganic compounds & real stones
What are the symptoms of renal stones?
Sudden onset of severe pain that radiates from side of back or abdomen & into the groin
How is Proteus UTI treated?
List the characteristics of Peudomonas aeruginosa.
Gram - rod
*Frequently seen in hospital UTI
How is pseudomonas aeruginosa diagnosed?
Blue green pigment
How is pseudomonas aeruginosa infection treated?
List the characteristics of Enterococcus.
Cram + cocci
Group D carbohydrate
Tolerates high salt & bile
What risk factors are associated with enterococus?
- Treatment with broad spectrum abx
What other infections are associated with enterococcus?
When do you treat asymptomatic bacteriura?
1) Pregnant women
2) Prior to urologic surgery
3) After renal transplant
When do you NOT treat asymptomatic bacteriuria?
How is uncomplicated cystitis treated?
How is pyeloephritis treated?
Gram (-)= Fluoroquinolones
Gram (+)= Amoxicillin