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Year 2 - Renal (DP) > Microbiology > Flashcards

Flashcards in Microbiology Deck (114)
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1

Urine in what areas is usually sterile?

Kidneys
Ureters
Bladder

2

What microbes are commensals in the lower urethra?

Coliforms
Enterococci
Anaerobes (rarely cause UTI)

3

What is cystitis?

Infection in bladder (Lower UTI)

4

What is an upper UTI?

Infection involving ureters

5

What is pyelonephritis?

An upper UTI involving the kidneys

6

What is a complicated UTI?

UTI complicated by:
- Sepsis
- Abnormality/Stones

7

What effect does a complicated UTI have on treatment?

Requires a longer antibiotics course

8

When might bacteruria not be an infection?

In the elderly
Patients with catheters

9

Why are females much more prone to UTIs?

Short and wide urethra
Urethral opening close to anus

10

What can increase the risk of UTIs?

Sex
Pregnancy

11

Why do posterior urethral valves increase the UTI risk?

Incomplete bladder emptying:
-> Urine stasis -> Infection

12

What is the most common route of UTI? What route does it take?

Ascending infection
Bowel bacteria -> Perineal skin -> Lower urethra -> Bladder -> Ureters -> Kidneys

13

How can a descending UTI occur?

1. Patient with bacteraemia/sepsis
2. Bacteria seeded in kidney
3. Multiple small abscesses -> Bacteruria

14

What are coliforms?

Rod-shaped, gram negative, non-spore forming, facilitative anaerobes

15

What is the most common causal organism in UTIs?

E. coli (70%)

16

What other coliforms can cause UTIs?

Klebsiella sp
Enterobacter sp.
Other

17

What are Proteus sp. UTIs associated with? How do they cause this?

Stone formation:
- Produce ureases
- Urea broken down into ammonia
- Urinary pH rises
- Precipitates salt formation

18

Proteus sp. UTIs have what other distinguishing feature?

Foul smelling

19

What are Enterococcus sp?

Types of Strep. living in the GI tract

20

Which of the following is antibiotic sensitive and which can be resistant and difficult to treat:
- Enterococcus faecalis
- Enterococcus faecium

Faecalis:
- Antibiotic sensitive
Faecium:
- Can be resistant and difficult to treat

21

Who gets UTIs caused by Staphylococcus saphrophyticus?

Women of child-bearing age

22

Why is Pseudomonas not a coliform?

Strictly aerobic

23

What are Pseudomonas UTIs associated with?

Catheters
Urinary tract instrumentation

24

What is the only antibiotic that can treat Pseudomonas UTIs and what does this increase the risk of?

Ciprofloxacin:
- Increased risk of C. diff

25

What symptoms suggest an upper UTI?

Fever
Loin pain
Rigors

26

What urine is likely to be infected in obtaining a urine sample?

1st urine (collects commensals from perineum and lower urethra)

27

What (ideally) needs to be carried out before obtaining a MSSU?

Wash perineum and urethral meatus with saline:
- Not antiseptic (May kill bacteria)

28

When would a clean catch urine sample be used?

In children and elderly when MSSU can't be obtained

29

In what individuals is a bag urine sample used?

Babies

30

What do you do if there is a positive culture from a bag urine sample?

Suprapubic specimen must be taken