Flashcards in Microbiology of Urinary Tract Infection Deck (65)
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1
What part of the renal tract is colonised by bacteria
The distal end of the urethra
2
What type of bacteria is found in the distal end of the urethra
Coliforms and enterococci from the large bowel
3
What is the definition of a UTI
The presence of micro-organisms in the urinary tract that are causing clinical infection
4
What is cystitis
Inflammation of the bladder that ay or may not be caused by an infection
5
What is a lower UTI
an infection that is confined to the bladder (cystitis)
6
What is an upper UTI
An infection involving the ureters +/ the kidneys (pyelonephritis)
7
Why is it important to determine whether the infection is upper or lower
Different antibiotics are used to treat different levels of the urinary tract
8
What is a complicated UTI
A UTI complicated by systemic sepsis or a urinary structural abnormality or stones
9
What patients are more likely to have bacteria in their urinary tract but not necessarily an infection
Patients with catheters or elderly patients
10
What is meant by bacteriuria
The presence of bacteria in the urine
11
Give 3 reasons that make women more susceptible to UTI than men
Short wide urethra
proximity of urehtra to anus is shorter
increased risk with sexual activity,
pregnancy (uterus presses down on the bladder resulting in incomplete emptying)
12
Ascending infection is more common. Describe how it occurs
Bowel organisms colonise the perineal skin. they travel to the lower end of the urethra, into the bladder, ureters and then kidneys
13
Describe how infection occurs from the blood
The patient has bacteraemia/ septicaemia from another focus of infection --> bacteria in blood --> seeded into kidney --> multiple small abscesses --> bacteria in urine
14
What organism is responsible for 70% of UTI
E Coli
15
What are almost all causal organisms
Gram negative bacilli
16
What are some other causal organisms
Coliforms
Klebstelle sp.
Enterobacter sp.
Proteus sp.
17
What is protest sp. associated with
the formation of stones (calculi)
They produce urease which changes urinary pH which causes precipitation of salts and this can result in the formation of stones
18
there are 2 common forms of Enterococcus spp.
Name them
What is more difficult to treat and why
Enterococcus faecalis and enterococcus faecium
Faecium is more difficult to treat as it is more resistant to antibiotics
19
What organism usually affects women of child bearing age
Staphylococcus saphrophyticus
20
What is pseudomonas aeruginosa associated with
UT instrumentation or catheters
21
What is the antibiotic that seems to be sensitive to pseudomonas aeruginosa.
What is the disadvantage of using it
Ciprofloxacin
Associated with C diff infection
22
How does pseudomonas aeroginosa behave differently to other coliforms
It grows aerobically
23
What are the signs and symptoms of a UTI
dysuria
frequency of urination
nocturia
haematuria
24
What are some signs of an upper urinary tract infection
fever
loin pain
rigors
25
How is the best specimen collected
Wash perineum / urethral meatus with sterile saline (not antiseptic)
Allow patient to pass first part in toilet. Collect second part which should have less organisms and not just urethral organisms
Pass last urine in toilet
26
Why should antiseptic not be used to wash the perineum
It can inhibit bacteria growth which may affect lab results
27
What is the difficulty with bag urine collection
It is often contaminated with bowel flora
A negative culture result is more useful than a positive as it can exclude infection from the differential
28
What might a clinician do lift he bag urine is positive
Suprapubic aspirate of urine
29
How is urine collected from a catheter for culture
Take from a collection port - not the bag
30
