Microbiology of Urinary Tract Infection Flashcards Preview

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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

What is the best container to collect urine for sending to the lab

Boricon container (red top)
It contains the preservativeve boric acid which will stop bacteria multiplying for 24 hours