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Microbiology UTI Flashcards

(50 cards)

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1
Q

What bacteria is normally in the kidney?

A

None.

Ureter and bladder should also be sterile

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2
Q

What kind of bacteria inhabit the urethra?

A

Coliforms and enterococci

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3
Q

What is a lower UTI?

A

Confined to the bladder

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4
Q

What is an upper UTI?

A

Involves ureters/ kidneys

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5
Q

What is the name for an upper UTI?

A

Pyelonephritis

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6
Q

True or False

The presence of bacteria in the urinary tract is the definition of a UTI

A

False.

Only if causes symptoms.

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7
Q

What is a complicated UTI?

A

Systemic sepsis
Stones
Structural abnormality

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8
Q

Why does bacteruria not mean infection?

A

Only infection if symptomatic.

Bacteria in urine common due to bacteria at urethra

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9
Q

What is cystitis?

A

Inflammation of the bladder.

Not always an infection

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10
Q

Who tends to get UTI?

A 
Women
Pregnancy
Sexual activity
Catheterised
Abnormal urinary tracts
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11
Q

Why does pregnancy cause UTI?

A

Incomplete bladder emptying causes stasis and encourages infection.
Urethra also more dilated

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12
Q

Where does bacteria in UTI come from?

A

Bacteria from bowel gets onto perineal skin and into lower end of urethra

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13
Q

Which bacteria are most common?

A

E Coli
Klebsiella
Enterobacter
Proteus

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14
Q

What is special about Proteus sp.?

A

Associated with calculi.

Foul smelling

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15
Q

Which organism is common in women of child bearing age?

A

Staph saphrophyticus

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16
Q

What bacteria is associated with catheters and instrumentation?

A

Pseudomonas

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17
Q

What abx is given for pseudomonas?

A

Ciprofloxacin

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18
Q

Which symptoms are associated with upper urinary tract infection?

A

Fever
Rigors
Loin pain

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19
Q

What is the issue with giving ciprofloxacin?

A

Precipitates C diff

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20
Q

What is MSSU?

A

Mid stream specimen of urine

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21
Q

How is a MSSU carried out?

Study These Flashcards
A

Wash perineum with sterile saline
First urine to be passed into toilet
Second urine to be collected
Last urine to toilet

22
Q

Why would you not use antiseptic before an MSSU?

Study These Flashcards
A

May inhibit bacteria

23
Q

What is a clean catch urine?

Study These Flashcards
A

Nurse tries to catch mid stream.

Common in children or in elderly

24
Q

When is bag urine used?

Study These Flashcards
A

In babies.

Useful for negative culturing

25
When is suprapubic aspiration used?
Babies
26
How should a catheter specimen be taken?
Aspirated from catheter ports and not from the bag itself
27
What colour of container should be used for urine specimen?
Red topped
28
Why is it important to get the sample to the lab asap?
Bacteria multiply rapidly!
29
Why can an absence of nitrites not rule out an UTI?
Enterococci do not give a positive test
30
What does a mixed organism growth mean?
Not significant. | Likely to get a single bacteraemia.
31
How many bacteria are required to be significant?
10 to the power of 5
32
What are ESBL producing bacteria?
Extended spectrum beta lactamase
33
What does ESBL do?
Breaks down the beta lactam rings. | Resistance to many abx
34
True or False | ESBL is a hospital acquired issue
False. | From community.
35
What is CPE?
Carbapenemase producing enterobacteriaecae
36
What is the problem with CPE?
Resistant to meropenum, basically all abx. | Spreads easily
37
Where did CPE come from?
India
38
How long should an abx course last for?
3 days for LUTI in women
39
What is the firstline abx for UTI?
Amoxicillin Trimethoprim Nitrofurantoin
40
What is given empirically for UTI?
Trimethoprim
41
Why is amoxicillin not given empirically?
Not always effective
42
Why is trimethoprim not given in 1st trimester?
Inhibits folic acid synthesis
43
Why is nitrofurantoin not given empirically?
Only in uncomplicated LUTI | Not in pregnancy, breastfeeding or young children
44
When is gentamicin given for UTI?
In hospital
45
What is the limitations of gentamicin when given?
3 days only Not in pregnancy Can cause deafness
46
When is temocillin given?
In hospital When renal function is too poor for gentamicin For Coliforms
47
What is given for LUTI in men?
Trimethoprim 7 days
48
What is given for LUTI in men?
Trimethoprim 3 days
49
What is given for pyelonephritis?
Co-trimaxozole or co-amoxiclac 14 days
50
Asymptomatic bacteruria is not treated, except when?
In pregnancy. | Causes IUGR

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